How to protect children's teeth with enamel problems

Tuesday, 1 January 2019
How to protect children's teeth with enamel problems

Less teeth enamel can occur in children from birth or can develop soon after. Kids with less teeth enamel (hypomineralisation) need special dental care, and diagnosing teeth enamel problems in children at an early age is key to preventing serious teeth problems. 

Cathy Imperial, Inspiro oral hygienist who specialises in dental for children talked to us about the issues she finds when checking children's teeth at school: "I recently visited a local kinder to teach the kids how to take care of their teeth. While there I do a basic dental check-up (called a teeth screening) for the children, this enables us to spot problems early before they become painful and costly."



It can be difficult to brush young children's teeth. 10 tips for brushing your child's teeth.

A common condition that affects the enamel of a tooth: What to do for your child with hypomineralisation

I was in disbelief when the dentist told me my daughter had 11 holes in her teeth:  11 holes in 20 teeth, and only 4 years old

Stop eating foods that harm your teeth: 7 foods to eat for healthy teeth

Did you k now? 1 in 2 Australian children need fillings before age 5

Answers to the 25 most commonly asked dental questions

Our kinder service helped a family; before it was too late

Are you flossing? Here's the easy way to floss


Inspiro dentists and oral hygienists checked 2,500 school children's mouths, that's 70,000 teeth!

Cathy said: "Last year, we did basic check-ups for over 2,500 kids in pre-schools and primary schools. It’s always fun to see them play with the giant toothbrushes and sets of teeth that we use to show how to brush their teeth with. My favourite part is singing the songs about teeth care together – it can get pretty loud and is always entertaining!

After each dental check-up (teeth screening), we give parents and carers a report with recommendations on the next steps to take. Sometimes that means they don’t need to do anything but in many cases the child will need one or more fillings and sometimes we see drastic situations like this: 11 holes in 20 teeth and only 4-years old.

Fortunately for parents, children who are under 12 years old are treated free for all dental work at Inspiro Lilydale. And in addition, our experience with children makes the experience a far easier one for children."

jack dental check up

On this particular visit, we saw a few kids with a condition called enamel hypoplasia and hypomineralisation

Cathy explains that enamel hypoplasia is when a tooth has less enamel than is normal. The enamel that the teeth do have is usually hard and healthy, but there is not enough of it to fully protect the teeth. This usually occurs in certain parts of certain teeth and can result in denting on the surface of the teeth, like a pit. These pits may be more prone to wearing and decay because there is less enamel to protect the tooth.

As you can see below it is not always easy to spot hypoplasia and hypomineralisation

hypoplasia and hypomineralisation

Hypomineralisation of a tooth is when the enamel of a tooth is more porous (think of the surface of a sponge or honeycomb). The texture of the tooth enamel is often rough and holey, which means food, bacteria and plaque are more likely to stick to it. The enamel is also more prone to acid attack from acidic foods and the acid in saliva, so the teeth may erode and decay very quickly.

Hypermineralised enamel is softer than normal enamel

Hypermineralised enamel contains up to 21% less mineral, making it softer than normal enamel. This means there’s also a higher risk of the enamel breaking off. It usually affects the first adult back teeth (molars) and sometimes the incisor teeth.

We can see hypermineralised teeth because they usually look more mottled, with opaque white, yellow or brown spots. Children with hypomineralisation often complain that their teeth are sensitive to cold or hot foods.

Hypoplasia and hypomineralisation are common but can be found early 

There are numerous causes of hypoplasia and hypomineralisation; common causes include infections contracted in early childhood, direct trauma to the teeth and jaws and genetic conditions. Molar hypomineralisation is a complex and challenging condition of developmental origin that may affect up to a fifth of all children. Hypoplasia, hypomineralisation and low tooth enamel can present in children with baby teeth and also in children with adult teeth.

4 year old needs 11 fillings dental for children

If the hypoplasia, hypomineralisation and tooth decay are not detected early on then the results can be devastating

Although more than 75% of enamel defects in the primary teeth of children are considered to be developmental in nature, it’s necessary to get children’s teeth checked regularly to protect and increase the chances of saving any teeth with hypoplasia and hypomineralisation early on. If the hypoplasia, hypomineralisation and tooth decay are not detected early on then the results can be devastating and expensive. I recommend having your child's teeth checked at an early age (no older than 2 years), doing that will help to prevent serious issues like those seen in one of our staff (non dental) members' child's teeth here."

Treatment of low tooth enamel - treatments available for your child if they have hypoplasia - low or no tooth enamel

Different treatments are available depending on how severe the hypoplasia and hypomineralisation is. Treatment could range from treating the affected teeth with a surface sealant, or a crown to protect the tooth. If the tooth cannot be saved, it would be removed. Dentists may also recommend dietary changes and brushing affected with a fluoride desensitizing toothpaste.

