dental enamel hypoplasia


Summary: An acquired or hereditary condition due to deficiency in the formation of tooth enamel (AMELOGENESIS). It is usually characterized by defective, thin, or malformed DENTAL ENAMEL. Risk factors for enamel hypoplasia include gene mutations, nutritional deficiencies, diseases, and environmental factors.

Top Publications

  1. Li Y, Navia J, Bian J. Prevalence and distribution of developmental enamel defects in primary dentition of Chinese children 3-5 years old. Community Dent Oral Epidemiol. 1995;23:72-9 pubmed
    ..05), and mean EDS (P < 0.05). Children born prematurely were shown to have four times more enamel lesions than children who were full term (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) ..
  2. Matee M, van T Hof M, Maselle S, Mikx F, van Palenstein Helderman W. Nursing caries, linear hypoplasia, and nursing and weaning habits in Tanzanian infants. Community Dent Oral Epidemiol. 1994;22:289-93 pubmed
  3. Guergolette R, Dezan C, Frossard W, Ferreira F, Cerci Neto A, Fernandes K. Prevalence of developmental defects of enamel in children and adolescents with asthma. J Bras Pneumol. 2009;35:295-300 pubmed
    ..08) or the frequency of medication use (p = 0.93). Pediatric patients with severe, early-onset asthma are at increased risk of dental enamel defects and therefore require priority dental care. ..
  4. Kanagaratnam S, Schluter P, Durward C, Mahood R, Mackay T. Enamel defects and dental caries in 9-year-old children living in fluoridated and nonfluoridated areas of Auckland, New Zealand. Community Dent Oral Epidemiol. 2009;37:250-9 pubmed publisher
    ..Guidelines and health-promotion strategies that enable children to minimize their risk to diffuse opacities yet reduce their risk of dental caries should be reviewed. ..
  5. Chaves A, Rosenblatt A, Oliveira O. Enamel defects and its relation to life course events in primary dentition of Brazilian children: a longitudinal study. Community Dent Health. 2007;24:31-6 pubmed
    ..To evaluate the cumulative incidence of enamel defects (ED) and its correlation with life course events such as malnutrition and pre- and postnatal infections, in a cohort of children of low socioeconomic status...
  6. Lunardelli S, Peres M. Breast-feeding and other mother-child factors associated with developmental enamel defects in the primary teeth of Brazilian children. J Dent Child (Chic). 2006;73:70-8 pubmed
    ..4) were associated with defects in tooth enamel after adjusting for possible confounding variables. In this study, premature children and those who did not breast-feed could be considered at risk for developing defects in tooth enamel. ..
  7. Mackay T, Thomson W. Enamel defects and dental caries among Southland children. N Z Dent J. 2005;101:35-43 pubmed
    ..While this benefit also exacts a "biological price" in terms of a greater prevalence of diffuse opacities, the clinical, social and public health significanceof those opacities remains unclear. ..
  8. Sujak S, Abdul Kadir R, Dom T. Esthetic perception and psychosocial impact of developmental enamel defects among Malaysian adolescents. J Oral Sci. 2004;46:221-6 pubmed
    ..Two-thirds of the subjects were affected by enamel defects involving at least one tooth; however, the esthetic perception and psychosocial impact of those affected were minor. ..
  9. Broadbent J, Thomson W, Williams S. Does caries in primary teeth predict enamel defects in permanent teeth? A longitudinal study. J Dent Res. 2005;84:260-4 pubmed
    ..3, 95% CI 1.3, 4.1; adjusted OR = 2.2, 95% CI 1.1, 4.3). These findings support a time-ordered association between dental caries in primary maxillary incisors and demarcated opacities in their permanent successors. ..

More Information


  1. Ford D, Seow W, Kazoullis S, Holcombe T, Newman B. A controlled study of risk factors for enamel hypoplasia in the permanent dentition. Pediatr Dent. 2009;31:382-8 pubmed
    ..By contrast, drinking optimally fluoridated water at 0 to 3 years old reduces the risk for enamel opacities. ..
  2. Jasulaityte L, Weerheijm K, Veerkamp J. Prevalence of molar-incisor-hypomineralisation among children participating in the Dutch National Epidemiological Survey (2003). Eur Arch Paediatr Dent. 2008;9:218-23 pubmed
    ..1%) who had both molars and incisors affected. A significantly higher prevalence of MIH has been found in Dutch 9 year-old children in the last National Epidemiological Survey of 2003 as compared with to the Survey of 1999. ..
