Written By: Dr Anitha Anchan | Updated : June 4, 2015 10:17 AM IST
You have done everything correctly brushed your teeth properly, followed a diet that is not acidic, etc. Despite your best efforts, do you still have sensitivity in your teeth? Chances are that you are born with defects in the enamel or dentine.
Enamel hypoplasia is a defect of the tooth characterised by deficiency of enamel formation. It can affect one or more teeth. It can affect milk teeth and permanent teeth. The affected tooth may be brown and yellow in colour. In mild cases enamel hypoplasia can exhibit as pits or grooves on the tooth. The defective enamel is thinner increasing the risk of teeth to caries and tooth wear. In some cases the enamel may be lacking and lead to sensitive teeth.
Enamel hypoplasia could be due to disturbances such as fever, malnutrition, calcium deficiency, Vitamin D deficiency, chronic kidney failure, etc. during tooth development. It could be hereditary too. A dentist can identify and diagnose the condition by the clinical signs and symptoms supported with a history of causative factor. Radiographs may be used to rule out other conditions of the teeth. Sealing or bonding may be advised for aesthetic reasons and tooth coloured filling may be done if the tooth is prone to cavity. If the enamel is extensively damaged veneers or crowns may be given.
Congenital enamel hypoplasia or amelogenesis imperfecta (AI) is a genetic disorder in which there is underdevelopment of tooth enamel causing it to be unusually thin, discoloured, pitted and fragile. It affects both milk teeth and permanent teeth. There may be defect in amount of enamel (hypoplastic AI), defect in growth and maturation of enamel crystals (hypomaturation AI) and defect in mineralization (hypocalcified AI).
This condition causes teeth to be prone to rapid wear and breakage. Thin enamel increases the sensitivity of the teeth to temperature changes and increases risk for teeth decay. Anterior open bite (bite with gap between the upper and lower front teeth) may be seen. The diagnosis is based on physical appearance of the teeth and family history of inheritance. Treatment of amelogenesis imperfecta is planned based on the type and requires involvement of various dental specialities. Sealants and bonding, fillings, crown, removable and fixed prosthetic reconstruction, orthodontic banding, jaw surgery, etc. are the various treatment options.
In dentinogenesis imperfecta there is defective formation of dentine. Both milk teeth and permanent teeth are affected. The teeth are discoloured and translucent. Teeth are weak and prone to rapid wear and tear. Early loss of enamel due to defective dentin causes the tooth to be sensitive to temperature changes. Some types occur with a condition called osteogenesis imperfecta, in which bones are brittle and easily broken. Diagnosis is based on the clinical appearance and radiographs. The goal of the treatment is aesthetic, preventive and restorative. Bonding may be done for aesthetic reasons. Crowns can restore the structure and function of the teeth as well as prevent further attrition.
Tricho-dento-osseous syndrome (TDO) is an inherited condition which primarily affects hair, bone and teeth. Hair is curly and kinky at birth, but may later straighten in most cases. Areas of bone show increased thickening. Teeth may be extremely thin due to the absence of mineralization leading to teeth sensitivity. Back teeth may have an enlarged pulp chamber (taurodontism).
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References:
1. Salanitri S, Seow WK. Developmental enamel defects in the primary dentition: aetiology and clinical management. Aust Dent J. 2013 Jun;58(2):133-40; quiz 266. doi: 10.1111/adj.12039. Epub 2013 May 5. Review. PubMed PMID: 23713631.
2. Alachioti XS, Dimopoulou E, Vlasakidou A, Athanasiou AE. Amelogenesis imperfecta and anterior open bite: Etiological, classification, clinical and management interrelationships. J Orthod Sci. 2014 Jan;3(1):1-6. doi: 10.4103/2278-0203.127547. Review. PubMed PMID: 24987656; PubMed Central PMCID: PMC4072389.
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