Etiology: Teeth

Any tooth surface can develop a cavity, but some surfaces are more prone to developing a cavity. These can include newly erupted teeth due to immature enamel and teeth with enamel defects.

Nature of Enamel Defects

The cells that manufacture enamel are very sensitive to systemic insults. Disruption in the production of enamel during tooth development will result in a defect which may be microscopic or macroscopic.

  • Twenty to forty percent of children have enamel defects.
  • Defects may appear as changes in translucency, color, or texture.
  • It may be difficult to distinguish enamel defects from early clinical signs of caries though this does not affect management.
  • Enamel defects are associated with substantially increased risk of ECC.
  • Increased incidence of enamel defects is associated with:
    • Lower socioeconomic status (SES)
    • Children born prematurely
    • Children with certain congenital and genetic diseases and other children with special needs, such as children with cerebral palsy and intellectual disabilities

Enamel Defects

Joanna Douglass, BDS, DDS
Joanna Douglass, BDS, DDS
Joanna Douglass, BDS, DDS


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Weerheijm KL. Molar incisor hypomineralization (MIH): clinical presentation, etiology and management. Dent Update. 2004 Jan-Feb;31(1):9-12.

Seow WK. Enamel hypoplasia in the primary dentition: a review. ASDC J Dent Child 1991;58:441-52.

Jacobsen PE, Haubek D, Henriksen TB, et al. Developmental enamel defects in children born preterm: a systematic review.  Eur J Oral Sci. 2014; 122(1):7-14.