Restorative Therapy for Enamel Hypoplasia

Enamel hypoplasia is a common finding in our canine patients and less common in our feline patients. Enamel hypoplasia is due to a disruption in the formation of normal enamel that appears as defect(s) in the enamel surfaces. Many times these areas appear pitted or discolored yellow. This is diseased enamel and/or exposed dentin.

The causes for abnormal enamel development include systemic illness (distemper, parvovirus, etc.), deciduous tooth abscess, trauma, or excessive force during deciduous tooth extraction. This condition is apparent at 6 months of age when the pet's permanent teeth have erupted. The affected teeth can be sensitive and may occasionally fracture if severely affected.

The areas of diseased and missing enamel are prone to rapid accumulation of plaque and calculus. Furthermore, unlike enamel, dentin is somewhat porous. The dentin tubules may serve as a pathway for bacteria or toxins from the oral cavity to invade the pulp. Remember that in pets under one year of age the dentin is still relatively thin and the root is not fully formed (note arrows on the X-ray) . As a tooth matures the dentin becomes thicker and the tooth becomes stronger.

Intraoral radiographs are necessary to evaluate the structure and viability of the roots. Then all diseased or weakly attached enamel is carefully removed. The exposed dentin and beveled enamel margins are sealed with a bonding agent. This is followed by a composite restoration that provides a smooth protective coating.

Due to the shearing forces our canine and feline patients exert on their teeth, these restoratives will wear over time. When this occurs the bonding agent and residual composite will still be present within dentin tubules thus sealing the teeth. Typically we do not replace the worn composite unless the owner requests for cosmetic reasons .

Restoration of the lesions seal and protect the tooth, allowing it to mature. For a period of time the smooth surface of the restoration allows for better management of plaque and calculus accumulation. Pet owners are counseled on the importance of routine home-care programs combined with regular professional cleanings.