The multidisciplinary approach: managing enamel defects

Article Abstract:

A case report is presented of a 10-year-old girl with multiple dental abnormalities, including the loss of enamel (the outer layer of the teeth) on several teeth, extensive calculus (hard substance deposited on the teeth), gum inflammation, severe overbite (eight millimeters), and extreme sensitivity to heat. The diagnosis was made of hypomaturation amelogenesis imperfecta, a type of hereditary enamel defect. The treatment plan is described. It ultimately involved an oral surgeon, a maxillofacial surgeon, an orthodontist, and a prosthodontist. The patient had intense anxiety and had undergone painful dental treatment earlier in life. After the initial extractions and crown placement (19 crowns were used), the patient returned at regular intervals to receive help with oral hygiene. Her fear lessened with time, but as she grew older, the patient became more concerned with her appearance. Consultation among several specialists resulted in a new plan involving orthognathic (jaw-straightening) surgery; this is described. Further cosmetic surgery was also needed. The patient was able to achieve a satisfactory esthetic result through this multidisciplinary approach, essential in disorders such as this one. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Children, Dental care, Child health, Oral hygiene

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Hastening the enamel microabrasion procedure: eliminating defects, cutting treatment time

Article Abstract:

Enamel microabrasion may be more effective than bur-cut enamel stripping for the removal of superficial tooth discoloration. Enamel microabrasion involves the rotary application of an abrasive compound to form a smooth enamel glaze. A nine-year-old boy had unsightly white spots on his maxillary central incisors. The right central incisor was treated with enamel microabrasion with a 12-fluted carbide finishing bur followed by application of a microabrasion compound. The left central incisor was treated with application of the microabrasion compound alone. No difference in appearance was observed between the right and left central incisors. An 11-year-old girl underwent a similar type of treatment for decalcification of the maxillary permanent incisors. No difference was seen between the two types of treatment. The main disadvantage of enamel microabrasion is that it may be more time consuming.

Innovations, Dental technology

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Enamel erosion resulting from hydrochloric acid tablets

Article Abstract:

Chewing hydrochloric acid (HCl) tablets can erode the tooth enamel. HCl tablets are available without prescription at health food stores and are used to treat digestive problems. It is well known that acid in food, drinks, or medicines can erode tooth enamel. A 67-year-old woman came for routine dental treatment who had not seen a dentist for several years. Her teeth were severely acid eroded. The enamel on her front teeth was entirely gone. A cast model of her teeth made about five years earlier showed that her teeth had been normal at that time. She had been taking HCl tablets for the past five years for a digestive problem, and since she could not swallow the pills, she chewed them instead. The directions on the bottle gave no instructions about chewing or swallowing. She reported no other sources of acid coming in contact with her teeth.

Hydrochloric acid

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