A Turner tooth is a permanent tooth that has deformities and is characterized by defects in the enamel (medical term enamel hypoplasia). The disease is named after the first describer of the phenomenon, the English doctor of dentistry J. G. Turner. The latter named the disease of the teeth as Turner’s tooth.
What is a Turner’s tooth?
Turner’s tooth is characterized by damage or defects to the enamel of the teeth. In all cases, the condition affects permanent teeth and not baby teeth. So-called hypoplasia of the enamel can result in malformation of the teeth and lead to the formation of a Turner tooth. As a rule, a malformed tooth crown occurs in the typical clinical picture of the Turner tooth. These malformations usually affect both the incisors and the molars (medical term premolars). In addition, malformations can also appear on the roots of the teeth, and incisors and premolars are also affected in most cases.
Causes
Various causes exist for the development of a Turner tooth, which must be clarified depending on the individual case. In numerous cases, a Turner tooth forms because there was a focal point of pus at the root of the tooth in the earlier deciduous tooth that was in the location of the later Turner tooth. This suppurative infection is responsible for damaging the permanent tooth. The cause of the suppurated deciduous tooth is usually due to damage caused by decay of the tooth. Trauma to the deciduous tooth can also cause the Turner tooth to develop. Potential traumatic disorders that may occur during tooth development include buckling of the tooth axis and stunting of the tooth structure. The subsequent infection leads to malformation of the permanent tooth, as the inflammation damages the germ of the tooth. As a result, tooth development is defective. A Turner tooth occurs in approximately one quarter of all cases in which pus foci have formed at the root of milk teeth. In addition, periodontitis of the corresponding milk tooth can also be responsible for the development of the Turner tooth. It does not matter whether the periodontitis is localized at the tip of the tooth or inside it. In both cases, the development of a Turner tooth can be favored. Due to the inflammatory processes on the affected deciduous tooth, the tooth germ can be damaged as a result of dissolution of the associated bone lamella. The bone lamella surrounds the developing tooth germ, which is indirectly damaged by the pressure resulting from edema formation. In addition, the tooth germ can also be directly damaged by the process of bone resorption (medically termed osteolysis) and promote the formation of a Turner tooth.
Symptoms, complaints and signs
A Turner tooth can cause various symptoms and discomforts that can vary depending on the location of the affected tooth, the particular severity of the Turner tooth malformation, and the severity of the condition. As a rule, a Turner tooth is visible to the naked eye and can thus be easily recognized either by the affected patient himself or by the treating dentist. Clinical signs of a Turner tooth can be seen, for example, in areas that show discoloration. This can range from limited white areas to brownish, opaque spots on the enamel. Hypoplasia in combination with defect formation of the tooth can also occur. The possible defects can range from enamel defects to malformations of the anatomical crown shape of the tooth. In addition to deformations of the tooth crown and root, enamel defects can also occur, some of which are filled with a cementum substance. In this case, the affected teeth may be reduced in size and the crowns may have a yellowish to brownish discoloration.
Diagnosis and course of the disease
The diagnosis of a Turner tooth should be made in any case by a doctor of dentistry. Self-diagnosis, despite seemingly clear symptoms, is not appropriate, as Turner tooth must be differentiated from other potential diseases of the teeth by a specialist. Sometimes symptoms of Turner’s tooth are also found in other diseases.During the examination, the dentist performs differential diagnostic testing of symptoms to rule out other conditions, such as amelogenesis imperfecta, dental fluorosis, tetracycline teeth, dilaceration, molar incisor hypomineralization, or regional odontodysplasia.
Complications
A Turner tooth can cause various complaints and complications. Depending on the location of the affected tooth and the severity of the deformity, for example, defects in the enamel or other malformations of the teeth may occur. In severe cases, a Turner tooth causes deformities at the root of the tooth, which can be associated with inflammation and chronic pain. Further complications depend on any underlying diseases. For example, if amelogenesis imperfecta is causative, caries and other dental diseases may occur down the road. Adverse events may also occur during the treatment of a Turner tooth. If a dental crown is placed, there is a risk of injury to the adjacent gums. The metals used can release harmful substances into the body, causing late effects such as dental disease or organ damage. A surgical procedure always carries the risk of injury and infection. Some patients experience temporary sensory disturbances after tooth surgery or suffer from phantom pain on the extracted tooth. Drugs can also cause discomfort if they are overdosed or if the patient has an allergy. This can lead to symptoms of poisoning and complaints such as headaches and gastrointestinal problems. Damage to internal organs, especially kidneys, liver and heart, cannot be ruled out either.
