Molar Hypomineralization - isn't it just caries?

Date: December 2021

Author: Natalie Bradley

Molar Hypomineralization, a developmental defect, contributes to breakdown of teeth. Here we discuss what it is, why it is different to dental caries, and what we can do to help manage it.

What is Molar Hypomineralization?

Molar Hypomineralization, also referred to as 'chalky molars' is one of 4 types of Developmental Dental Defect (DDD or D3), and the most common. All are the result of development defects that occur while the teeth are developing. Molar Hypomineralization mostly commonly affects one or more first permanent molars, while primary molars may be affected. In some cases, incisors are additionally affected. This defect occurs in the post-secretory phase of tooth development, i.e., after the enamel has been secreted. Teeth affected by this condition present with a chalky, demineralized area of enamel which can be more or less extensive. They may also present with areas that appear cream, yellow or brown in shade. The affected area can also be bumpy in appearance. The areas affected are defined, with normal enamel adjacent to them. Affected areas can also be bumpy in appearance.

Impact on oral health

This developmental defect results in the enamel containing less mineral and being softer than normal enamel. Teeth with Molar Hypomineralization are susceptible to breakdown, which may begin as soon as the tooth begins to emerge through the oral mucosa, or occurs post-eruptively. Affected teeth with severe demineralization may be at up to a ten-fold risk for dental caries. Additionally, breakdown can occur before dental caries begins, due simply to mastication on the weak enamel. Patients may also experience pain, including on brushing which then impacts oral hygiene, as well as from dentin hypersensitivity in affected teeth. Dental erosion is a further risk.

Dental management

The first challenge is recognition and accurate diagnosis of Molar Hypomineralization. It is important to fully recognize the differences between Molar Hypomineralization and dental caries. Regular dental examinations in children can lead to early diagnosis as and after teeth erupt, after which the condition can be managed. This condition should be discussed with parents and carers of children affected, being careful to make sure parents and carers do not perceive that you are blaming them.

Prevention messages and treatments with fluoride applications and improved oral hygiene can help slow the breakdown of the chalky molar. Ultimately, if a tooth has already broken down considerably, then extensive restorative care or removal of the tooth might be required. Dental professionals should be able to implement strategies to increase the life span of chalky teeth.

If affected teeth are sensitive, a soft toothbrush can be recommended as well as products that incorporate Pro-Argin technology. This technology provides rapid relief from dentin hypersensitivity, with a one-minute application. Options include Colgate Sensitive Pro-Relief Toothpaste which is available in some countries (not in the US), as well as Colgate Professional Sensitivity Relief Serum which is available in the US and some other countries.

Carers and children can also be directed towards resources such as D3's Sam's Story to educate them on Molar Hypomineralization, why it happens, what chalky molars look like and how they can be managed.


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