What Are Hypoplastic Teeth?

Medically Reviewed by Dan Brennan, MD on November 27, 2021
4 min read

Hypoplastic teeth, also known as enamel hypoplasia, is when your enamel has not formed properly or has formed incorrectly. There are many reasons why this might happen, including diseases, prenatal issues, and environmental conditions.

Problems with your enamel usually happen when your teeth are growing, but they can affect both your baby (primary) and adult (permanent) teeth.

It's the hardest tissue in your body. Enamel is made up of a highly organized structure of calcium phosphate crystals and can last for many decades.

Enamel has to withstand some harsh conditions in your mouth. Acids from foods and bacteria are constantly eating away at it. It’s sometimes immersed in freezing cold or very hot temperatures. You also place different forces on it when you’re chewing, biting, crunching, and grinding. 

One thing that enamel can’t do, however, is grow back. Once it’s damaged, enamel can’t regenerate or fix itself. 

Some of the signs and symptoms of hypoplastic teeth include:

  • White spots on your teeth
  • Easily stained teeth
  • Grooves or depressions on the enamel surface
  • Increasingly sensitive teeth as the dentine, or the layer under the enamel, is exposed
  • Bacteria, like plaque, staying on your teeth and penetrating them more easily
  • More cavities

Prenatal issues can cause hypoplastic teeth. These include: 

  • Low birth weight
  • Premature birth
  • Maternal Vitamin D deficiency
  • Multiple births
  • Smoking by the mother during pregnancy
  • More weight gain during pregnancy
  • Lack of or delayed prenatal care

Other conditions that can lead to hypoplastic teeth include:

  • Poor nutrition 
  • Celiac disease
  • Kidney and liver disease
  • Infectious diseases caused by viruses and bacteria, like urinary tract infections and upper respiratory infections
  • Cerebral palsy caused by maternal or fetal infection
  • Exposure to some chemicals and drugs, such as lead paint, pica, and tetracyclines
  • Trauma to the teeth

Hypoplastic teeth can also be caused by some rare inherited disorders, such as:

  • Amelogenesis imperfecta
  • Usher syndrome
  • Seckel syndrome
  • Ellis Van Creveld syndrome
  • Treacher-Collins syndrome
  • Oto-dental syndrome
  • 22q11 deletion syndrome
  • Heimler syndrome

When you have hypoplastic teeth or enamel hypoplasia, you’re more likely to have cavities. This is due to:

  • Difficulty removing plaque on teeth
  • Problems brushing because of the sensitivity of your teeth. 
  • Faster erosion of your teeth from acids in foods and drinks

In a study of children aged 6 to 9, researchers found that hypoplastic baby teeth are twice as likely to have dental cavities than non-hypoplastic teeth. Also, hypoplastic first permanent molars are four times more likely to have cavities.

Treatment for enamel hypoplasia depends on how severe your condition is. You may want a certain treatment for appearance reasons, as white spots and stains from enamel hypoplasia may be unappealing. You may also need treatment to help prevent tooth decay and preserve the structure of your teeth. 

CPP-ACP. Casein phosphopeptide amorphous calcium phosphate, or CPP-ACP, can help to remineralize your teeth. It has also been found to stop the growth of certain bacteria on enamel surfaces.

Stainless steel crowns. These are a durable and inexpensive treatment, especially when it comes to enamel hypoplasia in children. They’re placed in just one dental appointment, unlike crowns made of precious metal or ceramic, which need several appointments. 

Resin infiltration. This is a minimally invasive treatment that lessens the appearance of white spots. It involves applying a resin directly onto the white spots of your teeth. The resin reflects light in the same way that your teeth do, so it’s easy to match your teeth’s natural look.

Enamel microabrasion. This treatment uses acids and abrasive materials such as hydrochloric acid and silicon carbide to remove stains and discoloration on the enamel. After this, your dentist may also apply a composite resin to the surface of your teeth. 

Porcelain veneers. These are applied to your teeth. Because this laminate is so thin, the color of your teeth will be obvious beneath it. Your dentist may first need to bleach your affected teeth or use composite cement to make your teeth look whiter.

Tooth bleaching. This is done to reduce the contrast between the white spots and the unaffected areas of your teeth. Your teeth will be prepped, and then a bleaching gel is applied for about 40 minutes. You may need several sessions of tooth bleaching. However, this may not be enough if you have deeper white spots. 

To take care of your teeth at home: 

  • Get regular dental checkups to monitor the health of your teeth.
  • Brush your teeth twice a day.  
  • Brush with a soft toothbrush. 
  • Rinse your mouth with lukewarm water.
  • Fluoride rinses are also recommended for children older than 6 years. For those younger than 6, your dentist may apply fluoride gels or varnishes regularly every 3 or 6 months. 
  • To prevent cavities, keep sugary and acidic foods and drinks to a minimum.