Hypoplasia of tooth enamel: diagnosis and treatment

Caries is the most common problem that occurs with the teeth. Therefore, most people assume that tooth decay is the only reason that teeth can decay. But in fact there are also diseases that are not carious in nature, in which the damage and destruction of the teeth occurs not under the influence of environmental factors, but because of the peculiarities of their structure.

Such problems include hypoplasia of the enamel of the teeth. This disease carries a serious danger, and tooth damage caused by this disease, do not lend themselves to treatment or full recovery. However, timely identification of the problem can significantly change the situation. Accordingly, it is very important to detect the disease at its early stage, and also to establish the reasons for it. The dentists are helped by the symptoms, as well as by various kinds of diagnostics.

The concept of hypoplasia

The enamel layer with which the tooth of a healthy person is covered has a sufficiently strong structure, as its main purpose is to protect the internal structures of the tooth from the negative effects of the external environment. However, situations are possible in which the problem arises from internal problems in the body. For example, hypoplasia of tooth enamel is a disease, because of which all tooth tissues can be affected without exception.

The most common variant of the disease is hypoplasia of tooth enamel. When this disease occurs, tooth damage has a non-carious nature. The causes of hypoplasia are deviations that occurred during the formation and formation of enamel. As a result of this pathology, the enamel layer is thinning, and the pathology can have a different form of severity.

Types of the disease with hypoplasia

Dentists note that enamel damage with mild hypoplasia may be minimal, but the disease also has a severe form. In this case, the tooth does not have a protective layer at all. This form is called aplasia.

The development of this disease can begin at any age. Despite the fact that most often there is hypoplasia of tooth enamel in children who still have milk teeth, however there is no guarantee that the same symptoms will not occur in an adult.

If you adhere to the basic classification, the disease can be conditionally divided into two types - systemic hypoplasia and local hypoplasia. When there is a systemic form of the disease, the greatest threat appears, since in this case the entire enamel layer of the tooth is affected. The systemic form of hypoplasia in the severe state implies not only a thinning of the enamel layer, but a serious underdevelopment that manifests itself in the form of the formation of waves, furrows and points. Hypoplasia in the local form often affects the molars, which have undergone any damage at the stage of formation.

Hypoplasia of tooth enamel is a rather serious problem, as a result of it there is a general weakness of the tooth and its protective layer, which, in turn, is a favorable environment for the emergence of other pathologies and diseases.

Causes

Currently, doctors adhere to two main theories regarding the nature of hypoplasia. The first group of specialists believes that the beginning of the process destroying the enamel can be triggered by disturbances in mineralization. Another group of specialists is of the opinion that such a cause is not singular, and the delayed function of epithelial cells in the embryo of the tooth also influences the development of hypoplasia. However, it is worth noting that other factors, in addition to physiological reasons, have other factors that create favorable environment and conditions for the further development of enamel hypoplasia of permanent teeth.

Diseases of infant teeth

Due to the fact that the formation of milk teeth occurs at the stage of intrauterine development of the infant, their overall condition largely depends on how the pregnancy was carried out, as well as on the state of health of the child's mother. Influence on the development of hypoplasia of the enamel of infant teeth in the infant during its development in the womb and in the process of birth can such factors:

• Diseases of the digestive system in the mother;
• Infectious diseases that were transferred by the mother during pregnancy;
• Abnormalities in the fetal position;
• Congenital diseases of the cardiovascular system;
• The impact of factors such as chemicals or hazardous temperatures;
• Infant feeding by artificial means;
• Prematurity. Specialists are of the opinion that the latter reason was relevant not so long ago and caused an increase in the number of children suffering from hypoplasia. The situation is such that modern technologies allow nursing even too premature babies, but such children have not yet completed the processes of tissue and organ development. In this regard, premature babies and subsequently suffer from hypoplasia of the enamel of the baby teeth, since there was a violation of the process of its formation, or it was completely interrupted;
• Water scarcity;
• Toxicoses in severe form;
• Injuries of a traumatic nature. These include trauma from childbirth;
• Bad habits during pregnancy.

All these factors cause at an early age hypoplasia of the enamel of the baby teeth.

Pathology of molars

Such a pathology can begin to develop at an early age, in the first years of a child's life. Formation and development of embryos of molars begins to occur at about six months of age. Therefore it is quite logical to assume that a violation of the state of health at this age can provoke the process of impaired development of tooth enamel. In this regard, hypoplasia of the molars can often be found in those people who in childhood suffered such diseases as:

• Severe forms of infectious diseases;
• Rickets;
• Kidney disease, as well as disruption in the endocrine system;
• syphilis;
• Serious violations in the digestive system;
• Anemia due to iron deficiency;
• Dysfunction of the brain.

