Dental Health

How to solve enamel hypoplasia: causes, symptoms, types

Have you noticed that your child has stains on his teeth? How to solve enamel hypoplasia: First of all, you should know that different disorders can cause marks or darkening of some areas of the teeth.

When it comes to children, we rule out many of these possibilities. For example, they are not associated with the consumption of certain foods, alcoholic beverages, tobacco, etc. However, they can be related to the ingestion of acidic foods, sugary drinks, certain medications, bruxism, or poor oral hygiene.

In some cases, it is not a question of any of these factors, but rather a condition known as dental hypoplasia or enamel hypoplasia. This condition consists of an underdevelopment of the enamel that causes the appearance of stains on the teeth.

We can say that the enamel does not develop enough. If the condition is mild, the marks are barely noticeable. On the other hand, if it is more advanced, the stains will be very evident and can lead to other more serious dental problems: tooth deterioration, cavities, tooth sensitivity, gingivitis, etc.

What is enamel hypoplasia?

Dental hypoplasia is a disease that reduces the presence of enamel. While it is true that most of the time it occurs in children, adults also have this problem.

The lesions appear with white spots on one or more teeth. In fact, in some cases, they can be brown and, in the worst case, gaps occur in the teeth. Depending on the level of involvement, the appearance of the tooth can be quite deteriorated.

Dental hypoplasia is responsible for the existence of thin enamel. Therefore, teeth are more sensitive to the appearance of cavities. They can arise in any tooth. However, they are more common in the incisors.

What is tooth enamel hypoplasia in children?

Dental hypoplasia is a lack of enamel in children’s baby teeth. Their teeth may have transparent teeth, translucent teeth, or white spots on children’s teeth. 

Tooth enamel is a substance made up of minerals and is characterized by its hardness. This compound is responsible for protecting teeth from external agents. The lack of enamel mineralization during tooth formation that causes dental hypoplasia in children can be mild, moderate, or severe. 

Why does enamel hypoplasia occur?

The causes that cause hypoplasia are not known since, since it occurs during the growth stage, it can appear for multiple reasons, hereditary, deficiencies, or development during childhood. 

It can also be caused by diseases such as celiac disease or damage to the teeth. Likewise, this disease can develop during pregnancy since some babies are born with hypoplasia due to a lack of vitamin D. Other reasons are also malnutrition, infections, or fever. Medications also play an important role as some can affect tooth growth.

How do I know if I have weak enamel?

Dental hypoplasia manifests itself through white or brown spots, which is the symptom of enamel that is much weaker than usual, making it more prone to cavities, fractures, and wear. Depending on the degree of hypoplasia suffered, the spots tend to be more whitish in milder cases, while in severe cases they acquire a more yellowish-brown tone.

It also causes small gaps between teeth due to erosion and wear, as well as tooth sensitivity to the temperature of food.

Depending on the development of the hypoplasia, and if it has been treated in time, the effect will be almost imperceptible or it may show very damaged teeth.

Why is it so important to treat enamel hypoplasia?

In addition to the clear aesthetic defect caused by the presence of dental stains, dental hypoplasia carries a series of risks for the patient’s health.

Tooth enamel has the function of protecting teeth from possible external damage. In cases of hypoplasia (insufficient tooth enamel), the enamel cannot protect the teeth effectively, which allows the entry of bacteria and favors the formation of dental and/or periodontal diseases.

Caries is the most common dental disease in children, and dental hypoplasia is one of the elements that can facilitate its development.

How is enamel hypoplasia in children treated?

Tooth enamel does not regenerate on its own, so, to eliminate stains, a dental treatment is necessary to eliminate them.

When dental stains appear on baby teeth, the recommendations of specialists will be very important to prevent hypoplasia from also affecting permanent teeth.

If dental hypoplasia arises in children with permanent teeth, a good option is to opt for dental sealing, that is, the inclusion of filling material (the same color as the teeth in good condition) in areas with white or brown spots.

Types of enamel hypoplasia

*Teeth with opaque areas in the enamel. They may also present spots or color changes to white or yellowish tones.

*Yellow coating on the tooth, opacity, or brown spots on the enamel.

*Tooth with a hypoplastic-type defect in the form of a hole or depression.

*Dental piece with a line of hypoplasia in the form of a groove. It can be horizontal or transversal.