  3. Targino A, Rosenblatt A, Oliveira A, Chaves A, Santos V. The relationship of enamel defects and caries: a cohort study. Oral Dis. 2011;17:420-6 pubmed publisher
    ..Is there a relationship between enamel defects and early childhood caries?..
  4. Alaluusua S. Aetiology of Molar-Incisor Hypomineralisation: A systematic review. Eur Arch Paediatr Dent. 2010;11:53-8 pubmed
    ..Experimental dose/response studies and research on the molecular mechanisms causing the abnormal function of the ameloblasts are also necessary to deepen our knowledge of MIH. ..
  5. Velló M, Martinez Costa C, Catala M, Fons J, Brines J, Guijarro Martínez R. Prenatal and neonatal risk factors for the development of enamel defects in low birth weight children. Oral Dis. 2010;16:257-62 pubmed publisher
    ..Orotracheal intubation probably plays an important role as a result of laryngoscope trauma on the maxilla. ..
  6. Mostowska A, Biedziak B, Jagodzinski P. Axis inhibition protein 2 (AXIN2) polymorphisms may be a risk factor for selective tooth agenesis. J Hum Genet. 2006;51:262-6 pubmed
    ..This alternation may negatively affect the splicing process and cellular concentration of AXIN2 protein. Our findings suggest that AXIN2 polymorphic variants may be associated with both hypodontia and oligodontia. ..
  7. Casanova Rosado A, Medina Solis C, Casanova Rosado J, Vallejos Sánchez A, Martinez Mier E, Loyola Rodriguez J, et al. Association between developmental enamel defects in the primary and permanent dentitions. Eur J Paediatr Dent. 2011;12:155-8 pubmed
    ..38 times [95% CI = 1.17-1.64; p < 0.001]. An association between DED presence in both permanent and primary dentitions was observed. Further studies are necessary to fully characterise such relationship. ..
  8. Zhou Y, Lin H, Lo E, Wong M. Risk indicators for early childhood caries in 2-year-old children in southern China. Aust Dent J. 2011;56:33-9 pubmed publisher
    ..0-20%, OR = 5.71], and S. mutans [?10(5) CFU/ml vs. 0 CFU/ml, OR = 3.80]. Social, behavioural and biological factors during the life course of 2-year-old children in southern China are associated with the development of ECC. ..
  9. Grošelj M, Jan J. Molar incisor hypomineralisation and dental caries among children in Slovenia. Eur J Paediatr Dent. 2013;14:241-5 pubmed
  10. Corrêa Faria P, Martins Junior P, Vieira Andrade R, Oliveira Ferreira F, Marques L, Ramos Jorge M. Developmental defects of enamel in primary teeth: prevalence and associated factors. Int J Paediatr Dent. 2013;23:173-9 pubmed publisher
    ..7; 95% CI, 1.66-4.61). Prematurity and socio-demographic variables were not associated with enamel defects. ? Children with a history of very low birthweight had a greater frequency of enamel defects in primary teeth. ..
  11. Wong H, McGrath C, Lo E, King N. Photographs as a means of assessing developmental defects of enamel. Community Dent Oral Epidemiol. 2005;33:438-46 pubmed
    ..71-0.95). Multiple-view photographic slides of 'five-view' and 'three-view' are valid and reliable for assessing DDE on the 12 anterior teeth, while a 'one-view' (frontal) was acceptable to study only the incisors. ..
  12. Elfrink M, Ten Cate J, Jaddoe V, Hofman A, Moll H, Veerkamp J. Deciduous molar hypomineralization and molar incisor hypomineralization. J Dent Res. 2012;91:551-5 pubmed publisher
    ..4% at tooth level. The Odds Ratio for MIH based on DMH was 4.4 (95% CI, 3.1-6.4). The relationship between the occurrence of DMH and MIH suggests a shared cause and indicates that, clinically, DMH can be used as a predictor for MIH. ..
  13. Martínez Gómez T, Guinot Jimeno F, Bellet Dalmau L, Giner Tarrida L. Prevalence of molar-incisor hypomineralisation observed using transillumination in a group of children from Barcelona (Spain). Int J Paediatr Dent. 2012;22:100-9 pubmed publisher
    ..003). The population studied showed a prevalence of MIH of 17.8%. The presence of the defect did not differ according to sex in this population. Defects were more common among teeth in the maxilla. ..
