Dental Problems in Preterm Babies - Enamel Hypoplasia

Dental Problems of Preterm babies:

 A developing baby goes through important growth throughout pregnancy─ including in the final months and weeks. For example, the brain, lungs, and liver need the final weeks of pregnancy to fully develop.But  Preterm babies are born early before 37 weeks of pregnancy and so they face the following problems:

* Breathing Problems

* Hearing Problems

* Vision Problems

* Feeding Dificulties

* Developmemntal Delays

* Dental Problems etc.

Dental Problems:

The most common dental problems faced by preterm babies are

* Enamel Hypoplasia

* Stained Teeth

* Delayed Dental Development

* Palatal Groove

In this blog, we will be discussing about Enamel Hypoplasia in detail

What is Enamel hypoplasia - (Enamel Defect)

It is developmental enamel defect.

Dental enamel hypoplasia is an enamel defect characterized by thin or absent enamel. In some cases, the defect occurs on only part of a tooth’s surface, resulting in pits or grooves in the tooth’s enamel. In other cases, an entire tooth may have an overly thin layer of dental enamel or may have no enamel at all.

What are the cells that are responsible for enamel?

Ameloblasts are cells present only during tooth development that deposit tooth enamel, which is the hard outermost layer of the tooth forming the surface of the crown.

 Ameloblasts are part of the enamel organ that is composed of an outer epithelial layer, the stellate reticulum, the stratum intermedium, and the inner enamel epithelium (ameloblast layer).

What are the symptoms?

Some of the signs of enamel hypoplasia are obvious, but others are more difficult to detect and may not be noticeable until they cause major dental problems. Having thin tooth enamel can lead to:

*Pits, tiny groves, depressions, and fissures

*White spots

*Yellowish-brown stains (where the underlying layer of dentin is exposed)

*Sensitivity to heat and cold

*Lack of tooth contact, irregular wearing of teeth

*Susceptibility to acids in food and drink

*Retention of harmful bacteria

*Increased vulnerability to tooth decay and cavities

Enamel hypoplasia can also result from prenatal issues such as:

Maternal vitamin D deficiency

Maternal weight gain

Maternal smoking

Maternal drug use

Lack of prenatal care

Premature birth or low birth weight

Environmental factors and other problems in infancy that can cause enamel hypoplasia include:

Trauma to the teeth

Infection

Calcium deficiency

Deficiencies of vitamins A, C, or D

Jaundice, liver disease

Celiac disease

Cerebral palsy due to maternal or foetal infection

Causes of enamel hypoplasia:

Formation of the enamel on a child’s baby teeth begins in utero and continues into infancy. Disturbances to the matrix formation process during this time period can lead to enamel hypoplasia in baby teeth.

Formation of the enamel on permanent teeth begins during infancy and continues until the child is approximately eight years old. Disturbances during this time period can lead to enamel hypoplasia in the child’s permanent teeth.

In the case of both baby teeth and permanent teeth, the precise teeth affected by enamel hypoplasia will depend on the timing and the cause of the disturbance. For example, the enamel on a child’s permanent front teeth is typically formed by the time the child is five years old, whereas the enamel on a child’s second molars (the molars that are next to a child’s wisdom teeth) is not typically formed until eight years. This means that if a child contracted certain types of infections at age seven, his front teeth probably would not be affected, but his second molars would   be affected

Treatment depends on the severity of the problem. Goals of treatment are to:

Prevent tooth decay

Maintain a good bite

Preserve tooth structure

Keep teeth looking their best

Some of the smaller defects that are not causing decay or sensitivity may not need treatment right away. They still require monitoring, though. Your dentist will probably suggest you to apply topical fluoride to help protect your teeth.

In the case of sensitivity, cavities, or tooth structure showing wear, treatment options include:

Resin-bonded sealant. This can improve tooth sensitivity.

Resin-based composite fillings. These can be made to closely match tooth colour, which makes them ideal for use on front or back teeth. They are also quite durable.

Dental amalgam fillings. These are made from a combination of durable metals. Due to the silver colour, you may not want them on your front teeth.

Gold fillings. Like dental amalgam fillings, gold fillings are durable but lack a natural look. They also tend to be the most expensive.

Crowns. These completely cover the tooth.

Enamel micro abrasion. This is a minimally invasive procedure to improve appearance of the teeth.

Professional dental whitening.

There are cases in which a permanent tooth is so malformed that it may be best to extract it. If so, then consult an orthodontist first.

If your dentist offers a mercury amalgam filling, check if is suitable for you, as there may be a risk of toxicity.

 Mercury amalgam filling should be avoided if you:

Are pregnant, planning to become pregnant, or breastfeeding

Are under 6 years of age

Have a neurological condition or kidney problems

Have an allergy to mercury

Here are a few other tips for keeping your teeth as healthy as possible:

Brush at least twice a day using a soft toothbrush.

If cold sensitivity is a problem, rinse with lukewarm water.

Keep sugary and acidic foods and drinks to a minimum, and always brush and rinse thoroughly after consuming them.

See your dentist regularly for check-ups and whenever you suspect a problem.

What happens if Enamel Hypoplasia is not treated properly?

Without proper treatment, it may lead to the following complications:

Cavities, crumbling tooth (caries)

Browning of an entire tooth

Need for tooth extractions

Anxiety about the appearance of your smile

Things that contribute to these complications include poor oral hygiene, eating too much sugar, and crowded teeth.

Depending on the location and severity of the defect, enamel hypoplasia may cause aesthetic concerns, tooth sensitivity and/or bite issues. In addition, numerous studies indicate that children with hypoplastic teeth are at increased risk for cavities.

In order to minimize their risk of cavities, children with enamel hypoplasia should be especially diligent about brushing and flossing regularly and should minimize their consumption of cavity-causing foods and drinks. Professional fluoride varnish treatments may be recommended to further protect against decay and to help minimize any tooth sensitivity.

When enamel hypoplasia creates significant bite issues or aesthetic concerns, your child’s paediatric dentist might recommend dental restorations such as white fillings. However, white fillings do not always adhere as well to defective enamel as they do to healthy enamel and may not be the right option in certain cases.

In severe cases, your child’s dentist may recommend covering hypoplastic teeth with dental crowns to protect them and to restore their shape and function.

So always remember Early screening and diagnosis are crucial. That is why children should visit a dentist sometime between the appearance of their first tooth and their first birthday.

Keep following this blog to know more about the other dental problems... If you have some queries regarding dental Problems in  kids , you could send your questions to info@preemienmom.com .