*Line of hypoplasia in the form of a groove with a vertical orientation.

*It is the most severe type. The tooth has a hypoplastic defect in which the enamel is absent.

Symptoms of enamel hypoplasia

The most relevant symptoms of dental hypoplasia are the following:

*Dental erosions: these are very small gaps that appear in one to several teeth.

*Stains on teeth: Stains range from small white spots, in mild situations, to large yellow stains. When it comes to severe enamel hypoplasia, the color of the spots is brown.

*Tooth sensitivity: in these cases, the patient experiences pain when eating very hot or cold foods. There are also problems when consuming acidic foods. This happens because the dentin is more sensitive than normal.

When the case of dental hypoplasia is mild, the symptoms are practically undetectable. In most cases, they are detected at a more advanced stage.

Signs of childhood tooth enamel hypoplasia

The alterations or symptoms that children who suffer from dental enamel hypoplasia manifest are the following: 

*Brown, yellowish, or white spots on the teeth.

*Erosion in the teeth in the form of fissures, cavities, or holes.

*Tooth sensitivity due to the lack of protection of the dentin, they may suffer pain when ingesting cold or hot products or acidic foods such as citrus fruits.

If you notice any of these symptoms in your son or daughter, we recommend that you immediately go to the pediatric dentist’s office to diagnose your little one’s oral problem.

Causes of enamel hypoplasia

And what is the reason why the enamel does not develop correctly? It is not always easy to determine the origin of the condition, since the problem occurs during the first years of the baby’s life and manifests itself later.

Below we explain the possible causes of dental hypoplasia in children. However, when it occurs in adults, other factors can cause its appearance:

*Brushing that is too abrasive or using a brush with very hard bristles. This causes progressive damage to the enamel, as well as the appearance of stains.

*Another cause of enamel damage could be cavities or bruxism. This second is what we know as the famous teeth grinding that many people suffer unconsciously, generally at night and due to stress, although it can also occur during the day.

*Finally, when the person vomits frequently, the excess acids also deteriorate the enamel. This would happen in diseases such as bulimia, gastroesophageal reflux disorder, or during pregnancy.

Development problems during pregnancy or premature birth:

Children born before the 37th week of gestation or with low birth weight are more likely to have hypoplasia or defects in tooth enamel. A higher incidence has also been related to when the birth is by cesarean section or when it is a multiple birth.

On the other hand, some diseases or deficiencies of the pregnant mother can also affect dental development. For example, when she suffers from a high fever or as a side effect of some medications.

This disease has also been linked to a lack of vitamin D during pregnancy. This deficiency is also linked to a greater risk of suffering from cavities.

And what could be the cause of a lack of vitamin D during pregnancy? It may be due to an incorrect or nutrient-poor diet or insufficient exposure to sunlight.


Chickenpox, measles, or scarlet fever are some of the infectious diseases that can cause dental hypoplasia. It may also be that the child suffers from a localized infection in the mouth. In this case, hypoplasia could be detected right in the affected tooth.

Poor Nutrition:

We know that a nutrient-poor diet affects children’s development. In the case of dental hypoplasia, these are the nutrients whose deficiency is related to problems and alterations in the enamel:

*Vitamin A: It is a fundamental nutrient for oral health, both for the minerals that make up tooth enamel and for healthy gums. It also helps prevent dry mouth and improves the healing of wounds in the mouth.

*Vitamin C: This antioxidant vitamin is very beneficial for teeth and gums, and is needed to prevent periodontal disease or teeth from becoming loose. Its deficiency is related to bleeding gums and weakening of the enamel.

*Vitamin D: Vitamin D has two very important functions related to tooth enamel. On the one hand, it increases mineral density. On the other hand, calcium needs to reach the bones that support the teeth.

*Calcium: Calcium, combined with vitamin D so that it can be absorbed, is essential during dental development. The lack of this mineral causes the enamel to become thin and weak, or to become dull, whitish, or discolored in places. In addition, it can also lead to greater sensitivity to some foods.

Dental Fluorosis:

We have already mentioned fluorosis, a condition that can be confused with dental hypoplasia because it has similar symptoms. In both cases, the enamel does not develop well and the treatment is the same.

In any case, it is important to know about this disorder because of the consequences that overexposure to fluoride can have. Fluoride has proven to be a very beneficial mineral for teeth, but, like almost everything in excess, exceeding the limits is harmful at an early age.

