Marshman Z, Rodd H. The psychosocial impacts of developmental enamel defects in children and young people. In: Drummond BK, Kilpatrick N (eds). Heidelberg, New York, Dordrecht, London: Springer; 2014
Donly KJ, O'Neill M, Croll TP. Enamel microabrasion: a microscopic evaluation of the “abrosion effect”. Quintessence Int. 1992; 23:(3)175-179
Bezerra A, Leal SC, Otero SA, Gravina DB, Cruvinel VR, Ayrton de Toledo O. Enamel opacities removal using two different acids: an in vivo comparison. J Clin Pediatr Dent. 2005; 29:(2)147-150
Bassir M, Golnaz B. Comparison between phosphoric acid and hydrochloric acid in microabrasion technique for the treatment of dental fluorosis. J Conserv Dent. 2013; 16:(1)41-44
Kim S, Kim EY, Jeong TS, Kim JW. The evaluation of resin infiltration for masking labial enamel white spot lesions. Int J Pediatr Dent. 2011; 21:241-248
Wright JT. The etch-bleach-seal technique for managing stained enamel defects in young permanent incisors. Pediatr Dent. 2002; 24:(3)249-252
Tredwin CJ, Naik S, Lewis NJ, Scully C. Hydrogen peroxide tooth-whitening (bleaching) products: review of adverse effects and safety issues. Br Dent J. 2006; 200:371-376
Haywood VB, Leonard RH, Nelson CF, Brunson WD. Effectiveness, side effects and long-term status of nightguard vital bleaching. J Am Dent Assoc. 1994; 125:1219-1226
Buchalla W, Attin T. External bleaching therapy with activation by heat, light or laser – a systematic review. Dent Mater. 2007; 23:586-596
Wilson D, Xu C, Hong L, Wang Y. Effects of different preparation procedures during tooth whitening on enamel bonding. J Mater Sci Mater Med. 2009; 20:1001-1007
Enamel opacities can appear as white, cream, yellow or brown patches. They can result from developmental or acquired conditions. The diagnosis, severity of the opacity and patient's desire for treatment guide the clinician when choosing the correct management option. Microabrasion is indicated for surface opacities, whereas bleaching can treat opacities deep within the tooth. When these techniques have failed to achieve the desired result, camouflaging the opacity with composite resin may be useful. Novel techniques, such as infiltrating or sealing the opacity, can alter enamel's refractive index, offering further treatment choices.
CPD/Clinical Relevance: There are many conservative treatments available which can improve the appearance of enamel opacities.
Article
Enamel defects can present as a change in tooth colour; such as white, cream, yellow or brown opacities. The enamel structure can also be affected causing grooves or pits. The most recent UK Child Dental Health Survey (2013) found that 28% of 12-year-old children had an enamel opacity affecting one or more permanent teeth.1 Opacities can have a significant effect on a person's appearance and social wellbeing.2
Amelogenesis is a complex process which involves three stages:
Normal, fully formed enamel is comprised of hydroxyapatite crystals embedded in a protein and lipid matrix. Ameloblasts are sensitive to hereditary and environmental disturbances during amelogenesis. This can cause alterations in the enamel structure or mineral content. Disturbances in the amelogenesis process can result in an increased water and protein content compared to normal enamel. This can affect the enamel's refractive index, thereby creating an enamel opacity.
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
