What is chalky teeth or molar hypomineralisation (MIH)?

Enamel is the outermost layer of the tooth. It is harder than bone and plays a vital role in protecting the underlying tooth structure. Enamel develops during pregnancy and continues to form in infancy. It is during this time that enamel is very susceptible to any disturbances that occur during growth. The clinical importance of enamel relates to its role as a body defence mechanism against cavity-causing bacteria. Teeth with enamel defects are hence more vulnerable to acid attack and breakdown released by such bacteria.

The condition is ideally managed by a specialist in the area. We routinely and urgently manage referred patients through all phases of the condition.

What are the types of enamel defects?

There are various types of enamel defects including:

• molar-incisor hypomineralisatio/hypoplasia (MIH) – discoloured with an uneven surface and irregular shape due to enamel loss
• enamel hypoplasia – this presents as smooth edged surface defects in the form of pits, lines or missing enamel
• enamel opacities – these present as white or yellow areas of enamel on tooth surfaces
• amelogenesis imperfecta (AI) – this condition clinically resembles MIH, however it is an inherited condition affecting every single primary and adult teeth. There is also abnormal enamel formation

Untreated chalky teeth deteriorate rapidly. Soft enamel breaks down under chewing forces, and once a chalky molar starts to fracture, decay accelerates. Children with MIH often experience significant pain, sensitivity to temperature, and difficulty eating. Early specialist intervention — ideally before the affected molars start to break down — can protect the teeth with targeted remineralisation therapy, fissure sealants, and in more advanced cases, preformed zirconia crowns or stainless steel crowns.

Following a thorough examination and history of our child, we would recommend various treatment options ranging from prevention to extraction to full oral rehabilitation of your child’s dentition.

Chalky teeth need to be treated as soon as possible.

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