What are the sources of fluoride to which a child is exposed? First of all, toothpaste or rinses that are not suitable for their age or that the child swallows instead of spitting out. Therefore, the help and supervision of parents is essential during brushing until they learn to do it on their own.

Other sources of fluoride are drinking water, some supplements, and even certain foods. We insist that the problem is not fluoride, but excessive consumption during childhood.


Side effects of some medications include the possibility of damage to tooth enamel. These are the most notable:

*Tetracycline: Today this antibiotic is no longer prescribed for children under eight years of age.

*Chlorhexidine: Antimicrobial with harmful effects if used long term.

*Antidepressants, diuretics, and antihistamines: All medications that inhibit saliva also hurt the mouth. Saliva not only protects the enamel but also participates in its remineralization and facilitates its repair.

*Aspirin: Due to its high acidity, it is very important to take it appropriately and avoid contact with the teeth.*Chemotherapy: Both chemotherapy and radiotherapy cause defects in any part of the tooth (enamel, dentin, root, etc.).

Diagnosis of dental enamel hypoplasia

Tooth enamel hypoplasia can be evident with small white or opaque spots on the teeth. But in more serious cases, brown spots can be observed. Although, it is always the dentist who, with his knowledge and experience, can detect this condition.

Diagnostic process:

The dentist during a consultation performs a physical evaluation of the patient’s teeth. During this examination, she will try to find signs of dental neoplasia, such as the tooth enamel appearing thinner, with an opaque tone, or that it has changed its white color. Hypoplasia can also be evident by small pits or concavities in the enamel.

In addition to the physical checkup by the dentist, there are some techniques and tools that help achieve a more accurate assessment of oral health and the state of tooth enamel.

Diagnostic tools and techniques:

X-rays, enamel translucency tests, or microscopy are two tools that the dentist can use to make a more precise diagnosis of dental hypoplasia.

X-rays can show underlying damage to the layer that covers the teeth that may not be visible to the naked eye.

For its part, the enamel translucency test is performed to measure the amount of light that can pass through tooth enamel. When the tooth is opaque or the enamel is very thin, this causes more light to pass through, which can be an indicator of the presence of dental enamel hypoplasia.

With microscopy, tooth enamel can be analyzed in more detail and thus know what condition it is in, and detect signs of problems such as hypoplasia.

Identifying dental hypoplasia in time allows the oral health professional to offer appropriate treatment to the patient.

Tips to keep your enamel healthy

Taking care of your tooth enamel is very important, especially if you suffer from hypoplasia.

Below, we give you some basic tips that will help you keep your tooth enamel in good condition.

*Don’t smoke tobacco: The toxic elements in tobacco adhere to your teeth, weakening the enamel. In addition, they encourage the proliferation of bacteria in the mouth.

*Don’t brush too many times a day: brushing too much and brushing with a hard-bristled brush or in an inappropriate way wears down the enamel.

*Moderate sugar consumption: sugary food residue that sticks attracts a greater number of bacteria. When they break down, they produce an acid that demineralizes tooth enamel. That is why you need to control your sugar and starch consumption

*Use products with fluoride: Use mouthwash and toothpaste with fluoride.

Tips to prevent childhood dental hypoplasia

However, you should be aware that dental hypoplasia in many cases cannot be avoided no matter how many preventative measures and care you take: 

*Use a soft brush in your daily oral hygiene routine to avoid wearing down tooth enamel.

*Go to your trusted dental clinic regularly, especially during the first years of life, since the teeth and jaw are developing.

*Reduce the intake of sugary or acidic products, as they demineralize the teeth and help the proliferation of bacteria and, therefore, dental cavities.

Prevention of tooth enamel hypoplasia

As we mentioned, hypoplasia generally originates during the mother’s gestation period or in the first months of the baby’s life. To avoid it, the mother must maintain a balanced diet during pregnancy and consume the vitamins recommended by the doctor.

But, after birth, there are also certain care and habits that are necessary to prevent the condition or to prevent it from becoming more serious.

Oral hygiene habits:

A proper oral hygiene routine can help avoid hypoplasia. To achieve this, you must brush at least twice a day, for 2 minutes, with a soft-bristle brush and a toothpaste with fluoride. Brushing should be completed with the use of dental floss, at least once a day, to remove plaque and food residue that can lodge between the teeth and produce plaque or bacteria.