When should you go to the doctor?
In the case of Turner tooth, treatment by a doctor is necessary. Only proper treatment and especially early detection of the disease can prevent further complications and discomfort, so the affected person should see a doctor at the first symptoms and signs of the disease. The earlier the Turner tooth is detected, the better the further course of this disease usually is. A doctor should be consulted if the affected person suffers from various malformations or deformities of the teeth. Discoloration can also indicate this disease and should be checked by a doctor. Defects in the enamel itself are also not uncommonly indicative of the disease, with the teeth often turning yellow or brown, which also significantly reduces the aesthetics of the affected person. As a rule, Turner’s tooth can be treated well by a dentist, so a dentist should always be consulted first in the event of symptoms.
Treatment and therapy
For the therapy of a Turner tooth, various methods of treatment are available, which are used depending on the severity of the deformity. In most cases, the deformities of the affected tooth can be corrected with the help of dental abutments. In more difficult cases, crowning of the Turner tooth or even extraction must be considered. In the event that the Turner tooth is a molar and does not cause any discomfort to the affected patient, therapeutic measures can be dispensed with. Nevertheless, the Turner tooth should be subjected to regular check-ups and examinations by the dentist to prevent possible complications. If incisors are affected, cosmetic treatment is appropriate. Generally, no therapy is required for low-grade enamel hypoplasia.
Prevention
As a preventive measure to prevent a Turner tooth, timely treatment of the affected deciduous tooth is possible. Furthermore, in more severe cases, extraction of the infected deciduous tooth is appropriate. This can prevent potential tooth germ damage that can cause a Turner tooth.
Aftercare
Aftercare for Turner tooth depends on the extent of hypoplasia (underdevelopment) of the affected tooth and the resulting treatment. Treatment may not be necessary if the underdeveloped tooth is a molar without symptoms or if there are only minor defects in the enamel. Aftercare then consists of regular checks of the affected tooth as part of the usual prophylaxis. In this way, incipient complications can be quickly detected and treatment steps initiated.Larger deformities of a Turner tooth are treated by tooth build-up with composite or crowning. In the immediate aftercare, the treated person should observe the curing time of the composite of up to two days. It is advisable to protect the teeth for a short time by avoiding hard foods. When chewing, the patient should check whether the composite filling or the crown is correctly adjusted. If a replicated crown seems too high and interferes with biting together with the opposite tooth, the dentist can make a subsequent correction. This prevents the risk of temporomandibular joint pain due to incorrect loading. Regular dental check-ups are also important after this treatment. The patient should pay special attention to the crowned tooth during oral hygiene. Crown margins are a risk zone for caries formation and should be cleaned carefully, also in the interdental spaces by using dental floss or interdental brushes.
What you can do yourself
If Turner teeth have been corrected by dental restorations, the patient should refrain from eating and drinking for a few hours. In particular, hot, cold, spicy, sour or sticky foods should be avoided. If food is eaten, it should be chewed with the teeth opposite the filling. Mineral water and gentle food may be taken after the procedure. A composite filling is cured within 24 to 48 hours. Within this period, the teeth should be spared altogether. In addition, the affected areas must be checked for abnormalities. If any elevations appear on the filling, a visit to the dentist is recommended. Appropriate areas can be felt with the tongue or by biting gently. If other problems occur, such as discoloration or strong sensitivity of the restored tooth, a visit to the dentist is also recommended. Teeth should be cared for with special care after a composite filling has been placed. At best, coffee, tea and wine should be avoided completely, as these can cause discoloration of the fillings. Fluoride gels or pastes are recommended to protect the teeth and strengthen the enamel. If these measures are followed, the Turner tooth should not cause any further discomfort.