Dental issues in adults are rarely met with glee. Dental issues in children are even more complicated because the makeup of a child’s teeth is different than that of an adult’s teeth. Further, children are not as educated on proper oral hygiene and it can often be a battle to get a young child to practice daily oral hygiene.

With that being said, maintaining proper oral health is incredibly important for children. Despite the fact that baby teeth eventually fall out and are replaced by adult teeth, the enamel on baby teeth should still be properly cared for as its development is crucial for healthy adult teeth to form.  

Mottled Enamel: Causes and Concerns

Another term for weak enamel in children is “mottled” enamel. Mottled enamel can be caused by an array of factors. While some can be prevented, some are unfortunately unavoidable. Causes that can be prevented include: the unsupervised eating of a fluoride toothpaste or mouth rinse, an excess of fluoridation in the water that the child consumes, and a mother’s diet during her pregnancy.

Children under the age of six should not use toothpaste or oral rinses that have fluoride as an ingredient. Place your own toothpaste and mouthwash in an area that a child cannot reach. Further, for children under the age of six, it is a good idea to test your home’s tap water to see if it has too much fluoride. If so, a good solution is a water purifier.

Finally, if you are currently pregnant, include your dentist in your overall pregnancy and post-pregnancy plan. Consuming a tooth-healthy diet while you are pregnant, and by feeding your child a tooth-healthy diet post-pregnancy can help strengthen your child’s tooth enamel.  

Causes that cannot be prevented include: a history of high fevers or febrile seizures and developmental conditions. The American Academy of Pediatric Dentistry has found that cells called ameloblasts are largely responsible for the formation of the enamel of the teeth. If these cells have been damaged or have failed to fully develop, tooth enamel cannot develop properly; this weakens the teeth.

Aside from mottled enamel, children can also have a condition called enamel hypoplasia. Enamel hypoplasia is a disorder of the teeth where the enamel is very thin or deficient. This can present as pits or holes in the teeth; if no enamel is present, it can present in sensitivity and pain due to the fact that the inner surfaces of the tooth are fully exposed because of the lack of enamel.

An additional oral defect is enamel hypomineralization. This is caused by too much exposure to fluoride (also called fluorosis). Too much fluoride for children between birth and six years of age can result in severe discoloration of the teeth and improper growth of enamel. Your dentist can recommend a toothpaste without fluoride that is appropriate for your child’s oral health.

Treatment Solutions

As you can see, weakened enamel in children is a dental concern because it can affect the health of a child’s teeth well into adulthood and it can become a painful condition. Treatment options depend on the cause of the weakened enamel as well as how weak the enamel is.

If it is an issue that does not require much medical intervention, regular fluoride treatments (assuming that the cause of the weakened enamel is not hypomineralization) may be all that is needed to strengthen the enamel of the teeth. This, however, will likely not be a treatment option if your child is under the age of six.

The “middle ground” for treatment is usually either the application of sealants, bonding, or stainless-steel crowns. Each of these treatments are meant for teeth that are not overly compromised, but that do require more than just regular fluoride rinses.

Finally, if the teeth are severely affected by weak enamel, extraction may need to occur. While this is the most serious of the treatment options, it is also not as common as the aforementioned treatments available.

An easy way to determine whether or not your child is suffering from weakened enamel is if he or she complains of tooth sensitivity when eating or drinking either hot or cold foods/beverages. By speaking with your dentist and by paying attention to your child’s proper oral hygiene, this condition can be caught quickly and managed.