What is Hypomineralisation?

Hypomineralisation is a condition that affects the outer layer (enamel) of your child’s teeth. It occurs due to a disturbance during tooth development, either during pregnancy or in the first two years of life. Disturbances can occur as a result of coughs, colds, or antibiotics during pregnancy, severe illness during the first two years of life, dioxins in breastmilk or for no known reason. It has been suggested that there may also be a small genetic element.

Hypomineralisation causes the tooth enamel to be softer and therefore more prone to breakdown and decay. It is becoming more and more common, with up to 20% of the UK population having some form of hypomineralisation. Because of the nature of these teeth they are sometimes harder to numb up for treatment and fillings are not as durable as they are in healthy teeth. Hypomineralised teeth have chalky white or yellow patches and increased sensitivity.

Will all my child’s teeth be affected?

In the primary dentition (milk teeth), the second primary molars may be affected. If your child has hypomineralisation of the primary molars it is likely there will be some form of hypomineralisation of the adult teeth.

Hypomineralisation most commonly affects the first adult molars and incisors (front teeth), this condition is known as molar incisor hypomineralisation (MIH). The adult molars may break down quickly due to biting forces, however the incisors are usually only mildly affected but may create an aesthetic issue. The adult canines are very occasionally affected.

What treatment options are available?

Treatment options depend on the severity of clinical signs and patient symptoms. Your dentist will carry out a full clinical examination and may take radiographs to make sure they have the most accurate diagnosis of your child’s dental condition.

If your child has very sensitive teeth, your dentist may recommend a toothpaste with a higher fluoride concentration, regular fluoride varnish application or a tooth mousse to help with the sensitivity.

For primary teeth, your dentist may recommend preformed metal crowns to seal the healthy tooth structure and keep the teeth in the mouth until their natural exfoliation.

White fillings are possible in mild cases, however, they are often not an ideal treatment option as they cannot stick to the hypomineralised teeth as well as to healthy teeth.

White fillings will also require numbing and are often lost in a short time. The teeth may also continue to break down around the white filling.

For adult molars, treatment depends on severity and can range from fissure sealants and regular fluoride application to white fillings or interceptive extraction of the affected teeth. Removing adult molars is only considered for teeth that are severely affected, as a last resort option and this will be a joint decision between yourself, your orthodontist and your paediatric dentist. Removing adult molars at a young age may feel like a big commitment, however, your dentist will be able to explain all the risks and benefits associated with the treatment to ensure you have the best treatment plan for your child.

Adult incisors do not tend to break down and the issue can be purely cosmetic. There are several options available for treatment including microabrasion, bleaching, resin infiltration or restorations. Your dentist will explain all options available and recommend the best option for your child.

Important to Remember

If your child has hypomineralisation, regular dental check-ups and hygiene appointments as well as fluoride applications are essential, as problems can occur and progress very quickly.

We advise that your child brushes their teeth twice a day with a fluoride toothpaste.

We also recommend to limit all sugary foods and drinks to mealtimes only and not every day, to help prevent cavities.

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