A diagnosis of hypoplastic teeth in a child can sound pretty intimidating. Well, the team at Bitesize Pediatric Dentistry in Brooklyn is here to put your mind at ease by taking an in-depth look at what hypoplastic teeth are and how we can help manage this type of enamel defect.
Dental Enamel Hypoplasia: The Basics
The enamel is the outer protective layer that covers the teeth. It’s the hardest substance in the human body, which is pretty handy, given that it has to stand up to chewing and biting forces to keep the underlying dental pulp, which contains nerves and vital tissue, safe. It also acts like insulation, preventing hot and cold foods and drinks from causing painful sensitivity.
Enamel formation of the primary teeth, or baby teeth, starts in the womb. For permanent teeth, enamel formation begins in infancy and lasts through early childhood. Any disruption to the process can cause enamel defects in children, including enamel hypoplasia.
Enamel hypoplasia is a developmental defect in the amount of enamel, meaning hypoplastic teeth have enamel that is too thin. The condition can affect part of a tooth, a whole tooth, certain teeth or, less commonly, all of the teeth. So, just because your child has one hypoplastic tooth doesn’t mean the defect will be present in the other teeth.
Enamel hypoplasia can occur in both baby teeth and permanent teeth, depending on the type and timing of the disruption. When a disruption to enamel formation happens in utero or shortly after birth, it can cause enamel hypoplasia in baby teeth. If the disruption happens in infancy until around age 8, it can cause hypoplasia in whichever permanent teeth are developing at that point.
Hypoplastic Teeth vs. Hypocalcified Teeth
The terminology around enamel defects, particularly enamel hypoplasia vs. hypocalcification, can be confusing and the conditions often cause similar symptoms. But, with enamel hypoplasia, the enamel is hard but too thin. It’s a problem with the quantity of enamel. Hypocalcified teeth, on the other hand, have the normal amount of enamel but the enamel is soft and opaque.
What are the Signs of Hypoplastic Teeth?
The signs and symptoms of hypoplastic teeth may include:
- Teeth that look yellow or brown because the underlying dentin, which is yellowish in color, is exposed through the thin enamel
- White spots on the teeth
- Depressions, grooves or striations on the surface of the teeth
- Sensitivity (with the dentin exposed, painful sensitivity to cold and other thermal changes commonly develops)
- Teeth that stain easily (the more porous enamel will soak up highly pigmented foods and drinks)
- Excessive wear of the enamel
- Tooth decay and cavities
- Misshapen teeth
- In extreme cases, the enamel can flake off
What Causes Hypoplastic Teeth?
The teeth affected can give us some clues. For example, enamel forms on the first permanent molars between birth and 2.5 years of age. If your child has a hypoplastic molar, we know something interfered with the cells that produce dental enamel in that timeframe.
That said, pinpointing exactly what caused the disruption is difficult and, in many cases, if a genetic factor isn’t identified, it’s considered idiopathic, meaning the cause is unknown.
Current research suggests the following may be some of the risk factors and causes of hypoplastic teeth:
- Genetics, including a number of rare inherited disorders
- Premature birth
- Low birth weight
- Gestational diabetes and other pregnancy-related issues in the mother
- Health conditions
- Dental trauma
- Certain viral and bacterial infections
- Too much fluoride while the teeth are developing
- Exposure to some medications and chemicals like tetracycline, lead, etc.
Do Hypoplastic Teeth Need to be Treated?
Yes. Even though in a very mild case, a hypoplastic tooth might be more of an aesthetic concern, it will still be important to monitor the tooth since the thin enamel offers less protection.
A study found primary teeth with enamel defects are three times more likely to have dental caries (cavities) than those without defects. In addition to leading to frequent cavities, moderate to severe dental hypoplasia can also cause painful sensitivity to hot, cold and sweet foods and drinks, result in the breakage of teeth and impact the bite (the way the upper and lower teeth come together).
Early detection is super helpful. Since hypoplastic teeth, especially hypoplastic molars, are more susceptible to decay, if we catch it early, we can help you create a strong homecare routine, offer nutritional guidance and take cavity prevention measures to keep the teeth as healthy and strong as possible. This highlights the importance of bringing your child to the pediatric dentist twice a year for a dental exam and professional cleaning.
How is Dental Hypoplasia Treated?
