Enamel hypomineralization treatment


Enamel hypomineralization treatment

Enamel hypomineralization is often an esthetic issue when it is on a front tooth, so many people ask us to fix it.

What is enamel hypomineralization?

This is a condition affecting the enamel (the outer layer) of teeth. Normal enamel is a whitish and very hard.  Hypomineralization causes the enamel to be creamy white, yellow, or brown in color and is chalky in texture. It often appears very opaque white or brown. As a result these teeth look unattractive and break down and get decay at much faster rates.

What cause hypomineralization?

We do not completely know the cause but it results from some sort of interference during the enamel formation.  This would be from birth to the age of four when the enamel is actually forming; yes the enamel of the permanent teeth starts to form many years before the teeth are ever seen.  Respiratory problems, high fever temperatures, and exposure to antibiotics have all taken some blame in the past.

What will teeth with these enamel defects feel like?

In moderate to severe cases, these teeth are sensitive to cold due to the fact the enamel that is designed to protect the tooth is either porous and/or is breaking away.

How do we treat hypomineralization?

Many patients with more severe forms end up with dentures.  Partly because of the tooth destruction and partly because getting these teeth numb is for some reason very difficult and the pain to repair the teeth becomes intolerable for those with this condition. Management starts with desensitizing tooth pastes, application of remineralizing products like MI paste, and fissure sealants with glass ionomer as teeth erupting and with composite when fully erupted. When decay occurs restoration with a composite filling or crown is indicated. In severe cases, it may be necessary to remove the molars.
Enamel hypomineralization can create white or brown spots that need treatment for cosmetic reasons.

The front teeth may require cosmetic fillings but treatment is often delayed until the teeth are fully erupted. Long term, we often place porcelain veneers or crowns.

Dental research into enamel hypomineralization.

In systemic reviews, the most interesting find was that using a self etching composite is the best restorative material.  So either SE bond and composite or crowns/veneers.




This is moderate fluorosis (look similar but totally different)
These white spots are very mild fluorosis (again similar but NOT hypomineralization)

Large case treated patient with Amelogenesis Imperfecta