What Causes Enamel Hypoplasia In A 16 Month Old Infant?

Posted on Tue, 5 Apr 2016

Question: My daughter is 16 months at about 13 months her tooth got a chip on it which concerned us but we didn't look at her teeth good but looking back at pictures of her teeth they looked chalky. Around 15 months we looked and the enamel was chipping off on all four front teeth. She now has no enamel on her front 4 teeth and her top 2 molars she has look like they are crumbling but they do have enamel not sure if they are still growing or what. Her bottom teeth don't look as bad they look pretty normal although its hard to get a good look. I am flabbergasted at how all this happened so fast. Some background we live in XXXXXXX state so we don't see the sun much so there may be a Vitamin D deficiency. I We also nurse but with a nipple shield so I believe the milk may be pooling in her mouth throughout the night because she wakes up a lot. She has a upper lip tie we just noticed which I read can pool food and milk. We were also feeding her a lot of carbohydrates which I read have phytic acid and were giving her sweets and with very limited brushing (near to no brushing). I feel so bad I had no idea how fragile baby teeth are and how important brushing their teeth is. Is it possible for the enamel to just fall off and expose the dentin without it looking like they are rotten? I have gone to three dentists and have been told its early childhood caries and enamel defects like hypominirealization and enamel hypoplasia. I wish I could post a picture to show the progression!

Answered by Dr. Honey Arora (1 hour later)

Brief Answer:
Seems like Enamel Hypoplasia..

Detailed Answer:
Hi..
Welcome to HEALTH CARE MAGIC..

I have gone through your query and can understand your concerns..

As per your complain, evaluation of the image attached and the detailed description it seems to me more like Enamel Hypoplasia..

Due to incompletely formed Enamel, the Enamel layer is weak and it leads to easy chipping from the inner layer dentin..

The entire explanation that you have given is pointing towards the same..
It does not look like early childhood caries as the appearance and symptoms are somewhat different..

The Enamel is appearing not to be completely formed and is week leading to easy chipping while dentin seems fine and well formed..

I would also like to know a few more things before I can guide you further..

1.Is your child experiencing sensitivity of teeth or pain in teeth?
2.As you consulted a doctor, did they advice any treatment?
3.Before the Enamel started falling did the teeth had white or brown spots since the teeth erupted?
4.Other than dietary precautions did any dental treatment like Fluoride application done till now?

Kindly answer the following questions so that I can guide you better towards treatment..

Hope this information helps..

Thanks and regards.
Dr.Honey Nandwani Arora.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Honey Arora (19 hours later)

Hello thank you for the response! To answer your questions
1. Not that I can tell when she eats she mostly eats on the side with her molars but she does have a hard time me brushing her top half of teeth she makes a face like its painful.
2. I have but they all want to wait until she turns 2 to go under general anesthesia but I fear that her teeth will only continue to deteriorate.
3. I honestly can't remember if they did or not I never really looked at her teeth and now I wish I did.
4. Yes they put on a fluoride treatment on her at her last dentist appointment.

We are going to another dentist on March 1st to see if we can do any kind of treatment sooner and possible answer more questions.

Is it possible her teeth demineralized? What I noticed in pictures last night that on December 2nd she had what seems like normal teeth except for that chipped one. Its not until we started brushing her teeth that the enamel started to fall off and by Dec 22 it was nearly all gone from the second photo I sent. It just all happened so fast!

Answered by Dr. Honey Arora (10 hours later)

Brief Answer:
Yes, enamel is not completely mineralized leading to wear off..

Detailed Answer:
Hi..
Welcome Again..

Thanks for the reply..

As far as your answers are concerned, her teeth did not get demineralized within a period of less than a month, rather due to weak enamel as you started brushing, enamel started getting worn off..
In one of the tooth I can also see yellowish discolouration..
All of these are pointing towards enamel hypoplasia only..

You should consult a Pedodontist [Pediatric dentist] and get evaluated..
The dentist can advised either bonding, filling or capping of teeth once the teeth are completely erupted..
As of now Fluoride application, maintaining a good oral hygiene and dietary restrictions can help in decay of teeth further..

In case if you have any further queries, you are most welcome..

Hope this information helps..

Thanks and regards.
Dr.Honey Nandwani Arora.

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Honey Arora (20 minutes later)

I am starting to get concerned now with her bottom teeth do you think this is enamel hypoplasia too?

Answered by Dr. Honey Arora (11 minutes later)

Brief Answer:
Seems like Enamel hypoplasia..

Detailed Answer:
Hi..
Welcome Again..

I have seen the image you attached and it shows a patchy white surface along with brownish staining..
Such features are seen in enamel hypoplasia..
I will again suggest you to consult a Pedodontist and get a proper evaluation done . Treatment will be planned accordingly..

Hope this information helps..

Thanks and regards.
Dr.Honey Nandwani Arora.

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Above answer was peer-reviewed by : Dr. Deepak