Hypoplasia of the enamel of the teeth will develop and manifest itself on the molars, depending on the age at which the child has suffered a particular disease. For example, if the disease was transferred at the initial stages of life, damage to the tooth enamel can be observed at the edges of the central incisors and the first large permanent teeth. The disease in the ninth month of life can provoke enamel damage on the second and third order incisors on both sides, as well as on the central incisors and large chewing in the area of their crown.

Symptoms of hypoplasia

Diagnosis of this disease is not a complicated procedure for a competent specialist, because he has specific symptoms. But patients should still independently monitor the enamel of their teeth. Only this will allow timely detection of the problem at the stage of its early development.

Systemic form of hypoplasia

As we have already noted, the systemic form of the disease can manifest itself in various degrees of severity. Thus, with the appearance of a light form, a partial change in the color of the enamel of the tooth is observed: areas of yellowish color develop on its surface, which have clearly delineated boundaries. Such defects can be seen in the photo with tooth enamel hypoplasia. Specificity of this form is that the lesions in the form of spots have exactly the same size and are located symmetrically - on the same teeth on both sides of the jaw. Most often this form of the disease affects the front of the teeth, therefore, if you pay due attention to the state of your teeth, then the development of the disease at an early stage is absolutely not difficult to notice. With this form of hypoplasia, soreness is not felt, and the thickness of the tooth enamel on the affected and healthy areas of the tooth is the same.

At the second degree of complexity occurs underdevelopment of tooth enamel, which can be characterized by the appearance of changes of different types. Wave pattern can be identified visually and in the absence of additional devices. If you dry the tooth, then on its entire surface will be viewed rollers of small size. Another manifestation are grooves - they tend to have a single location and are across the tooth. Along with wave-like manifestations, the grooves are arranged alternately with healthy areas of tooth enamel. The third type of manifestation is the most common - a point type. In this case, along the whole surface of the tooth are located grooves, which eventually change their color to a darker. Therefore, it is necessary to detect and start treatment of tooth enamel hypoplasia in children in time.

Aplasia

The most dangerous stage of hypoplasia is aplasia, that is, a form in which tooth enamel is absent altogether. Such a manifestation can be localized at a particular area of the tooth or can affect the entire tooth. With this form, there are significant pain sensations that arise as a reaction to environmental stimuli. A specific characteristic is that the painful sensation passes immediately after the external effect on the tooth has been stopped.

Local form

The main sign of the local form of enamel hypoplasia of permanent teeth in children and adults is the process of appearance of spots on the surface of the enamel coating, which can have different colors. The shades of such spots can range from pale yellow to dark brown. Such damage to tooth enamel is manifested by the formation of punctures of a point character, which are everywhere located on the entire surface. It should be noted that this form can manifest only on molars.

Diagnosis of hypoplasia

Inherited is the enamel hypoplasia of the teeth as a dominant trait linked to the X chromosome. As a rule, the diagnosis of hypoplasia does not cause difficulties for dentists due to the fact that the disease has a visual symptomatology that can be easily noticed. The main task of the dentist is the differentiation of hypoplasia from a carious lesion. In order to make a similar examination, doctors use three main methods:

• Visual evaluation of the enamel surface. With carious manifestations, tooth enamel has a rough surface, and with hypoplasia it remains smooth;
• Assessment of the number of spots (hypoplasia is characterized by multiple manifestations);
• Staining of affected areas of enamel with methylene blue solution. The spots, characteristic for hypoplasia, are not stained with this solution, in contrast to carious lesions.

Treatment of enamel hypoplasia of permanent teeth

The method of treatment of the disease depends on the clinical manifestations, that is, on the form and severity of the pathology, as well as on the nature of the changes.

In the event that hypoplasia is manifested by the appearance on the enamel of light spots in small amounts that are located on such areas of the teeth that are not too visible, treatment of this manifestation is not necessary.

In the event that the spots are located on the front surface of the incisors and are noticeable, the defect can be eliminated. Unfortunately, it is not possible to restore the affected enamel, so the doctor can apply various filling materials, as well as veneers or crowns.

What if hypoplasia in the form of furrows and strips?

If the disease manifested itself in the form of depressions, furrows or striae, then the tooth filling according to the classical scenario may prove to be effective.

If the teeth thus restored are treated with care, they will be functional and aesthetic for a sufficiently long period.

Veneers are plates that the dentist attaches to the outer surface of the tooth. This kind of crowns has an impeccable appearance, but the inner side of the teeth still has an unpleasant appearance. But due to its invisibility, veneers can be an excellent solution in the treatment of hypoplasia.

If the tooth has a sufficiently changed shape, formed as a result of pathology, then dentists tend to use orthopedic crowns. The installation of such a crown is rather difficult work. Therefore, if there is an alternative opportunity to restore the aesthetic appearance of the teeth, then it should be delayed with the installation of an orthopedic crown.