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Chalk teeth
Enamel formation disorders
Hypomineralisation

A guide

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Whitish or brownish discolouration, structural anomaly up to tooth malformationSo-called

chalk teeth are the result of impaired enamel formation during tooth development. Both milk teeth and permanent teeth can be affected, in some children and adolescents even both dentitions.

One particular form of this irreversible enamel formation disorder is so-called molar incisor hypomineralisation, or MIH for short, which affects the first molars (molars) and the central front teeth. The upper jaw is statistically more frequently affected than the lower jaw. The changes are usually recognised when the teeth erupt, usually from the age of 6 in the case of permanent teeth.

There are different degrees of severity. 90% of all MIH cases show whitish-creamy to yellowish-brownish, opaque discolouration, but with a largely intact structure and unchanged tooth shape. More severe forms are characterised by structural defects (mostly pores) and even slight changes in the shape of the tooth. In rare, very severe cases, there are yellowish-brownish, very pronounced morphological changes in shape and structural collapses.

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Frequency and complications

In German-speaking countries today, approx. 30% of 10-year-old children and approx. 40% of 15-year-old adolescents have at least one hypomineralisation in their permanent teeth. Approximately 10% to 15% of this age group worldwide suffer from MIH (chalk teeth); 5% in a severe form.

A frequent complication is early superimposed, usually rapidly progressing caries in the affected areas.

In severe cases, the affected teeth are often very sensitive or painful. This can lead to functional limitations when chewing and often to social problems (appearance).

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The cause is still unclear

The frequency of cases has risen sharply since the 1980s, so that in the early days, environmental influences and pesticides were seen as the main possible causes. This could not be scientifically confirmed.

Today, it is assumed that a combination of several causes could be responsible. In particular, early childhood respiratory diseases such as bronchial asthma, pneumonia, pseudocroup etc. are suspected, probably together with a genetic predisposition.

Drug interactions with antibiotics or asthma sprays taken in early childhood or endocrine interactions, for example with special plastics (e.g. Bis-GMA), are also being discussed.

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Causal prevention is almost impossible

As the causative factors and triggers of the disease have not yet been clarified, primary prophylaxis for prevention is unfortunately still not possible.

Nevertheless, there are indications that vitamin D supplements, which are also urgently needed to prevent rickets in the first year of life (e.g. Vigantol drops or similar), could have a positive effect and help to prevent the disease.

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Early clarification recommended

Tooth discolouration and enamel malformations often have different causes and are not always due to chalky teeth. In any case, an early examination and clarification should be carried out by a dentist. Especially if the teeth are persistently sensitive or painful. Only the dentist can differentiate which disorder is present and which treatment is most promising.

For regular, thorough daily tooth cleaning, preferably with sensitive electric toothbrushes (ApaCare Sonic), it is essential to use fluoride toothpastes, ideally in combination with liquid enamel, such as ApaCare toothpaste. Liquid enamel is the stuff that teeth are made of, the very thing that is missing in chalky teeth.

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Professional treatment at homeLiquid

enamel works best when it is applied to the affected teeth or dental arch in a highly concentrated form after brushing with intensive repair pastes such as ApaCare Repair using a dental splint (ApaCare Repair dental splint). The recommended minimum application time is 20 minutes, the splint with the ApaCare Repair tooth repair paste can also be worn throughout the night. Repair enamel

minerals from the liquid enamel attach to the tooth surface, penetrate it and "fuse" with it.

ApaCare mineralising tooth varnish (brush bottle) can be applied to the affected tooth surfaces regularly after brushing. This sticks to the affected areas for a few hours to 2-3 days and releases enamel minerals into the tooth in the long term.

Everything you need (incl. instructions) is included in the ApaCare chalk tooth kit for self-treatment.

By the way: Highly concentrated fluoride varnishes or gels alone are usually of little use.

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What the dentist should doRegular

, regular check-ups at the dentist (every 3-6 months depending on the severity and age of the problem) are essential. The

dentist

will document the enamel defects and their progression, as well as the effect of the aforementioned remineralisation.

The dentist can also gently clean and dry the teeth and apply bonding varnish such as ApaCare mineralising dental varnish. This can sustainably reduce sensitivity and further support remineralisation.

It is very important to detect any caries at an early stage and treat it with remineralising tooth varnish (ApaCare tooth varnish) or targeted small fillings. In severe cases, a long-term temporary or permanent restoration with partial crowns or crowns may be necessary.

The very last (exceptional) measure is tooth removal and, if possible, orthodontic gap closure.