Chalk teeth are now considered a widespread disease, according to a statement by many concerned German dentists. Affected by the crumbling tooth substance are mainly children and adolescents. In the meantime, 30 percent of all twelve-year-olds are already affected by chalky teeth. Doctors are still investigating the exact causes of the increased incidence of chalky teeth. The demineralization of teeth has been known since the 17th century. Today, medical experts speak of molar-incisor hypomineralization when the milk teeth are already recognized as chalk teeth.
What are chalk teeth?
Chalk teeth – popularly known as cheese molars – are defined as a systemic defect in the enamel and tooth structure. This defect, which is based on a chronic mineral deficiency, often first appears in the milk teeth. Later, the permanent teeth are also affected by the chalk-like roughened and yellowish discolored areas on the teeth. Chalky teeth are also described as hypomineralization of the teeth. The hard tooth substance is increasingly lost. This increases the risk of caries and the sensitivity of the teeth to cold stimuli or touch. By definition, it is a systemic, but not hereditary dental disease.
Causes
Strikingly, chalky teeth are often already diseased while they are still growing out of the jaw. Therefore, internal or systemic causes are the likely cause. It is possible that the cause of demineralization of the child’s teeth originates in the womb. It then continues during the first four years of the child’s life through the supplied nutrition. During this period, the teeth are normally mineralized. It is not yet clear why this happens. There may be causes outside the body as well as internal to the body. However, research into the causes of the increased occurrence of chalky teeth is still in full swing. It must be questioned why this phenomenon was already widespread in the 17th century and is now occurring again with increased frequency. The plasticizers in plastics and other products, which are held partly responsible by many dentists, did not exist at that time, as is well known. It is true that research confirms that environmental factors, such as bisphenol A or phthalates, in plastics can very well have an influence on the development of chalky teeth. However, this can only be proven by a long-term study. Other possible causes are certain respiratory diseases, latent oxygen deficiency during the birth process, or the repeated administration of antibiotics to young children. It is also possible, however, that the demineralization of the teeth is linked to excessive sugar consumption by mother and child. Soft drinks and cola beverages in particular, which have a high sugar content, could come under critical scrutiny. In addition to phosphoric acid and carbonic acid, such drinks contain other substances that are harmful to teeth. The acids contained in such beverages could dissolve the plasticizers from the bottle. Further studies are still to be carried out on the causes. It can be suspected that chalky teeth may be due to several causes. Such complex pathways of occurrence are difficult to determine.
Symptoms, complaints, and signs
Typical symptoms of chalky teeth include increased sensitivity of the child’s teeth to cold stimuli and touch. The teeth hurt when brushing, touching cold air, and eating cold foods and stimulants. The developmental disorder can affect both the molar region and the anterior teeth. Visually, a medical professional recognizes chalky teeth by their rough surface, which is often yellowish-brown in later stages. The teeth appear attacked by demineralization. This makes them significantly more susceptible to caries or other damage to the tooth structure.
Complications
One of the most common complications of chalky teeth is that they can crumble or break off more easily than other teeth during normal stresses from chewing. The demineralized tooth structure is much more crumbly. It is less resilient and much more vulnerable to caries. Therefore, complications during dental treatment are to be expected even at an older age. Chipped or severely damaged chalk teeth in adult patients may have to be surgically removed and replaced by implants.Psychological stress due to the unattractive appearance cannot be ruled out either. However, the dentist could prevent such side effects with veneers.
When should you go to the doctor?
When parents discover rough or discolored baby teeth in their young children, a close examination of the child’s dentition is advised. If the affected teeth are sensitive to cold stimuli, a visit to the dentist is advisable. The sooner treatment begins for the demineralization consequences that are already apparent, the sooner later damage to the tooth structure can be prevented. The dentist can determine that the demineralized tooth has defective enamel. Early diagnosis of chalky teeth is important so that all possible measures can be taken today. In particular, the consequential damage to the permanent teeth must be kept as low as possible. At the latest when the first permanent teeth erupt, parents should present their child to a dentist because of chalky teeth.
Diagnosis
Chalk teeth can be easily diagnosed by visual diagnosis. Numerous other examinations are not necessary for this. Already the deciduous dentition reveals the traces of demineralization. Based on this, the dentist can conclude that the permanent teeth will also be affected by demineralization. It is only unclear to what extent this will be the case. Often not all teeth are recognizable as chalky teeth. In most cases, it is primarily the molars that are affected. On an X-ray, the dentist would not be able to tell whether the molars that have not yet grown back are demineralized in the same way as the milk teeth. However, a diagnostic distinction must be made as to whether the discoloration of the teeth that can be seen actually indicates chalky teeth or not. In some children, it could rather be the consequences of dental trauma. This would occur narrowly in only a few teeth directly adjacent to each other. The anterior teeth are most commonly affected by dental trauma. Molar incisor hypomineralization, on the other hand, also occurs in locations that are not normally trauma-prone sites.
