Hypoplastic premolar

Hypomineralisation is a condition of teeth where the enamel has areas of less mineral than unaffected enamal. The teeth most likely effected are the first molar teeth (which erupt at 6 -8 years) and the anterior incisor teeth.

Teeth with hypomineralisation may have patches of very white, yellow or brown enamel (that is not the result of decay). These areas contain up to 21% less mineral.

Problems this may cause -

  • Decay because they are softer;
  • Breaking more easily under normal biting pressure;
  • Sensitive to touch and cold
  • Cosmetic concerns due to the appearence on front teeth

Why does hypomineralisation occur?
We don't really know.
The problem occurs during the development of the tooth so things that occur to children between the ages of 0 and 4 years have all been blamed e.g. high temperature fevers; ear infections; antibiotics used to treat high temperatures or ear infections!
There does tend to be a family tendency towards teeth with hypomineralisation but it is hard to know if the factors are genetic or the tendencies to have similar environmental problems.

Difficulties in treatment
It has been shown that hypomineralised teeth are three times more likely to lose any fillings or seals than normal enamelled teeth. Therefore we need to carefully watch and retreat these teeth.
These teeth may need crowns at a younger age to preserve them. Where the condition is extensive extraction and orthodontic treatment may be the best long term choice.

What you can do
Because a hypomineralised tooth is much more likely to be decayed it is important that children with these teeth are helped by the parents to be very conscientious about diet and cleaning. A desensitizing toothpaste may help with sensitivitiy and tooth mousse is another helpful option.

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Monash University Health Service Dental Clinic (Clayton)
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Dr Erik Magee BDSc (Melb)
Dr Stephen Liew BDSc (Mel), FPFA, FADI, MAICD, FICD
Dr Sue King BDSc (Melb)
Dr Lin Liang BDSc (Hons Melb)
Dr Jordan Hawkins DDS (Melb)
Dr Marjan Ardebili BDS (Manchester,UK), MFDS (RCS Ed)
Dr Nigel Gamage BDSc (Sheffield)
Dr Balakka Reddy BDSc
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