Chalk teeth in children

What is this and what can I do?

Chalk teeth pose a whole new challenge for many parents and even dentists. The common specialist term for chalk teeth is Molar Incisor Hypomineralisation (MIH). This term means that the molar teeth ("molar") and incisors ("incisor") are not mineralised, i.e. fully developed, enough ("hypomineralisation"). According to current figures, over 30% of 12-year-olds have this porous teeth disease. This makes MIH a new widespread disease among children.

What exactly does chalk teeth mean?

Unlike the healthy permanent teeth, chalk teeth are not completely mineralised. Normally, around 97% of our enamel is made up of hydroxyapatite – a calcium compound. This hydroxyapatite starts forming while the teeth are not yet visible in the oral cavity. A number of different proteins are responsible for the development of healthy, hard enamel. These proteins make sure that the enamel receives enough calcium and that this is correctly arranged in the form of hydroxyapatite crystals. When the healthy teeth push through the gums, the remains of the proteins are still present on the enamel. However, these are quickly dissolved by chewing. This is a normal process.

Chalk teeth: Here, the proteins do not "function" properly during formation of the teeth. The hydroxyapatite crystals are defective and there are still too many proteins between the crystals. When the teeth push through, this damage to the teeth can be seen with the naked eye in many cases. The enamel is unstable and crumbles during chewing. This causes pain and often results in caries in children because painful and sensitive teeth are usually not brushed sufficiently.

Incisors and molars in the permanent teeth are often affected by this disease. This is why this "new widespread disease" is also called Molar Incisor Hypomineralisation. However, an increasing number of children are also affected by chalk teeth in their milk teeth. In principle, all teeth in children can even push through into the oral cavity as chalk teeth: incisors, canines and molars.

What exactly does chalk teeth mean?
Schematic representation of a mixed dentition with MIH tooth (chalk teeth).

What are the known causes of chalk teeth in children?

Researchers and dentists are unfortunately in the dark about the exact causes of chalk teeth in children. Frequently, plasticisers in plastic are named as the cause for chalk teeth. There are many kinds of plasticisers. Scientific studies indicate that bisphenol A in particular can be considered as a cause of chalk teeth. But infectious diseases, upper respiratory diseases, and medicines such as antibiotics also come into question. Environmental toxins are also not ruled out as a cause of chalk teeth.

Can chalk teeth be prevented?

Specifically preventing chalk teeth is very difficult at present. No specific prevention measures can be recommended until the cause of chalk teeth in children is found. The earlier MIH is detected and treated, the better.

  • As soon as all the milk teeth are there, you should arrange an early prophylactic appointment with the dentist (at two to three years).
  • Regular check-ups and follow-ups at the dentist allow the course of damage and the extent of chalk teeth to be continuously diagnosed.
  • With early diagnosis, the dentist can treat progressive substance loss from chalk teeth in good time and also take other necessary measures.

How can chalk teeth be treated?

Chalk teeth are often painful and unpleasant for the affected child. Depending on the severity, it must be decided case-by-case as to whether the chalk teeth must be preserved, restored or removed. A highly concentrated fluoride varnish is often recommended. This is suitable for caries prophylaxis, but not to "repair" chalk teeth. This is because chalk teeth are not lacking in fluoride, but in calcium. The first visit to a specially trained paediatrician is very important here. Initially, they will explain what you can do for the varying severities of chalk teeth and will also give you comprehensive advice for further treatment. It is crucial for the parents of affected children to take the pain seriously and to support their child as carefully as possible during dental care.

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