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Treatment of Enamel defects (Hypoplasia and Hypo-calcification) – Part Five: More extensive treatment – Other options – more severe cases

March 9, 2020

We don’t like removing teeth but sometimes the lack of quality tooth structure, and even tooth structure itself, means the life expectancy of the tooth is short. Most of the severe hypoplasia cases are in back teeth, particular in the first molars, also called six year old molars. 

Severe hypoplasia (reference photo http://www.dentalnews.com/2017/02/20/mih-lebanon/)

The tooth will not be able to resist the bacteria of the mouth and decay quickly. The biting pressure of the jaws will wear it away and can even crack the tooth. A crown needs good quality tooth structure to hold onto at the neck of the tooth near the gum line. Otherwise it will break off.

What do we do?

If the mouth is crowded, then removing the tooth and closing the space with orthodontic treatment would provide a long term solution. This may be more possible with the back teeth.

If orthodontic treatment is not possible then removing the tooth and placing an implant may need to be done.

Left: X-ray of upper right Incisor Implant with crown attached; Right: Photo of upper right incisor implant with crown attached

Care: implants should only be placed when the person stops growing. With males this could be up to 25 years old.

Implants stop the growth of bone height when the person is still developing. This will make the gum and bone next to the natural teeth look shorter!

Sometimes we have to wait before we remove the tooth or if that is not possible, then making an interim denture (to stop the teeth moving).

Flexible Denture - Now You See It
Flexible Denture - Now You Don't

You could leave a space but this not the best choice as the bite collapses into the void left by the removal of the tooth. This means teeth tilt or even opposing teeth move towards the space.

Not good long term as it’s uncontrolled and unstable for life!

Need an Appointment?

If you’d like to book an appointment with the dentist at Seymour Dental then call us in Dulwich Hill, Sydney on (02) 9564 2397 or
contact us

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“Hey Doc, I get this swelling in my palate after I eat and it’s annoying me; what is it?”