The most common causes of enamel defects in children's baby and adult teeth are developmental anomalies and minor facial accidents or injuries. These causes can occur before, during, or after birth of the child. Some of the he treatment options for enamel defects in children include aesthetic composite (filling material) veneering and microabrasion.

Best toothbrush to use for hypoplasia

The best toothbrush to use for low tooth enamel (hypomineralisation)

The best toothbrush to use for hypoplasia, hyperminalisation - low or no tooth enamel is an electric toothbrush with a soft head. Remember to replace the brush head every 3 to 4 months or sooner if the bristles become frayed.

Note: Go easy on your teeth. Brushing too hard or fast can wear down your enamel. So, too, can brushing your teeth immediately after eating sweets or high-acid foods like citrus. These harmful foods soften your enamel, making it easier for your to damage your teeth; wait up to an hour before you clean.

How to protect children's teeth with enamel problems

10 tips for brushing and maintaining teeth with low enamel

Use an electric toothbrush with a soft head

Use a gentle circular motion

Use a pea sized amount of toothpaste with fluoride

Aim the brush at an angle towards the gum line

Use a light back and forth motion on the chewing surfaces

6. Replace your brush approximately every three to four months, or sooner if the bristles become frayed

7. Brush your teeth twice per day and around one hour after eating sugary or highly acidic foods (though its best to avoid sugary foods and sweets). The American Dental Association recommends brushing your teeth twice a day for 2 minutes each time

Use floss and or piksters. Never heard of a pikster? Find out here. Nearly half the surface area of your teeth lies between them! Flossing and using interdental brushes will help remove plaque, food, and bacteria from nearly half your teeth!

Don't forget to brush your tongue

Visit your dentist regularly for professional cleanings and exams. 

10 tips for thorough brushing of your child's teeth

Sometimes it can be difficult to brush young children's teeth. Here are 10 tips for brushing your child's teeth.

How to brush your teeth Inspiro Lilydale

The best toothpaste to use for hypoplasia / hypomineralisation

The best toothpaste to use for low teeth enamel is a toothpaste that contains more fluoride. Keep in mind that you want to make sure that your child does not swallow the toothpaste. Our dentists also recommend applying tooth mouse to your child's teeth every night before bed. 

Research from the Journal of Clinical Dentistry found that a toothpaste which contained sodium chloride, dissolved calcium, phosphate, and fluoride ions reduced the decrease in tooth enamel hardness by a little over 3% and it increased the hardness of soda-weakened enamel by 12 percent when used as a restorative treatment. When shopping for toothpaste, look for remineralizing ones.

fluoride desensitizing toothpaste

Why does hypomineralisation occur in children - enamel hypoplasia causes

When parents find out that their child has low tooth enamel they are often alarmed and shocked, this is a normal reaction. Immediately they ask questions like; "why do children get low enamel (hypomineralisation)", or "what have I done for this to happen, I always make sure that my child brushes his teeth!?" But the most common question is "why does my child have low or no teeth enamel and what can I do?" These questions are usually asked with a look of panic of shock, which is completely understandable.

It’s pointless to blame yourself

In most cases of child hypoplasia it’s pointless to blame yourself or feel like you have failed your child. Several theories have been presented as to why hypermineralisation in children occurs but there is still no consensus in all cases. What we do know is that brushing often using a high fluoride toothpaste, using tooth mouse before bed and limiting consumption of sugary foods (here's 7 foods your should eat to maintain healthy teeth) will significantly decrease the likelihood of ongoing tooth decay.  

Free teeth check and dental work for children

Book an appointment with one of our dentists today by calling 9028 0153 

If you are a kinder or primary school teacher and would like our dental outreach team to do a dental screening for your class or school, please call us on 9028 0153

Inspiro provides local residents with key health services

Inspiro provides dental, physiotherapy, counselling, occupational therapy, adult speech therapy, child speech therapy, podiatry, child & family support, dietetics & nutrition advice, diabetes education, an on-site GP & skin clinic, small loans for those in need and My Aged Care and aged care services to the Yarra Ranges community.


Get inspiro email newsletter

Fear of going to the dentist

Fear of going to the dentist is one of the biggest anxiety disorders and affects about one in seven Australian adults, making it one of the most prevalent anxiety disorders in the country. Avoiding going to dentist or not going regularly can lead to decayed, damaged and missing teeth. 

Many parents put of  going to the dentist and often do the same for their children, in many cases not taking their child to the dentist until they are over 5 years old. If this happens then hypoplasia can cause huge dental bills and trauma for young children.

Don't let fear ruin your teeth or smile (of your child's teeth)

For some adults and children, fear of the dentist can be the result of a bad experience as a child. Others are more likely to be afraid of going to the dentist if they consider it to be uncontrollable, unpredictable, or dangerous.

For many years I was one of these adults. I was not just fearful. I was absolutely petrified. The experience which instilled fear into me was a certain dentist appointment when I was a child that... read more here.

Fear of the dentist effects one in seven Australians - dont' let fear ruin your teeth