It is essential to teach children to have correct oral hygiene habits.

Regular visits to the dentist:

Another form of prevention is to take the child to the dentist before the first year of age and have him examine the development of his teeth and jaw. An early evaluation allows us to detect if there is hereditary hypoplasia, and in this way, it is possible to develop an effective action plan.

To achieve a timely diagnosis, it is necessary to schedule check-ups with the pediatric dentist every six months, starting at 12 months of age or from when the first tooth begins to emerge.

Diet and nutrition:

If the child is likely to develop hypoplasia, consult with the doctor and dentist if he or she should consume vitamin A or D supplements. Because these are of great help for the development of teeth.

When the baby begins to eat solid foods, it is key that he consumes foods rich in calcium, phosphorus, and vitamin D. A good amount of green leaves and other foods such as milk and yogurt should be included in his diet, which promote good teeth formation.

It is also important to avoid consuming sugary or acidic foods and drinks.

Since the exact cause of hypoplasia is unknown in some cases, even if the necessary preventive measures are taken, it occurs in the same way.

How to solve enamel hypoplasia: treatment

Dental hypoplasia treatment is as explained below:

Remineralizing pastes:

These pastes contain minerals such as calcium and fluoride that can help strengthen weakened tooth enamel and prevent tooth decay.

Crack sealing

Dental sealants can help protect teeth affected by dental hypoplasia by sealing fissures and preventing plaque from accumulating on the teeth.

Dental veneers

When the damage caused by hypoplasia is severe, one of the recommended treatments is the placement of dental veneers.

These are small, thin sheets of mostly porcelain or ceramic that are placed on the visible surface of the teeth. They are ideal for correcting both aesthetic and functional problems of teeth.


This procedure involves removing a small layer of tooth enamel by applying a mild acid. This can improve the appearance of teeth affected by dental hypoplasia and reduce tooth sensitivity.

Teeth whitening

Teeth whitening can improve the appearance of teeth affected by dental hypoplasia and make them appear whiter and brighter. If you don’t know what teeth whitening consists of and the types there are, we leave you all the information in our post.

Tooth filling

In cases of tooth decay, a dental filling can be performed to remove the decay and restore the affected tooth.

Veneers or crowns

In more severe cases of dental hypoplasia, it may be necessary to use dental veneers or crowns to cover the affected teeth and improve their appearance and function.

Dental implants

In extreme cases where teeth are too damaged to be repaired, dental implants can be placed to replace missing teeth.

Dental implant or bridge

In the most severe cases of hypoplasia, the tooth must be removed and replaced with a dental implant. This treatment consists of replacing the roots of the teeth with pins that are fixed to the jaw bone and placing a crown or artificial piece that is similar to the superficial part of the natural piece. This, in addition to returning functionality to the mouth, allows it to preserve its aesthetics.

After undergoing any of these treatments, you should visit your dentist periodically or as often as your dentist tells you to. In this way, you will evaluate if the results were satisfactory.

It is also important that you maintain good eating and dental hygiene habits.

When should you take your child to the dentist?

Finally, to treat dental hypoplasia or any other condition as quickly and effectively as possible, it is important to make regular visits to the dentist. Whether you have seen stains or any other abnormality, or if you have not detected anything, the dentist is the one who can do a thorough evaluation.

These are the recommendations by age when taking children to the dentist :

*Before the age of two: The first visit to the dentist when the first teeth erupt is intended to check that the child’s oral health is good. In addition, it is time to clarify parents’ doubts and learn in detail how to start carrying out daily dental hygiene with a toothbrush and toothpaste from the age of 3. For example, do you know that you should clean your baby’s mouth and gums with a moistened gauze pad or a silicone thimble once a day?

*Between three and six years: Possible spots that indicate dental hypoplasia or fluorosis; bad habits, such as thumb sucking; chewing problems; deformations in the teeth, etc. It is time to prevent more serious problems.

*Between six and twelve years: Control and monitoring of the replacement of baby teeth with permanent ones. It is essential to become aware of the importance of correct dental hygiene at these ages.

*Adolescence: Cavities, misaligned teeth, oral diseases… The health and aesthetics of your smile are important and today we have effective, quick, and discreet treatments so as not to alter your pace of life.

Read more: The 13 most common oral diseases