Treatment of Enamel Defects (Hypoplasia and Hypo-calcification) – Part Two – Early Intervention
Early intervention treatments include:
- Desensitising agents – these can be applied to the surface of tooth where there is sensitivity to cold and air. The enamel is porous so an application of special chemicals by the dentist can block air and cold getting into the tooth thorough the porous enamel. Certain tooth pastes can be helpful such as tooth mousse, high fluoride tooth called NeutraFluor 5000, and Sensodyne toothpaste.
Tooth mousse
- Remineralisation – if the depth of the defect is shallow, sometimes this technique can remove it and allow good enamel to take its place. This is especially so in the front teeth. The procedure involves chemicals that remove the affected enamel and allows the body to lay down new enamel. This is technique is only for shallow areas of affected enamel, especially on non-biting areas of the tooth.
Upper Central Incisors - Hypocalcified white and yellow patches
Upper Central Incisors post-op treatment with Prema
- Fissure seals – if the enamel defect is within a fissure (groove) in the tooth (usually the back teeth) then the chance of decay are extremely high. Some fissures are so deep that there is hardly any enamel at the base of the fissure. With porous enamel this situation can arise later on due to wear of the defective enamel, allowing food to impact into the deepening fissure. Bacteria can enter the dentine under the enamel and start invading the tooth causing decay, which can be at a rapid rate.
The fissure sealant will change the shape of the tooth by flowing into groove and building up fissure into a smooth easy to clean surface. It will also cover the porous enamel. This situation needs to be monitored as defective enamel can still collapse underneath. A filling may need to be done in the future. Hopefully never!
Left: Hypocalcified fissure; Right: fissure sealant treatment
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Next week
Treatment of Enamel Defects (Hypoplasia and Hypo-calcification) - Part Three - Restoration