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Enamel hypoplasia (EH) is a tooth enamel defect that results in a tooth or teeth having less than the normal amount of enamel. The missing enamel is usually localized, which results in small dents, grooves or pits on the outer surface of the affected tooth. This makes the tooth’s surface very rough, and the defects often stand out because they are brown or yellow in color. In extreme cases, the tooth enamel is missing entirely, causing the affected tooth to be misshapen or abnormally small.
Sometimes the hypoplasia shows up as a distinct white spot on a tooth. This is often referred to as “Turner’s tooth” or “Turner’s hypoplasia,” and is typically caused by a trauma to the tooth during its mineralization phase. These white spots can also be the result of a high exposure to fluoride during enamel development, a condition that is known as flourosis. Other times the EH shows up as cloudy streaks on all of the teeth. This indicates some sort of unknown trauma to the enamel for a long period of time.
Enamel hypoplasia is typically caused by malnutrition, illness, infection or fever during tooth formation. Some medications can also affect the teeth that were developing at the time of dosage. Environmental factors can interfere with tooth formation as well, such as being exposed to toxic chemicals at a very young age. In many cases, the exact cause of hypoplasia of the enamel cannot be determined.
Most cases of enamel hypoplasia occur before the age of three. Any trauma occurring after this time is less likely to cause enamel defects. This is because the tooth enamel is already calcified and more resistant to traumatic factors.
Fortunately, hypoplasia of the enamel can usually be managed by restoring the affected enamel, following proper oral hygiene methods, receiving fluoride treatments and avoiding foods containing an excessive amount of sugar. If the EH is very mild, the dentist will generally fill in the pits or dents with a clear sealant. Another common treatment for this dental condition involves bonding a tooth-colored material to the tooth in order to protect it from further wear.
If the enamel has such a rough surface that it is impossible to bond anything to it, the dentist might choose to place a permanent cast or stainless steel crown on the affected tooth. In extreme cases, the dentist might choose to remove the tooth affected and replace it with a dental implant or a bridge.