“Molar Hypomineralization”, is the name for various defects in the primary and adult molars. Other descriptions include “hypoplastic,” “hypomineralized,” “non-fluoride hypomineralized” or “cheese” molars. However the incisors may be affected at times which has created the commonly used term molar incisor hypopla-sia (MIH) . Recent research shows that it has become a widespread problem .
The cause of these defects is unclear, but a new research may shed some light on the cause. It is important to stress that is it not your child’s fault and you should not blame yourself, that maybe you did something wrong to cause this situation. Research has produced many hints that the problem is, something to do with an illness in infants and that such disturbances may somehow damage the developing tooth. The reason the molars and incisors are affected is largely due to the timing of the interference and the different stages teeth are, in their developmental process in the infant . So the problem seems to boil down to a cause that happens at a certain time (i.e. illness in infants) and, at the same time, some teeth that are at a particular stage in their development which makes them prone to being damaged.
The resulting defects are seen as white-yellow or yellow-brown demarcated opacities that vary greatly in their distribution, size, color and shape. The enamel is soft and, on eruption, chips away easily exposing dentin. These teeth are porous, more susceptible to plaque accumulation and at high risk of being affected by decay. So it is common for both problems to co-exist.
Decay happens when a tooth is attacked by acids, which are produced by bugs in dental plaque. This acid-attack leads to softening of the enamel and subsequently a cavity forms, in hypomineralised teeth (which are already soft and porous), the acid-attack can progress extremely rapidly and cause pain when eating. This is usually an unpleasant surprise to the child and his parents, that the newly erupted tooth may start to crumble even without excess sugars or acids in the diet. For this reason it is important that these teeth are cleaned properly and treated to avoid problems with decay.
The treatment of the hypomineralised teeth starts with early detection. It is important for children to see Dr. Kaufman before their second birthday for the first time. If a hypomineralised tooth is detects the first step is to promote mineralization by using casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) technology to deliver calcium and phosphate to the tooth . Dr Kaufman uses the newly developed fuji 7 EP to both protect and mineralize the newly erupted teeth. Once the teeth are fully erupted we can concentrate on maintaining the existing tooth structure and providing adequate function.
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