My son was born with enamel hypoplasia. Several years ago, his pediatric dentist said that we could wait until my son’s teenage years before considering any cosmetic work because my son seemed unfazed about his teeth. During that time, my son had regular exams for the dentist to monitor signs of tooth decay.
Now that he is a teenager, my son is more self-conscious. He notices his teeth and asks what we can do about it. Fortunately, the kids in school are not teasing him yet. My son’s pediatric dentist says that she does not do cosmetic work but recommends that we see a dentist who does it. Could she be passing us off to someone else because she doesn’t want my son’s case? What are the options for restoring spotted teeth from enamel hypoplasia? Will insurance pay for it because it is a genetic condition? Thank you. Madilynn from Reno, NV
Thank you for your question. We will provide some background on enamel hypoplasia for our readers.
What Is Enamel Hypoplasia?
Enamel hypoplasia is a tooth enamel defect that occurs while teeth are developing. The condition causes teeth to erupt with damaged, deficient, or discolored tooth enamel. Enamel hypoplasia increases tooth decay risk.
What Are the Signs and Symptoms of Enamel Hypoplasia?
Enamel hypoplasia signs and symptoms include:
- Lack of tooth enamel
- Pits, dents, grooves, or deep lines in teeth
- Tooth sensitivity to heat and cold
- White spots
- Worn teeth
- Recurring tooth decay and cavities
- Yellow or brown stains in areas of exposed dentin (the layer beneath the enamel)
What Causes the Tooth Enamel Defects?
A 2017 article in Osteoarchaeology lists the following causes of tooth enamel defects while teeth are developing:
- Nutritional stress
- Infectious diseases
- Stress associated with weaning
What Is the Treatment for Enamel Hypoplasia?
Treatment for enamel hypoplasia depends on the condition of the teeth and the extent of damage to the enamel. After an exam and x-rays, a cosmetic dentist may recommend dental bonding, porcelain veneers, or dental crowns. Most pediatric dentists lack advanced cosmetic dentistry training, so it is not unusual to refer them to skilled cosmetic dentists who treat children.
Possible treatment options:
- Dental bonding – Skilled cosmetic dentists blend dental composites and apply them by hand over teeth. A dentist will shape, harden, and polish the bonding for natural-looking results.
- Porcelain veneers – A cosmetic dentist can take impressions of your son’s teeth, conservatively prepare them for porcelain veneers, and collaborate with a dental ceramist for veneers.
- Dental crowns – Severe damage to tooth structure may require dental crowns to cover teeth entirely.
After a consultation and exam, a cosmetic dentist will discuss the options for your son, including:
- What to expect for retreatment as your son’s jawbone and teeth grow
Will Dental Insurance Pay for Enamel Hypoplasia Treatment?
Although your dental insurance company will not pay for the entire cost of treatment, it may provide some benefits. You can contact your dental insurance provider to ask about plan benefits. After a cosmetic dentist gives you a treatment estimate, you can send it to the dental insurance company for a more accurate assessment of their coverage and your out-of-pocket expenses.
Monroe, Louisiana, dentist Dr. David Finley sponsors this post. Dr. Finley is a Fellow of the American Academy of Cosmetic Dentistry and the Academy of General Dentistry.