What's Enamel Hypoplasia and How Is It Treated?

Enamel hypoplasia is an alteration in the development of the tissue that covers and protects the teeth. Here, we'll tell you how it manifests itself, its complications, the causes, and treatment options.

Reviewed and approved by the dentist Vanesa Evangelina Buffa.

Written by Vanesa Evangelina Buffa

Last update: 10 October, 2022

Enamel hypoplasia is the weakening of this important tissue on the teeth. This alteration in the teeth’s protective covering can cause many issues for those who suffer from it.

Dental enamel is the most superficial and external tissue of the teeth and consists mostly of minerals. It’s made up of a group of calcium crystals called hydroxyapatite, the hardest and most resistant material in the body. Its main function is to cover and protect the teeth.

If this structure’s insufficient or weakened, you may be looking at enamel hypoplasia. In this article, we’ll tell you what this alteration in the teeth is, why it occurs, and what complications it can cause. Also, we’ll tell you what you can do if you suffer from this condition.

What is enamel hypoplasia?

Enamel hypoplasia’s a condition of this dental tissue that has to do with improper development. In general, it occurs when during the formation of the tooth.

The result is a tooth element with an enamel deficit or with low tissue quality. Sometimes, the manifestations of this condition are barely noticeable and almost imperceptible.

However, at other times, they’re very evident. They can be seen as white spots or dots, streaks, pits, dents, grooves, or deterioration in the shape and texture of the teeth. The surface appears rough, and the defects we mentioned above appear brown or yellow. In the most severe cases, there’s a total absence of enamel, and the teeth are smaller and deformed.

As we’ve already mentioned, enamel’s responsible for covering and protecting the teeth. When this tissue is insufficient or damaged, the innermost and less hard layers of the tooth may be exposed.

This leads to some of the following complications:

• Pain
• Sensitivity to cold, heat, and sweets
• Increased risk of cavities
• An unsightly appearance of the smile

Causes and related conditions

It’s often difficult to determine the cause of enamel hypoplasia. As we’ve already told you, the problem arises during the growth and formation of the tooth, but it becomes evident later when the tooth appears in the mouth.

It’s usually due to conditions or situations that favor its appearance and that occur during gestation or in childhood. Below, we’ll detail some of the circumstances that give rise to enamel hypoplasia.

Problems during pregnancy

Our teeth begin to form already when we’re in our mother’s womb. Calcium minerals are deposited, thus forming what will be the crown of the future teeth.

Any factor that affects the pregnancy can have repercussions on the development of the enamel, stopping or slowing down its formation. Thus, a maternal illness, high fever, infection during pregnancy, the intake of certain medications, drug addiction, or nutritional deficiencies can cause enamel hypoplasia in the developing baby.

Problems in early childhood

Just like in the womb, in the first years of a person’s life, the teeth are still forming. Any harmful event that happens during this period can affect the cells that are developing the enamel and cause hypoplasia.

Harmful situations that can occur in childhood include premature birth, low birth weight, malnutrition, vitamin deficiency, infections, systemic diseases, use of certain medications, and very high fevers.

Trauma during childhood is a very frequent cause of enamel hypoplasia. In general, what happens is that the blow affects the baby tooth and causes injury to the permanent tooth underneath, through its root.

Inheritance

There are inherited genetic patterns that affect the formation of the teeth in the mouth. Some defects occur in a small region of a single tooth. However, there may be more severe cases that can involve several tooth elements.

Enamel hypoplasia of genetic origin is often one more manifestation of a complex syndrome with other additional signs in the rest of the body.

Other acquired causes of enamel hypoplasia

Enamel loss and wear can also be the result of the action of external factors on tooth surfaces. This decreases the quality and thickness of the tissue, exposing the softer, deeper layers.

And although it’s not a developmental defect, like hypoplasia itself, it produces the same alterations that characterize this condition.