If your child has hypoplastic teeth, the treatment options will depend on how severe the condition is and which teeth are impacted. Treatment is usually aimed at reducing sensitivity, maintaining a healthy bite and strengthening or restoring weakened enamel and may include:
- Remineralization – The first line of defense is generally treatment to help remineralize the teeth, such as a professional fluoride varnish or other options. This reduces the risk of tooth decay and manages sensitivity.
- Desensitizing Toothpaste – A desensitizing toothpaste has compounds in it that stop the transmission of sensations from the surface of the tooth to the nerve. Regularly using a desensitizing toothpaste can help to alleviate sensitivity.
- Dental Sealants – While we recommend sealing the first and second permanent molars as soon as they erupt in all children, it’s especially important for kids with hypoplastic molars. During the procedure, we paint the sealant material onto the chewing surfaces of the back teeth and it adheres to the pits and grooves to seal out bacteria, plaque and food debris. This will help prevent cavities and can also reduce sensitivity.
- Bonding/Filling – If your child has a cavity in a hypoplastic tooth, we’ll remove the decay and restore the tooth with a filling. We can also use a composite-resin to help build up deficient areas of enamel, improve the tooth’s appearance, create a stable bite and help protect the dentin. Unfortunately, conventional tooth-colored fillings don’t always bond well to the defective enamel, so we may have to explore different options.
- Dental Crowns – For teeth with severe enamel hypoplasia, a dental crown could be the best way to protect the tooth and restore its shape and function. The type of dental crown and when we’d recommend placing it varies by case. For example, we’d usually hold off on placing a porcelain crown on a hypoplastic molar until your child’s permanent teeth are in.
- Other Restorations – When your child is done growing, if necessary, a dentist can address both cosmetic and functional issues that result from hypoplastic teeth with more permanent options, such as porcelain veneers, which are thin, porcelain shells that cover the front of the teeth. In really severe cases, the hypoplastic tooth could be extracted and replaced with a dental implant or dental bridge.
Caring for Hypoplastic Teeth at Home
Hypoplastic teeth require extra TLC to prevent cavities and infection. While your Brooklyn pediatric dentist will give you personalized recommendations based on your child’s unique needs, following these general oral care guidelines will help keep your child’s teeth healthy:
- Have your child brush their teeth at least twice a day for two full minutes each time. For young kids, be sure to check that they thoroughly cleaned their teeth.
- Encourage your kiddo to floss once a day.
- Adding an alcohol-free fluoride mouthwash to the mix can be helpful for kids over the age of six who won’t swallow it. Swishing with mouthwash after brushing and flossing will get rid of any lingering food debris and plaque that they may have missed while brushing.
- Have kids rinse their mouth out with water after eating and drinking anything aside from plain water. This stops food bits from settling in the teeth and reduces the risk of staining.
- Serve starchy and sugary foods and drinks in moderation, as well as sticky foods that tend to get stuck in the teeth. A healthy diet will go a long way in warding off tooth decay in kids with enamel hypoplasia. Try to stick with fresh fruits and veggies, lean proteins, dairy, healthy fats and complex carbohydrates as much as possible. It’s a good idea to include foods that help remineralize the teeth, such as milk, cheese and nuts, too.
- Minimize acidic foods and drinks. The enamel on a hypoplastic tooth is already too thin. Acids in food and drinks will lead to even faster erosion of the enamel, worsening sensitivity and the risk of tooth decay. If children do have something acidic like a citrus fruit or glass of orange juice, have them rinse their mouth out afterwards.
- Visit your pediatric dentist for a dental exam and cleaning every six months, or as often as they recommend. During professional cleanings, we can remove hardened plaque (tartar) that can’t be eliminated at home with regular brushing and flossing, which helps keep teeth cavity-free.
Your Brooklyn kids’ dentist will also monitor your child’s teeth for any changes and work with you to come up with a personalized cavity prevention plan that may include sealing hypoplastic molars or treatment to help remineralize the teeth. Routine care lets us address little problems before they become big ones.
Expert Dental Care for Kids in Brooklyn, NY
If you think your child might have an enamel defect like hypoplastic teeth, schedule a visit at Bitesize Pediatric Dentistry in DUMBO, Park Slope or Williamsburg, Brooklyn.
We put a big emphasis on patient and parent education, and if we do diagnose your child with enamel hypoplasia, we’ll walk you through our findings, teach you about optimal homecare and design an individualized plan to keep your child’s teeth healthy.