  14. Cruvinel V, Gravina D, Azevedo T, Rezende C, Bezerra A, Toledo O. Prevalence of enamel defects and associated risk factors in both dentitions in preterm and full term born children. J Appl Oral Sci. 2012;20:310-7 pubmed
  15. Jälevik B. Prevalence and Diagnosis of Molar-Incisor- Hypomineralisation (MIH): A systematic review. Eur Arch Paediatr Dent. 2010;11:59-64 pubmed
    ..Further standardization of study design and methods is needed to make the results comparable. ..
  16. Zhou Y, Yang J, Lo E, Lin H. The contribution of life course determinants to early childhood caries: a 2-year cohort study. Caries Res. 2012;46:87-94 pubmed publisher
    ..mutans were risk predictors for ECC of the children. There appears to be a relationship between socioeconomic, behavioural and biological factors and ECC. Early life factors play an important role in the development of ECC. ..
  17. Kazoullis S, Seow W, Holcombe T, Newman B, Ford D. Common dental conditions associated with dental erosion in schoolchildren in Australia. Pediatr Dent. 2007;29:33-9 pubmed
    ..Dental erosion is strongly associated with caries experience and enamel hypoplasia. ..
  18. Hong L, Levy S, Warren J, Broffitt B. Association between enamel hypoplasia and dental caries in primary second molars: a cohort study. Caries Res. 2009;43:345-53 pubmed publisher
    ..Enamel hypoplasia appears to be a significant risk factor for caries and should be considered in caries risk assessment. ..
  19. Masumo R, Bårdsen A, Mashoto K, Astrøm A. Prevalence and socio-behavioral influence of early childhood caries, ECC, and feeding habits among 6-36 months old children in Uganda and Tanzania. BMC Oral Health. 2012;12:24 pubmed publisher
  20. Ortega Páez E, Junco Lafuente P, Baca García P, Maldonado Lozano J, Llodra Calvo J. Prevalence of dental enamel defects in celiac patients with deciduous dentition: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:74-8 pubmed publisher
    ..Dental examination of these defects may be useful to alert for this disease. ..
  21. Fagrell T, Ludvigsson J, Ullbro C, Lundin S, Koch G. Aetiology of severe demarcated enamel opacities--an evaluation based on prospective medical and social data from 17,000 children. Swed Dent J. 2011;35:57-67 pubmed
    ..We conclude that nutritional conditions during first 6 months of life may influence the risk to develop severe demarcated opacities in first permanent molars...
  22. Arrow P. Risk factors in the occurrence of enamel defects of the first permanent molars among schoolchildren in Western Australia. Community Dent Oral Epidemiol. 2009;37:405-15 pubmed publisher
    ..The effects of residential location and the association between deciduous tooth caries experience and enamel defects require further investigations. ..
  23. Farsi N. Developmental enamel defects and their association with dental caries in preschoolers in Jeddah, Saudi Arabia. Oral Health Prev Dent. 2010;8:85-92 pubmed
    ..The prevalence of enamel defects and caries was high, as the enamel defects were strongly associated with caries; therefore, this association must be considered when focusing on the prevalence of caries in the Saudi community. ..
  24. Robles M, Ruiz M, Bravo Perez M, González E, Peñalver M. Prevalence of enamel defects in primary and permanent teeth in a group of schoolchildren from Granada (Spain). Med Oral Patol Oral Cir Bucal. 2013;18:e187-93 pubmed
    ..The study population showed a high prevalence of DDE in primary as well as in permanent dentition, reflecting the current increasing trend of this condition, which should be considered as a significant public health problem. ..
  25. Arrow P. Prevalence of developmental enamel defects of the first permanent molars among school children in Western Australia. Aust Dent J. 2008;53:250-9 pubmed publisher
    ..Majority of defects were white diffuse opacities and the prevalence of demarcated opacities is at the high end of that reported for some European countries. Possible risk factors for enamel defects remains to be tested. ..
  26. Elfrink M, Schuller A, Veerkamp J, Poorterman J, Moll H, ten Cate B. Factors increasing the caries risk of second primary molars in 5-year-old Dutch children. Int J Paediatr Dent. 2010;20:151-7 pubmed publisher
    ..These aetiological factors associated with childhood dental caries need to be investigated further in longitudinal clinical trials. ..
  27. Montero M, Douglass J, Mathieu G. Prevalence of dental caries and enamel defects in Connecticut Head Start children. Pediatr Dent. 2003;25:235-9 pubmed
    ..The prevalence of caries and defects in these Head Start children was high, with most defects located on anterior teeth. Enamel defects were associated with an increased caries incidence. ..
