Brief overview: chalk teeth
- What are chalky teeth? Teeth with developmental enamel defects. Affected are mainly the first permanent molars and incisors.
- Causes: unknown; suspected triggers include maternal diseases during pregnancy, birth complications, diseases in the first four years of life, etc.).
- Symptoms: depending on the severity, discoloration of the teeth up to enamel eruptions; in addition, hypersensitive and very caries-prone teeth.
- What can you do yourself? desensitizing pastes against pain-sensitive teeth, consistent dental care with fluoride, cross-brushing of the molars, tooth-friendly diet, caries prophylaxis every three to six months at the dentist.
“Common disease” chalky teeth: What is it?
In the meantime, however, it has become clear that the disease is not limited to the first molars and incisors – all permanent teeth can be affected. Even milk teeth can already emerge through the gums as chalky teeth. This is then called deciduous molar hypomineralization (MMH).
How common are chalking teeth?
However, of the affected 12-year-olds, only a few had severe MIH with extensive enamel eruptions. In most children, the disease was mild.
New disease?
Chalk teeth: Causes
The causes of chalky teeth are still unclear. The only thing that experts agree on is that the function of the enamel-forming cells, the ameloblasts, must be disturbed in those affected. This means that tooth enamel formation (amelogenesis) does not proceed correctly.
This is how tooth enamel formation normally proceeds
Various triggers for chalky teeth suspected
Why ameloblasts do not work properly in some children, leading to chalky teeth, is still unclear. Several factors probably play a role. So far, there is only conjecture as to what these factors might be. For example, scientists are discussing the following factors as possible triggers of chalky teeth:
- Diseases of the mother during pregnancy
- Illnesses of the child in the first four years of life such as bronchitis, asthma, recurrent high fever or measles and chickenpox
- Vitamin D deficiency
- frequent use of medications such as antibiotics or aerosols
- disturbances in calcium-phosphate balance, e.g. due to chronic kidney disease
- environmental toxins such as dioxins or plastic softeners such as bisphenol A* or polychlorinated biphenyl
- genetic factors
Chalk teeth: symptoms
If your child’s baby teeth or first permanent teeth show the following symptoms, they could be signs of the enamel defect:
- white-creamy to yellow-brown looking sharply demarcated areas
- missing cusps or chipped enamel on newly erupting teeth
- pain when brushing teeth (touching!) or when eating cold or hot food
You should have such symptoms clarified by your dentist at an early stage.
The dentist must first find out whether your child actually has chalky teeth. This is because there are other reasons why the enamel may be insufficiently mineralized. These include:
- some forms of the genetic disease “amelogenesis imperfecta” (in this case, all milk teeth and permanent teeth are affected by the enamel defect)
- long-term fluoride overdose
- treatment with the antibiotic tetracycline
Chalk teeth: Classification into severity levels
If your child does have chalky teeth, the dentist will look at how severe they are. Mild forms often occur, in which the teeth are merely discolored. However, there are also cases in which entire parts of the enamel are missing or chipped.
- Index 1: MIH without hypersensitivity, no substance defect
- Index 2: MIH without hypersensitivity, with substance defect
- Index 3: MIH with hypersensitivity, without substance defect
- Index 4: MIH with hypersensitivity, with substance defect.
Severe cases of chalky teeth are considered a pain emergency. The dentist should therefore treat your child immediately – do not accept long waiting times!
Chalk teeth: Treatment by the dentist
Chalk teeth are more susceptible to caries bacteria than normally formed teeth because:
- the teeth are more sensitive to touch, which makes brushing more difficult.
Therefore, the main goal of treatment is to protect teeth from decay. In addition, permanent teeth should be preserved for life, if possible, and become less sensitive to touch and temperature stimuli.
Intensive prophylaxis
In any case, the dentist will use intensive prophylaxis to protect the affected teeth from caries in particular. For this purpose, he will apply a highly concentrated fluoride varnish to the affected teeth every three to six months up to four times a year.
Sealants and coverings (“sealing”)
Mild forms of chalky teeth and hypersensitive teeth are treated by the dentist with sealants and covers made of plastic or so-called glass ionomer cement.
If the enamel is already cracked or chipped, the teeth are restored with the help of fillings made of composite, a composite plastic.
Crowns
In the case of major damage to the tooth, crowns made of stainless steel or composite are used. They provide long-lasting protection of the tooth from further damage and make the teeth less sensitive to pain.
Surgical measures
In the case of chalky teeth, the usual local anesthetic injection works only very poorly. The dentist should therefore prescribe painkillers for your child (preferably paracetamol or ibuprofen) before any planned treatment. He can also tell you when and in what dosage your child should take the medication.
Chalky teeth: What you can do yourself
Dental care with fluoride
Chalk teeth are not a sign of neglected oral hygiene – unlike dental caries, where a high-sugar diet and poor dental hygiene cause teeth to rot. Nevertheless, consistent dental care with fluoride is very important for chalky teeth – it reduces the risk of caries and makes the teeth less sensitive to pain. Specifically, dentists usually recommend the following for chalky teeth:
- Apply a fluoride gel (12,500 ppm fluoride) to the teeth once a week.
- Prepare meals with fluoridated table salt
Proper diet
Additionally, a balanced diet can help prevent tooth decay. Sweets are best eaten (if at all) as a dessert and not between meals. Sweetened beverages should be avoided altogether – better thirst quenchers are water and unsweetened tea.
Cross-cleaning the new molars
You must cross-clean your child’s first permanent molars. Your child cannot do this alone! You should also carefully brush your child’s teeth until around the age of nine.
Desensitizing pastes
Regular visits to the dentist
Because of the high risk of caries, children with chalky teeth should visit the dentist for regular checkups every three to six months.
