What is Enamel Hypoplasia?
Enamel hypoplasia (EH) is a developmental defect of the enamel affecting up to 25% of people. It occurs due to flawed development of a tooth during its formative stages, leading to imperfections in the enamel’s structure, texture, and density:
- Hypomineralization — Less mineral content makes enamel softer and rougher.
- Less enamel — Enamel may be physically missing, malformed, or deficient.
Causes of Enamel Hypoplasia
- EH on permanent teeth typically develops due to factors occurring between birth and age 3.
- Common environmental factors: premature birth, infant infections (tooth, ear, measles, etc.), use of antibiotics, vitamin D deficiency, trauma, or household smoking.
- Not all children exposed to these factors develop EH.
- EH can also be linked to congenital or genetic disorders.
What This Means for My Child’s Teeth
- Cleaning — Affected teeth have rougher surfaces, making them more plaque-retentive.
- Physical durability — They wear faster from grinding, eating/use (attrition), or acid erosion; cavities may form more easily, be larger, and progress faster.
- Sensitivity — Teeth may be sensitive to temperature and more difficult to numb for dental procedures.
- Appearance —
- “Puzzle piece” patterns of white-to-brown discoloration.
- Missing enamel segments.
- Texture is more “frosted” than “glassy.”
How to Manage This Condition
- Teeth may require restoration for proper form, function, and color — discuss long-term plans with your dentist.
- Keep tooth surfaces free of plaque and carbohydrates (thorough brushing).
- Avoid whitening toothpastes (abrasive, can cause enamel loss and sensitivity, and will not whiten discoloration).
- Consider toothpastes with extra fluoride, minerals, or desensitizers to strengthen the outer enamel layer.
- Avoid sticky carbs, hard foods, and acidic foods.
- Use a night guard if grinding is an issue.