  28. Grisart B, Rack K, Vidrequin S, Hilbert P, Deltenre P, Verellen Dumoulin C, et al. NF1 microduplication first clinical report: association with mild mental retardation, early onset of baldness and dental enamel hypoplasia?. Eur J Hum Genet. 2008;16:305-11 pubmed publisher
    ..Main phenotypic features are mental deficiency, early onset of baldness (15 years old), dental enamel hypoplasia and minor facial dysmorphism...
  29. Hoffmann R, de Sousa M, Cypriano S. [Prevalence of enamel defects and the relationship to dental caries in deciduous and permanent dentition in Indaiatuba, São Paulo, Brazil]. Cad Saude Publica. 2007;23:435-44 pubmed
    ..The results of this study indicated that children had increased odds of dental caries when enamel defect was present, both in deciduous and permanent dentition; further studies are needed to give evidence to this association...
  30. Oliveira A, Chaves A, Rosenblatt A. The influence of enamel defects on the development of early childhood caries in a population with low socioeconomic status: a longitudinal study. Caries Res. 2006;40:296-302 pubmed
    ..0001). Enamel defects are strongly associated with early childhood caries and, therefore, this correlation must be considered when focussing on low-socioeconomic communities. ..
  31. Mohamed A, Thomson W, Mackay T. An epidemiological comparison of Dean's index and the Developmental Defects of Enamel (DDE) index. J Public Health Dent. 2010;70:344-7 pubmed publisher
    ..Although the use of Dean's index is important for historical comparisons, investigators should appreciate its limitations. ..
  32. Seow W, Ford D, Kazoullis S, Newman B, Holcombe T. Comparison of enamel defects in the primary and permanent dentitions of children from a low-fluoride District in Australia. Pediatr Dent. 2011;33:207-12 pubmed
    ..In the primary dentition, the predominant defects were demarcated opacities and missing enamel, while in the permanent dentition, the defects were more variable. ..
  33. Lunardelli S, Peres M. Prevalence and distribution of developmental enamel defects in the primary dentition of pre-school children. Braz Oral Res. 2005;19:144-9 pubmed
    ..1% (CI 95% 11.7-18.5) was observed, with the most affected teeth being the canines (33.6%) and second molars (33.6%). One quarter of the pre-school children presented enamel defects, with diffuse opacities being the most prevalent ones. ..
  34. Seow W. Enamel hypoplasia in the primary dentition: a review. ASDC J Dent Child. 1991;58:441-52 pubmed
    ..It is likely that many of these individual factors may in fact act through a central mechanism: mineral deficiency. ..
  35. Clarkson J, O Mullane D. Prevalence of enamel defects/fluorosis in fluoridated and non-fluoridated areas in Ireland. Community Dent Oral Epidemiol. 1992;20:196-9 pubmed
    ..The prevalence of enamel fluorosis/defects was similar in children living in fluoridated and non-fluoridated areas but the prevalence of diffuse opacities (DDE) was higher in the fluoridated areas. ..
  36. Nation W, Matsson L, Peterson J. Developmental enamel defects of the primary dentition in a group of Californian children. ASDC J Dent Child. 1987;54:330-4 pubmed
    ..The most frequently given was hyperbilirubinemia. ..
  37. King T, Hillson S, Humphrey L. A detailed study of enamel hypoplasia in a post-medieval adolescent of known age and sex. Arch Oral Biol. 2002;47:29-39 pubmed
    ..5 years and the last growth disruption occurred when she was 4.6 years of age. The distribution of the defects was examined to identify any seasonal pattern in the occurrence of the growth disturbances. ..
  38. Slayton R, Warren J, Kanellis M, Levy S, Islam M. Prevalence of enamel hypoplasia and isolated opacities in the primary dentition. Pediatr Dent. 2001;23:32-6 pubmed
  39. Seow W, Amaratunge A, Bennett R, Bronsch D, Lai P. Dental health of aboriginal pre-school children in Brisbane, Australia. Community Dent Oral Epidemiol. 1996;24:187-90 pubmed
    ..It is hypothesized that the high levels of underlying developmental enamel defects, compounded by low fluoride exposure, poor oral hygiene and a diet high in refined sugars pose an important caries risk factor in this group of children. ..
  40. Jälevik B, Klingberg G, Barregard L, Noren J. The prevalence of demarcated opacities in permanent first molars in a group of Swedish children. Acta Odontol Scand. 2001;59:255-60 pubmed
    ..5% had severe defects, 5% had moderate defects, whereas 7% had only mildly hypomineralized teeth. In conclusion, hypomineralized first molars appeared to be common and require considerable treatment in the Swedish child population. ..
