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What is Enamel Hypoplasia?

A. B. Kelsey
A. B. Kelsey

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 can make the surface of a tooth rough.
Enamel hypoplasia can make the surface of a tooth rough.

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.

A dentist examines a patient's teeth for enamel problems.
A dentist examines a patient's teeth for enamel problems.

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.

Infections during teeth development can cause enamel hypoplasia.
Infections during teeth development can cause enamel hypoplasia.

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.

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Discussion Comments


I just discovered that my 6 year old has this on both lower back molars. She was six weeks premature. This site has been very useful with some great answers. Thank you.


Neither of my parents had this, but I and my two siblings all had absolutely no enamel on the molar no. 6, both sides, top and bottom. Luckily I needed teeth taking out when it came to braces!


My 7 year old always had sort of browning at the roots of his baby teeth and has hypoplasia on the two front teeth. It really upset me, but the dentist says he could do more damage by trying to fill the one bit of teeth where there is no enamel.

I am thinking of getting a second opinion. I thought it was decay and another child said to him, “Oh, you have decay like me,” but the dentist said it definitely isn’t decay. He didn’t have any severe illnesses as a baby that I can think of or any trauma to his tooth, so I don’t know why it’s happened. I’m not sure what to do now, though.


@post 24: In my family, all of us girls have terrible teeth because of this. It affects all of our teeth. During my childhood I was on a no-sugar diet because of a condition which meant I did not produce enough insulin and I see several other people on here saying they didn't have a sugary diet either.

I'm 25 and I have managed to only have four fillings but my teeth are terribly discolored. I am embarrassed because I think that people's first impression of me is that I have poor oral hygiene.


Just read "Cure Tooth Decay" by Ramiel Nagel. It might give some interesting insight as to what a tooth healthy diet needs to be. He goes way beyond low-sugar recommendations and talks about how to support your body's natural re-mineralization process. I found it very informative.

Also for those whose children get ear infections, my son's ear infection was effectively healed using craniosacral therapy to adjust his bones (so liquid could drain out of his ears), along with garlic/mullein oil applications in his ears. It never returned again. Hope this helps!


It is not always a deficiency. I have it and so do two of my children. It can be inherited.


It seems that reflux has something to do with this. My son has this but hasn't had antibiotics much at all (probably three times in eight years) but he did have thickening powder for reflux as a baby. However, I'm convinced my son has Celiac after reading it's linked to this (and he has 99% of the other symptoms for Celiac too). Thank you for posting about the link to Celiac. I may have found the answer I've been looking for - it's only taken six years!


I'm so happy I found this post because my daughter's front teeth are growing in with yellowish brown streaks on them, and I believe it is caused by trauma. When she was a year old, almost two, she fell from a bunk and her teeth were ripped from the root and she's been toothless ever since. Now she's six and the new set is discolored. I hope I can get some cosmetic help for her. I just want to cry.


Just yesterday found out my six year old daughter has this. I am absolutely gutted. I can't even begin to tell you how upset I am.

I know it's not life threatening, that it's purely cosmetic, but I was bullied in school for no reason, so I can only begin to imagine what she is going to go through, and for that, my heart is absolutely breaking for her.


Our dentist indicated that there is no definitive research proving the cause for it. She did mention that antibiotics, high fevers, and other factors while infants are in the womb can be responsible. It does sound like there are some here that see it as hereditary. My brother had it and now my son has it so I kind of see that - although they both had a lot of ear infections too which equals a lot of antibiotics.

They gave us a "super floridated" toothpaste and told us to use it daily, applied directly to the teeth and spit out after two minutes. This has kept problems at bay for my son from age 4 to age 9, however, one of his molars chipped off and now his very back one is really aching. Poor kiddo. Sorry to all those with the embarrassment of this. May God protect your spirit and heal your body (teeth!). Amen!


My son is nearly eight years old and has hypoplasia. His back molars are affected and our dentist has advised removing his four molars, to make room for the next set.


My daughter has this. Her teeth have always been very chalky looking. She has had seven cavities now and she is 5 years old. We have had three cavities filled and two fillings have fallen out within one year. Now she is about to have four crowns. We're hoping her permanent teeth will be better. She was in NICU at birth because they thought she might have a blood infection and they had her on an antibiotic that was said to be Ototoxic. Our pediatric dentist thinks this might have been what caused her EH.


@post 22: I totally understand how you feel. I was born with this, it is hereditary in my family and the women seem to be the carriers only. I am a 31 year old female and I have two older sisters and they both have "normal" teeth, and I ended up with sugar teeth (that's what we call it because the enamel chips off like sugar cubes).

