is a whitish and very hard. Hypomineralized enamel is creamy white, yellow, or
brown in color and is chalky in texture. As a result these teeth look unattractive and break down and get decay at much faster rates.The cause is not completely understood 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 been blamed.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. 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.1 In severe cases, it may be necessary to remove the molars.
The front teeth may require
cosmetic fillings but treatment is often delayed until the teeth are
fully erupted. Long term, porcelain veneers or crowns are usually needed.
In this systemic review, 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. 1
|This is moderate fluorosis (look similar but totally different)|
|These white spots are very mild fluorosis (again similar but NOT hypomineralization)|