  41. Sedano H, Moreira L, de Souza R, Moleri A. Otodental syndrome: a case report and genetic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:312-7 pubmed
    ..The parents of the child were not aware of any similarly affected relatives. Suggestions with respect to possible genetic mechanisms and gene participation in the etiology of this syndrome are offered. ..
  42. Batina N, Renugopalakrishnan V, Casillas Lavín P, Guerrero J, Morales M, Garduno Juarez R, et al. Ultrastructure of dental enamel afflicted with hypoplasia: an atomic force microscopic study. Calcif Tissue Int. 2004;74:294-301 pubmed
    ..In some samples, the HYP part of enamel surface appeared in the form of a point-defect, which we believe may be associated with the early stages of the HYP deformation. ..
  43. Oka A, N Cho K, Bakayoko Ly R. [Complications of injuries to deciduous teeth]. Odontostomatol Trop. 2003;26:36-40 pubmed
    ..Some of these complications observed in some patients are stakes in evidence by some iconographic illustrations. ..
  44. DenBesten P, Zhu L, Li W, Tanimoto K, Liu H, Witkowska H. Fluoride incorporation into apatite crystals delays amelogenin hydrolysis. Eur J Oral Sci. 2011;119 Suppl 1:3-7 pubmed publisher
  45. Kevrekidou A, Kosma I, Arapostathis K, Kotsanos N. Molar Incisor Hypomineralization of Eight- and 14-year-old Children: Prevalence, Severity, and Defect Characteristics. Pediatr Dent. 2015;37:455-61 pubmed
    ..0001). Predominantly mild MIH was common in children's permanent teeth, with some intracountry variation. A surface predilection of MIH opacities was clearly revealed. The severity in 14-year-olds was threefold that of eight-year-olds. ..
  46. Ozgul B, Saat S, Sonmez H, Oz F. Clinical evaluation of desensitizing treatment for incisor teeth affected by molar-incisor hypomineralization. J Clin Pediatr Dent. 2013;38:101-5 pubmed
    ..Desensitizing agents effectively reduced the hypersensitivity of teeth with MIH. CPP-ACP paste was found to be more effective, and ozone therapy prolonged the effect of CPP-ACP paste. ..
  47. Mello Moura A, Bonini G, Suga S, Navarro R, Wanderley M. Multidisciplinary approach on rehabilitation of primary teeth traumatism repercussion on the permanent successor: 6-year follow-up case report. J Indian Soc Pedod Prev Dent. 2009;27:125-30 pubmed publisher
  48. De La Peña V, Valea M. Treatment of enamel hypoplasia in a patient with Usher syndrome. J Am Dent Assoc. 2011;142:938-41 pubmed
    ..The treatment has met both esthetic and functional expectations for 10 years. ..
  49. Corruccini R, Townsend G. Decline in enamel hypoplasia in relation to fluoridation in Australians. Am J Hum Biol. 2003;15:795-9 pubmed
    ..However, fluoridation of metropolitan water has emerged as the statistically strongest hypoplasia-preventing factor. ..
  50. Bailey S, Hublin J. Dental remains from the Grotte du Renne at Arcy-sur-Cure (Yonne). J Hum Evol. 2006;50:485-508 pubmed
    ..Thus, the preponderance of dental evidence from the Grotte du Renne strongly supports that Neandertals were responsible for the Châtelperronian industry at Arcy-sur-Cure. ..
  51. Law V, Seow W. A longitudinal controlled study of factors associated with mutans streptococci infection and caries lesion initiation in children 21 to 72 months old. Pediatr Dent. 2006;28:58-65 pubmed
    ..01) compared to those who remained free of caries lesions. Lack of oral hygiene, consumption of sugar-containing snacks, and enamel hypoplasia are significant factors for both MS infection and caries lesion initiation. ..
  52. Wogelius P, Haubek D, Poulsen S. Prevalence and distribution of demarcated opacities in permanent 1st molars and incisors in 6 to 8-year-old Danish children. Acta Odontol Scand. 2008;66:58-64 pubmed publisher
    ..Nearly half of the examined 6 to 8-year-old children had permanent 1st molars or incisors with demarcated opacities. More than 6% of the children had macroscopic loss of tooth substance due to demarcated opacities. ..
  53. Opydo Szymaczek J, Gerreth K. Developmental Enamel Defects of the Permanent First Molars and Incisors and Their Association with Dental Caries in the Region of Wielkopolska, Western Poland. Oral Health Prev Dent. 2015;13:461-9 pubmed publisher
    ..The results confirm that demarcated opacities and hypoplasia should be considered important caries risk factors. ..