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Human development starts at the time of conception… it is a very complicated and intriguing series of events. Certain processes need to occur at exact times in order to result in a normal functioning entity. What exactly does this mean as it relates to your teeth?
In order for teeth to form properly, certain criteria and conditions need to be met as they are developing. If the process is interrupted, then the teeth may not form as they should.
A premature birth, high fever as a young child, or even antibiotics given to a child for an infection, can throw off the process of development and cause weakness in the tooth’s structure.
It is when the normal metabolism of the developing cells is altered, that you end up with problems relating to the tooth’s development.
Generally, these abnormalities show up as white chalky discolorations called Hypomineralization.
These areas arise because there is a lack of minerals that are needed to adequately make up the outer layer or enamel of the tooth.
Weaker enamel is more prone to decaying. If plaque sits on these weaker surfaces, then this is a sure recipe for decay. In addition, these areas are more prone to temperature sensitivity.
Hypomineralization can affect both primary and secondary teeth.
Primary (baby) teeth form in the womb. We generally see this weakened enamel in children who are born three months premature and have a low birth weight.
Secondary (adult) teeth are affected if there is a disruption with the child’s metabolism in their first three years of life.
The teeth most commonly affected are the first and second molars, incisors and canines.
The various causes of the malformations are the use of amoxicillin, high fevers and diseases that affect the metabolism of the tooth.
We treat these kids by increasing the frequency of their fluoride treatments. Remember: Fluoride acts to strengthen the enamel and decrease the temperature sensitivity of the tooth.
In addition, impeccable oral hygiene is a must; there should be a zero tolerance for plaque on the teeth.
The images above are from an actual case from a patient I’ve seen.
The image at the top (Decay #1) shows the white chalkiness mentioned earlier. The one on the bottom (Decay #2) shows decay that often occurs underneath these weakened areas. In this case, there was a vast amount of decay present.