I was always made fun of in school. Kids called me gumby and wrote it on my locker, even. I had eight teeth pulled when I was 16 and the rest of my teeth were filed down and I had to wear dentures over them. Then when I was 25, I had the rest of my teeth pulled and was fitted for new dentures. People are very mean.

This condition gets worse with every generation in my family. My younger cousins teeth were poisoning her. At age 9 she already has had a lot of work done and many teeth pulled.


Thank you for posting this info. Now I at least know what it's called and better understand what I have been experiencing with my teeth all my life. In May 2011 I was also diagnosed with a severe vitamin D deficiency. Work on that continues and hopefully it will improve my teeth somehow, as well as my sleep. Yes, low D can cause insomnia too. Look up Dr. Stasha Gominak and sleep.


I have something similar to this which I think must be because I was born very prematurely. It's painful and embarrassing, especially if you eat a healthy diet, because other people can be so judgmental. People are led to believe that prematurity only affects infant teeth but my experiences seem to prove otherwise. I am only 32 but the inside of my mouth gives the impression of a much older person.


I have been researching my son's syndrome, Aarskog Syndrome, and it looks like I have found the source of my tooth problem. I am supposedly a carrier, although it looks like more than that now. My teeth are just deteriorating and falling apart. The only thing holding them together is the fillings.


No one has talked about a reason for hypoplasia of teeth could be Celiac disease. Found this out after diagnosing myself and tons of research.


i am a dental nurse in the uk and brought my son to work as i noticed another hole in his baby tooth. He has a really low sugar diet. i have been very paranoid about his oral health and have been trying to understand how he can get holes when i don't let him eat many sweet things, and it's also very embarrassing as my job is to teach people to look after their teeth.

Now my son is 6 1/2 years old and my boss has told me he has enamel hypoplasia in his first adult molars. i am so sad about this but i suppose he's in the right place for it. i just hope that his front teeth aren't affected. when my son was four months old he was admitted to hospital for reflux and was dehydrated from this and was on a drip for a few days, he has also been on amoxicillin all his life for ear infections so i guess it's a combination of the two.

My boss says that the best thing is to keep an eye on him and every couple of months apply fluoride varnish and then when he is about nine years old extract these four first molars so the second molars grow in their place around 11-12 years old.


My son's six year old molars are badly affected by this. Had never heard of it before. He had reflux as a baby which was treated by giving mylanta and also he had chicken pox at six months.

It's great to be armed with some more info so we can discuss treatment with his dentist.


i have this, but only on my front two teeth and they're yellow. It really embarrassing at school and my dentist says i have to have veneers or something.


Too bad none of the handful of dentists I went to could tell me why my teeth were breaking while chewing an apple. I'm glad I finally know the truth, but I'm thankful they only affected my molars. Going back the the dentist Friday to get another filling redone because my tooth is decaying so quickly around it!


I have this. I am 21 years old.. I am getting cavities like crazy. i wish there was a way to fix this cause i go through tons of pain with all the dentist visits and novocaine. i also right now have no insurance and my teeth hurt so bad.


my son has this and it's so annoying when he has never drunk fizzy drinks, doesn't like lollies and hardly ever touches juice and brushes his teeth every day! It would be nice for the school dentist to hand out this sort of info and give it a name so we haven't had to go searching for an answer. Thank you!


I guess this gives me more information. A pediatric dentist told my mom I was born with no enamel.


Thanks for writing this article. it's very helpful.


Question: Can you still have your teeth bleached?


This helps me but cannot change the fact my son is now going to have a lot more dental treatment. He had medicine when he was four months old for reflux and now i am blaming myself for the way his teeth are. I was told his teeth did not develop properly in the womb and this is the result.


this runs in my family all the woman get it. my teeth were stained yellow and i got teased for it as they were all over the place as well. I'm glad i found this because i can now take it to the dentist and get proper treatment.


My daughter has this. Her dentist says it was caused by her 105 degree fever she had at the age of two. Now all of her permanent teeth are growing in discolored and with soft spots/pitting.

I don't know what can help her but she will eventually need something to help her from a cosmetic standpoint.

She will also need braces and I don't know if she can even have them as soft as her teeth are. Small pieces of her teeth have fallen off. I never knew that childhood sickness can hurt the formation of the enamel.


very precise and nicely written.


Wrong Diagnosis says enamel hypoplasia is caused by vitamin A, C, or D deficiency, infectious disease, prematurity, birth injury, Rh incompatibility, trauma, or local infection.


my daughter has it. the doctors said it wasn't anything I did during pregnancy.


i have a really bad case of enamel hypoplasia. this is very helpful. i was teased a lot in school for the brown spots. now i know how it happened. thank you.


I have it and now I understand it more. --Emma


very, very nicely and sufficiently written. helped a lot! thank you.

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