Hypomineralisation or ‘chalky teeth’ makes children’s teeth more prone to decay and sensitivity.
3 minute read
Tooth enamel is the strongest material in the body, but sometimes it can fail to develop properly. Teeth affected by hypomineralisation can have a softer, ‘chalky’ surface that’s more vulnerable to decay and other damage. The teeth might also feel painful or sensitive without treatment.
Dentists will identify problems such as hypomineralisation during a child’s regular check-ups and can discuss suitable treatments and home care. You should schedule an appointment if you notice anything unusual or have any concerns about your child’s teeth.
What is hypomineralisation?
Hypomineralisation is a fairly common dental condition that affects the development of enamel on one or more permanent teeth. Having less mineralised enamel can make these teeth softer and weaker, with a similar texture to chalk.
The condition is thought to affect as many as 1 in 6 children, who may experience it in one or more teeth, depending on its severity. Hypomineralisation is most likely to happen with the molars, but incisors may also be affected.
Chalky teeth can appear whiter than usual in some spots, brown or yellow and visibly dull rather than smooth and shiny.
What problems are associated with chalky teeth?
The effects of hypomineralisation can range from mild to severe. Associated problems can include:
Teeth affected by hypomineralisation have less protective enamel. This can make them more prone to a number of oral health problems, including tooth decay and cavities, root canal infections, chips and cracks and resulting pain and sensitivity.
More difficult to treat
Corrective dental treatments can also be more challenging, as there is less enamel to support fillings. This often means that a larger restoration such as a crown may be needed to restore or protect a damaged tooth. These teeth are also more likely to need an extraction if they are too badly damaged for restoration.
Teeth affected by hypomineralisation can feel more sensitive to temperature and pressure. This can cause day-to-day discomfort and may cause a child to become fussy with food, affecting their diet and nutrition. They may also require a higher level of local anaesthesia or sedation during dental treatments due to heightened sensitivity.
Living with chalky teeth can also be an aesthetic concern, affecting a child’s confidence to smile.
What are the signs of chalky teeth?
Possible signs of chalky teeth can include:
- One or more teeth may look dull and chalk-like
- Teeth feel more sensitive to heat and cold
- White spots or yellow-brown stains on teeth
- Pits or grooves on teeth
- Excessive or irregular tooth wear
- Teeth are more prone to cavities or other oral health problems
In other cases, there may not be obvious signs, and the condition will need to be diagnosed by a dentist.
What causes chalky teeth?
The causes of chalky teeth isn’t fully understood and more research is needed into the condition, but a number of factors have been suggested by researchers that may make it more likely to develop in some children.
Reduced production of enamel is associated with the genetic condition congenital enamel hypoplasia, which can also result in smaller teeth. A number of other hereditary conditions may also be a contributing factor, including:
- 22q11 deletion syndrome
- Ellis van Creveld syndrome
- Heimler syndrome
- Otodental syndrome
- Seckel syndrome
- Treacher Collins syndrome
- Usher syndrome
Early childhood diseases, other medical conditions and treatments and general poor health during a child’s first three years may affect the production of enamel in their permanent adult teeth. This can include:
- Respiratory tract infections
- Liver disease
- Celiac disease
- Metabolic disorders
- Calcium or vitamin A, C or D deficiency
- Recurring high fevers, pneumonia and ear infections
- Extended use of antibiotics in childhood
Premature birth or low birth weight may be risk factors for hypomineralisation in later childhood. Maternal weight gain, vitamin D deficiency, smoking or drug use during pregnancy may affect the development of enamel in the womb.
Exposure to dioxins or other organic pollutants during pregnancy, breastfeeding or the first three years of life have been suggested as causes of hypomineralisation.
Injuries or trauma to primary (baby) teeth or early tooth loss may prevent enamel from forming properly in the replacement teeth.
Concerned that your child may have chalky teeth? Book a consultation with a Kelmscott dentist today.
How do dentists treat chalky teeth?
Treatment for chalky teeth depends on how severe the condition and its symptoms are. Early diagnosis can improve the effectiveness of treatments and reduce unnecessary suffering and costs in the long term.
If there are only minor defects in teeth, and your child is not experiencing sensitivity or other discomfort, treatment may not always be necessary. Their dentist will recommend regular check-ups so they can monitor the condition and provide hygiene treatments to help prevent decay, including applying fluoride for extra protection.
If a tooth is missing more enamel, or is causing discomfort or other problems, your child’s dentist will recommend appropriate treatments. These will aim to protect a weak tooth, improve its function and appearance, and prevent complications such as sensitivity and orthodontic issues.
Treatment options may include:
Composite bonding, fissure sealants or fillings may be applied to seal gaps, repair minor defects of tooth surfaces and to protect a tooth from decay. As resin may not bond as successfully to teeth with reduced enamel, these treatments may need to be repeated periodically, or may only be recommended as a temporary measure before a more permanent restoration.
For teeth that are more severely affected by hypomineralisation, dentists may recommend placing a crown to reinforce and protect the tooth. This is a custom-made restoration that covers the tooth, improving its strength, function and appearance. Crowns are made from tooth-coloured zirconia and /or porcelain for a natural appearance. The tooth is prepared by removing a layer of enamel before a crown can be bonded to the tooth surface.
If chalky teeth are only an aesthetic concern, their appearance may be improved by cosmetic dental treatments such as enamel microabrasion, teeth whitening or veneers. However, teeth whitening treatments need to applied carefully under the strict guidance of a registered dentist to avoid worsening the sensitivity that chalky teeth can cause.
If a tooth is too badly affected by hypomineralisation to repair, extracting the tooth may be the only option to prevent further pain. Careful timing and regular monitoring are essential to prevent problems such as teeth shifting or crowding. Early orthodontic treatment may be necessary to help guide the surrounding teeth into proper alignment while they are still developing.
How to care for chalky teeth
Good daily care can help to prevent or reduce sensitivity and other problems associated with thin tooth enamel. General advice includes:
- Brushing teeth at least twice a day using a soft toothbrush and fluoride toothpaste
- Cleaning between teeth at least once a day using floss or an interdental brush
- Limiting sugary and acidic food and drinks
- Drinking plenty of water
- Keeping up with your scheduled dental visits
Your child’s dentist may have specific recommendations based on their condition.
Talk to our family dentists in Kelmscott
If you want professional advice about your child’s teeth or your own oral health, book a consultation with our family dentists at Kelmscott Dental. Call (08) 9495 7999 or book online.
We also see patients from all nearby suburbs, including Armadale and Gosnells.
- Almulhim B. Molar and Incisor Hypomineralization. JNMA J Nepal Med Assoc. 2021 Mar 31;59(235):295-302. doi: 10.31729/jnma.6343. PMID: 34506432; PMCID: PMC8369532. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369532/
- Thakur, H., Kumar, S., Kaur, A., Singh, N. and Singh, R. (2020). Prevalence and Clinical Characteristics of Molar–Incisor Hypomineralization in 8–16-year-old Children in Industrial Town of Solan District of Himachal Pradesh. International Journal of Clinical Pediatric Dentistry, 13(3), pp.230–234. doi:https://doi.org/10.5005/jp-journals-10005-1767. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450191/