What Causes Enamel Hypoplasia In Children?

Enamel is the outermost covering on our teeth and the hardest substance in our bodies. This hard outer layer protects the sensitive centers of our teeth which are filled with nerves while we chew and bite on hard foods. Unfortunately, some of us might not have fully formed dental enamel. Such disruptions during enamel formation lead to many enamel disorders, one of these is enamel hypoplasia. Another name for enamel hypoplasia is Turner’s tooth or D3 (Developmental Dental Defect).

Due to a reduction in the thickness of the outer shell, our teeth can become more sensitive and are left more susceptible to decay. Turner’s tooth occurs mainly during a child’s developing years but can affect the baby and adult teeth. 

We will uncover more about this disorder in this article, starting from what exactly enamel hypoplasia is, its symptoms and causes, and the treatment options available.

What is Developmental Dental Defect?

The primary characteristic of dental hypoplasia is a thin or absent outer shell in teeth.

• Turner’s tooth occurs only when teeth are developing.
• Enamel defects can affect any teeth and generally aggravate over time.
• This defect can range from minor (where only parts of a tooth are affected with spots, grooves, or pits appearing on the hard outer shell) to severe, where the coating has a significant deformity and is absent, giving the tooth a translucent appearance.

Symptoms of Turner’s Tooth

Symptoms of D3 can be obvious or hard to detect and not noticeable (though they may cause major oral issues). Some common observations of enamel hypoplasia are:

• Depression in the outer covering – When a child has this condition, the teeth can erupt with pits that can trap food leading to plaque. These fissures start during early development, and the leading cause is problems with cells in the enamel.
• White spots on teeth
• Sensitive tooth – If a tooth has a thin or absent outer hard coat, it would be sensitive to extreme hot or cold temperatures.
• Excessive dental caries or cavities – Teeth with poor-quality enamel are more prone to cavities and decay.
• Yellow or brown stains on teeth due to inner dentin benign exposed by missing enamel.
• Teeth are more vulnerable to acids in foods and beverages.

Causes of Turner’s Tooth

Defective development of the tooth’s outer coating can result from various factors such as amelogenesis imperfecta (an inherited condition), congenital enamel hypoplasia, etc. The potential reasons for this condition fall into three broad categories. We will look at each of the categories in detail below:

• Hereditary D3 – When a child inherits a genetic defect, it can impact the development of the kid’s teeth. In general, the congenital defects that can cause developmental dental defects are rare such as:
  • Amelogenesis imperfecta (also known as congenital enamel hypoplasia)
  • Treacher Collins syndrome
  • Usher syndrome
  • Ellis-van Creveld syndrome
  • Seckel syndrome
  • Otodental syndrome
  • Heimler syndrome
  • 22q11 deletion or velocardiofacial syndrome
• Prenatal problems – Since the tooth’s shell’s foundation is laid in utero, Turner’s tooth can occur even before the child is born. Specific prenatal issues that can cause this condition are:
  • Premature birth 
  • Low birth weight
  • Lack of prenatal care
  • Maternal vitamin D deficiency
  • Gestational diabetes
  • Maternal drug use or smoking
  • Illness or infection during pregnancy
• Environmental D3 – As a child grows, several environmental problems can result in defects in the tooth’s shell that, include:
  • Malnutrition
  • Dental trauma
  • Viral or bacterial infections
  • Deficiency of Vitamins A, C, or D
  • Jaundice
  • Liver disease
  • Diabetes
  • Celiac disease
  • Exposure to toxic substances.
  • Premature babies who undergo intubation.
  • Certain medications consumed during infancy or pregnancy
• Other Factors – Few other factors apart from the ones mentioned above can cause developmental dental defects, such as:
  • Lack of oxygen to tissues in our bodies (also called Hypoxia).
  • Diseases or chronic illnesses in the first couple of years of a child’s life.
  • Cerebral palsy due to fetal infection or to the mother.

How To Treat Enamel Hypoplasia?

Treating this defect depends on its severity. If the problem is minor and only presents cosmetic issues (and not dental complications), they can be treated with certain cosmetic procedures. Others might require acquiring excellent dental hygiene along with some medical interventions.

• Cosmetic treatments
  • Tooth bonding – Your dentist would attach tooth-colored resins to the impacted teeth.
  • Microabrasion – This procedure needs abrading or roughening your tooth’s surface, followed by a teeth whitening treatment.
  • Tooth veneers – This involves getting custom-made porcelain overlays to cover the entire tooth.
• Other treatments:
  • Fluoride treatments
  • Use of re-mineralizing cream or enamel-strengthening toothpaste.
  • Tooth extraction along with orthodontic evaluation, an implant, or a bridge.
  • Dental crowns

Summing Up

Turner’s tooth starts either in the embryo or in early childhood, and its causes are varied, as described in this article. Fortunately, there are many treatments available for this condition, and your dentist would be the best person to recommend the best treatment plan for you.