Wednesday, October 8, 2014

Enamel Dysplasia

What is Enamel Dysplasia?
Enamel, the first word in the title, is probably familiar to you as the hard outer covering of the tooth crown. The second word, dysplasia, is probably less familiar. Enamel dysplasia is a dental term that discusses a number of dental problems, both cosmetic and structural. The condition may affect only the tooth surface and appear as small pits in the enamel or as a gross malformation of the enamel and shape of the tooth. Enamel dysplasia can range from slight to severe with all grades in between.

What causes it?
The causes of the dysplasia are numerous, but occur during a critical stage of enamel/tooth formation. Fever, illness, medication, change in nutrition, or prescription medication have all been cited as causes.

Is the tooth weaker?
Rarely do these conditions make the tooth weaker or more prone to decay. Teeth with dysplasia are not "soft." In fact, many times these affect teeth exhibit less incidence of decay than teeth that have normal shape, color, contour, and texture!
How do you correct it?
Everyone agrees that enamel dysplasia is unsightly and correction of the problem is needed. The solution depends on the type of defect and the extent to which the teeth are involved. 

If the blemish is superficial: many times it can be polished off the tooth, and  it never returns. This is done either with a drill or with special polishing compounds, or both. Sometimes a whitening agent is also used. Local anesthetic is not required because there is no pain involved. A restoration (filling) is not necessary to correct a superficial dysplasia.

When the defect is deeper in the tooth: the defect may have to be mechanically removed (drilled) and a bonded, tooth-colored restoration will be placed. Sometimes an injection of a local anesthetic is needed to correct a deeper defect. The filling should last for many years before it needs to be replaced. The color match is usually perfect.

Smoothing the enamel defect or replacing the area with a small filling is often all that is needed. When the defect is more severe, however, reconstruction of the tooth with bonded onlays or crowns is necessary. We will tell you what is indicated after examining your mouth and determining the extent of your problem.

Enamel Decalcification
There is one type of white spot or line that forms on a tooth that is not really a dysplasia of the enamel but it looks like one. This appears as a white line along the gumline and is caused by a decalcification of the enamel because of plaque or debris sitting on the tooth. In short, the area is not being brushed properly and a cavity has started to form. When a patient has orthodontic braces, cleaning the space between the orthodontic band and the gumline can be a problem. Proper oral self-care is a must for patients undergoing orthodontic therapy.

Treatment, other than some treatment with topical fluoride, may not be necessary if the enamel decalcification is discovered in the early stage. When the white line is soft or the decalcification has invaded the underlying dentin, drilling and restoration will be needed.

If you have any questions about enamel dysplasia, please feel free to ask us. 


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