These are some of the associated situations:

• Dental erosion: The exposure of the tooth surface to acidic foods, vinegar, soft drinks, and citrus fruits frequently irreversibly destroys the enamel. Acid reflux can also cause this problem.
• Bruxism: Grinding the teeth wears down the teeth, exposing the innermost layers.
• Trauma: Blows to the mouth can produce small lesions, such as cracks in the enamel.
• Very traumatic hygiene practices: Toothbrushing with very fast movements, too much force, or too hard bristles frequently can wear down the protective enamel.

Currently, there are several treatment alternatives to solve enamel hypoplasia. The choice of approach will depend on each clinical case, depending on the degree of involvement of the tooth element and the patient’s needs.

A previous evaluation and a rigorous examination by a dentist are necessary. Of the options available, we’ll explain the most common below.

Tooth whitening

This is a convenient therapy when enamel hypoplasia presents itself in the form of white stains. Tooth whitening evens out the shades, thus achieving a more uniform color on all the teeth.

Through the use of specific chemical substances applied to the tooth surface, it’s possible to lighten the color of the teeth. The treatment can take place in the dental office, at home under the indications of the dentist, or by combining both methods.

Dental microabrasion and resin fillings

This is a useful treatment when enamel hypoplasia presents itself in the form of severe staining. It consists of polishing the damaged area of the tooth to remove the stain completely.

Then, the professional must fill the site with a composite of the same color as the tooth element. In some cases, a dentist may perform this maneuver with rotary instruments, but sometimes it’s not necessary, and only hydrochloric acid’s necessary.

Dental sealing

Dental sealing consists of placing a fluid resinous material over the grooves, pits, or spots where enamel hypoplasia’s present. This filling then hardens with the help of a special light. Finally, the professional polishes the area for a better finish.

In general, it’s useful when the imperfections are slight and superficial. This protects the dental element and reduces the retention of bacterial plaque and the risk of cavities in the area.

Dental veneers or crowns

Your dentist may consider this option for very severe cases; when the affected area’s very large. Veneers or crowns can cover very noticeable stains, rough surfaces, and misshapen teeth.

The professional places them on the front portion of the tooth, after previous wear. These consist of porcelain or composite.

Crowns, on the other hand, cover the entire tooth, like a cap. In this case, the dentist must grind the tooth to place the crowns on them, the wear greater than with veneers. They can consist of porcelain, metal, and porcelain, or zirconium.

Their design takes into account the color, shape, and size of the tooth, customizing them for each particular clinical case.

Dental implants or dental bridges

There are rare and extreme cases in which it is necessary to resort to a prosthesis as a solution to enamel hypoplasia. These are those cases in which the deterioration is such that there is little tooth remaining and the best option is to eliminate it and replace it with an artificial piece.

Depending on the possibilities and conditions of the patient, an implant or a bridge can be used to rehabilitate the lost tooth.

Recommendations for enamel care to prevent enamel hypoplasia

Enamel hypoplasia isn’t usually preventable. However, caring for your teeth is essential when it comes to preventing other pathologies, such as cavities, from developing on top of this defect.

As we said before, the tissue covers and protects the innermost tissues of the teeth and, if it’s damaged, it’s unable to regenerate. So, here are some good habits that will allow you to take care of this important material:

• Food: The consumption of very acidic, hard foods, or foods with high sugar content should be reduced. It’s important to reduce your intake of sodas, soft drinks, vinegar, ciders, and citrus fruits.
• Dental hygiene: Brushing your teeth three times a day with fluoride toothpaste is vital to keeping your teeth free of bacterial plaque. Movements should be gentle, making sure to reach all sides of all teeth. Flossing and mouth rinses are also necessary.
• Visit the dentist regularly: Visiting the dentist every six months allows any problems to be detected and treated in time. In addition, in-office cleanings and fluoride treatments protect the enamel.
• Use fluoride: Fluoride gives extra protection to the enamel. Your dentist may prescribe the use of a prescription toothpaste or a special fluoride rinse to take better care of your teeth.

These basic steps do much more than just prepare the enamel on your teeth. In addition, you can avoid many mouth problems and take care of your smile in general.

Now you know what enamel hypoplasia looks like. So, if you suspect that you or someone you know has it, the best idea is to consult your dentist immediately. The professional will be the one who will help solve this problem.