Enamel hypoplasia (EH) is a developmental defect that can affect the primary and permanent teeth in one of two ways. It is sometimes identified as a physically missing tooth structure, and can be seen as pits, grooves or just missing parts in the crown of the tooth. Hypomineralization, on the other hand, is a mere decrease in the mineral content of the enamel. It can be severe enough to give the tooth a translucent appearance or mild enough to maintain its opacity. It is hypomineralization that leads to soft enamel.

How It Forms

Teeth are formed with three highly mineralized and complex tissues: Enamel forms the outer layer of the tooth’s crown, with dentin covering the inner layer of both the crown and underlying root. Cementum, another mineralized tissue, covers the dentin to form the inside of this root. The enamel of your tooth is the only visible portion, so although EH can produce developmental defects involving dentin and cementum, they are not usually noticeable at first relative to the case shown below.

The Root Cause

In both your primary and permanent set, individual teeth develop at a different times. So there can be a spectrum of severity in the mouth based on teeth that either have enamel hypoplasia or just some minor hypomineralization, both of which raise one’s risk for decay.

Because the formation of teeth hinges on genetic coding for proper development, inherited health problems in a small minority of the population can affect the entire dentition with EH. Systemic health issues that alter the metabolic process of enamel development can effect the teeth, as well. These issues include prenatal problems like maternal smoking, vitamin D deficiency and even preterm birth. In the event of a birth infection, diseases like the measles can also cause EH – particularly in the molars, according to the American Academy of Pediatric Dentistry (AAPD). Traditionally helpful chemicals can do the same thing – these include fluoride and the antibiotic tetracycline.

The Problem

Children with EH or hypomineralization can suffer from the same cosmetic issues, tooth sensitivity and increased risk for decay you can. So an early dental evaluation by your dentist or dental hygienist is perfectly appropriate. He or she will recommend fluoride applications, as well as remineralizing paste such as Colgate® Sensitive Prevent & Repair™ to decrease tooth decay. Teeth may also require repair with bonding, filling materials or crowns, especially if you or your child grinds at night. In this case, a nighttime mouthguard will be necessary to prevent excessive tooth wear.

Ultimately, homecare is a must. Kids need great oral hygiene now to keep EH under control later. With great toothpaste, toothbrushes and rinses, however, this shouldn’t be a problem.

Preventions:

Your teeth are covered with a strong coating of enamel, which, as a result, plays a very important role to their protection from decay and discomfort. And although it’s the hardest substance in your body, enamel is actually pretty fragile. A number of things, from the foods you eat to the amount of force you use when brushing, can cause it to wear away.

Because it can’t be replaced, your best option is to do what you can to prevent tooth enamel loss.

Skip the Soda

Soda may taste sweet and refreshing, but it’s bad news for your teeth’s enamel in large amounts. Most sodas are full of sugar, which contributes to the production of decay-causing bacteria. Even diet soda or unsweetened fizzy drinks, like seltzer, can lead to tooth enamel loss because they are so acidic. Kicking the soda habit can be challenging, but if you give yourself plenty of other options – such as water or unsweetened tea – you’ll soon find you no longer miss it.

Watch the Citrus

Too much of a good thing is bad for you, and that includes your dental health. Although citrus fruits are high in vitamins and fiber, for example, they are also fairly acidic. Consuming a lot of oranges, grapefruits or beverages flavored with lemon juice can therefore take its toll on your teeth. Keep in mind you don’t have to give up citrus fruits for good; just keep an eye on how many you eat. More importantly, drink water at the same time to rinse away its abrasive juices.

Go for Dairy

Some foods wear down your enamel, whereas others build it back up – as long as it hasn’t been lost entirely. Cheese and dairy products help protect your teeth in two ways, according to the University of Rochester Medical Center. First, eating cheese produces saliva, which helps rinse away debris and acidic residue during your meal. Cheese is also high in calcium and phosphate, both of which can help remineralize enamel that has become weaker.

Chew Gum After Meals

Chewing gum after meals also helps stimulate the flow of saliva, which washes acids off of your teeth and protects the enamel constantly during the day. Some types of gum are better for you than others. If you’re hoping to protect your enamel, though, pick a sugar-free gum.

Drink in Moderation

Whether you prefer beer, wine or a cocktail, it’s best to drink in moderation for the sake of your teeth (and overall health). Some alcoholic beverages are high in sugar, whereas others – such as red wines – tend to be very acidic. Alcoholic drinks are also dehydrating, which means they can dry out your mouth and reduce the production of saliva, according to the American Dental Association (ADA). When you do drink, dilute your beverage by sipping water alongside it.

Time Your Teeth Brushing

Brushing your teeth twice a day helps reduce your risk for cavities. But brushing too soon after a meal, particularly after eating acidic foods, can contribute to enamel erosion and the sensitivity that awaits underneath. To protect your teeth from enamel loss, wait at least 30 minutes before your brush.

Brush Gently

When you do brush, remember to be gentle. Brushing too vigorously can lead to enamel erosion, too. If you’re particularly concerned about enamel loss, try using an extra soft toothbrush such as Colgate 360° Enamel Health.

Rinse Often

As with alcohol, taking sips of water while you eat sugary or acidic foods can help prevent enamel loss as well. It’s also a good idea to rinse your mouth out with water when you’re still waiting to brush for a while after dinner.

Treat Certain Conditions

Some medical conditions can damage your enamel in the same way. For example, the acid that washes up into your mouth when you experience GERD can erode your teeth very easily. Conditions such as bruxism (tooth-grinding) can also wear away the enamel. Treating the biological habits that affect your teeth can go a long way toward protecting them.

Work with Your Dentist

Ultimately, one of the best ways to protect your teeth’s enamel is to work with your dentist. He or she can detect any erosion and offer tips on ways to reduce it. If it’s been awhile since you’ve been in a dentist’s chair, book an appointment with one today.