Treatment and therapy
Treatment of chalky teeth is complex and lengthy. It is not possible to remineralize chalky teeth that have already been damaged. Rather, the therapy is about protecting the chalky teeth from further damage to the tooth structure. The main aim must be to prevent later caries damage or to detect it at an early stage. The porous chalk teeth are more susceptible to tooth damage due to the attacked enamel. One of the most important measures to protect the tooth structure in chalky teeth is regular fluoridation. The age of the young patient plays an equally important role in the treatment as the extent and severity of the identified tooth damage. The application of fluoride varnish on the affected teeth is a possible measure against later tooth damage. Fluoridation must be performed regularly. For very young patients, it may not yet be indicated to use a fluoride toothpaste. This is often swallowed. Parents must teach children the importance of good dental hygiene at an early age. In addition, regular visits to professional dental cleanings are also an important measure of caries prevention. The chalky teeth can also be provided with a fissure sealant for protection. The problem is that such sealants do not adhere very well to the roughened tooth surface. If some of the chalk teeth turn out to be friable or very painful, they can be protected with a suitable crown if necessary. In adults with chalky teeth, heavily discolored chalky teeth can be veneered with veneers. In the long term, however, it is likely that chalk teeth that are particularly badly damaged will need to be crowned or removed.
Outlook and prognosis
The prospects of the chalk teeth being affected by caries, despite all dental efforts, are better if the child affected by them is treated early. In the medium and long term, treatment would have to start much earlier – before pregnancy. The generation of expectant mothers may have something to do with the development of chalky teeth in their offspring. If this hypothesis were to be confirmed by long-term studies, prophylactic treatment would have to start here so that the still unborn children would have less tooth damage later on.How this can be achieved and which factors contribute to the development of chalky teeth must therefore be urgently researched. If plasticizers or other chemicals do indeed contribute to the decay of tooth substance, these substances would have to be banned as soon as possible. In addition, nutritional factors would have to be researched and subsequently eliminated. Otherwise, the prospects are poor for children with chalky teeth to receive more than symptomatic treatment. Prophylaxis is currently only feasible in terms of later caries damage. Here, early education about the dangers of sugar consumption and unhealthy, mineral-poor food can help improve the prognosis for those affected in the long term. Based on current knowledge, the number of people affected is likely to increase.
Prevention
As a preventive measure, expectant mothers would already have to do a lot to ensure that their offspring do not develop chalky teeth. With the occurrence of neurodermatitis or chalk teeth with small children probably play apart from further influencers also nourish-physiological deficits under circumstances with the mother a larger role. Those who do not eat a healthy diet as a child and later as an adult are likely to pass on these nutritional deficiencies to a growing child. Especially during the phase when children’s teeth are in the process of mineralization, attention should therefore be paid to mineral richness in the diet. This may no longer be the case if the child’s parents have been satisfied for years with fast food or generally nutrient-poor and industrially produced food. Parents should set a decisive course for their young children in the first four years of life so that the children are not beaten with chalk teeth. Especially in the last third of pregnancy and in the first year of life, important decisions are made for the later health of the child and its teeth. Since insufficient mineralization probably also affects the skeleton, later skeletal damage cannot be ruled out in children with chalk teeth.
Follow-up
Regular check-ups and follow-up visits to the dentist continuously diagnose the progression of the damage and the extent of the chalk teeth. During this process, the dentist intensively treats the damaged teeth with a fluoride sealant, which helps to protect the teeth and prevent their sensitivity to pain. This sealing should be repeated every three months. In this way, the progression of the disease can be controlled and major tooth damage can be averted. For the aftercare of chalky teeth, toothpaste containing fluoride is effective. The toothpaste must come into direct and intensive contact with the teeth showing damage. A short contact time optimizes the result of fluoride treatment. If early diagnosis and prophylaxis have been neglected, the chances that the chalky teeth will not be affected by caries are very low. The loss of substance of the teeth is then so far advanced that treatment will hardly bring the desired success. The damaged teeth must then be removed during an operation. The burden of pain and altered to disfigured appearance for the patient increases. Patients with chalky teeth and such disease processes therefore require additional psychological care. Ultimately, diets rich in minerals and vitamins can protect against the spread of damage caused by chalky teeth.
What you can do yourself
People who want to become parents later in life probably don’t worry at a young age about whether or not their children will have chalk teeth later in life. Therefore, there should be approaches throughout society at as many levels as possible to look at such problems and develop feasible solutions. Every individual can play a part in this. If you eat a healthy diet throughout your life and make sure that your food is rich in vitamins and minerals, you have probably done a lot to prevent the possible development of chalk teeth in your offspring. One should also take a critical look at one’s own sugar consumption. Above all, however, the phthalates in plastic bottles are currently the focus of attention for the development of chalky teeth. It may therefore be sensible to avoid the consumption of sugary and acidic beverages from plastic bottles as far as possible. The recyclable glass bottle should be chosen as a healthy alternative. In addition, it is also important for one’s own health to keep chemicals of any kind out of one’s life as much as possible.Plastic outer packaging of vegetables and fruit is avoidable by buying at the weekly market. If plasticizers are indeed confirmed as one of the causes of chalky teeth, all products containing plasticizers should be avoided. Plasticizers are found in numerous products, including perfumes, plastic toys, rubber, caoutchouc, paints, brittle materials such as plastics, and adhesives. It is to be feared that in the long term such substances cause more than just chalky teeth as consequential damage. Demineralization of the tooth substance could also indicate that demineralization of the bones is also present in those affected. This could lead to osteoporosis later on.