If your teeth have white spots or stains, your tooth enamel could be showing signs of hypocalcification. White discoloration appears when acidic conditions in the mouth dissolve the calcium in the tooth enamel and cause it to leach out. Another cause of low levels of calcium in tooth enamel is the genetic disease amelogenesis imperfecta. This is an inherited condition that affects the teeth and causes weakened enamel. The tooth enamel doesn’t develop normally in primary or adult teeth, it’s soft and easily worn away or it may may form only a very thin layer over the underlying dentin.

Acids from oral bacteria or acidic foods and drinks can break down the calcium in tooth enamel too. This is called demineralization and its the first step to cavity formation. Calcium helps strengthen tooth enamel, and wherever it’s lost the tooth becomes weaker. The first signs of calcium loss are white spots or stains on teeth because the structure of the enamel has changed. Hypocalcified enamel is more porous and chalky than healthy enamel. When left untreated, the calcium loss continues, the enamel breaks down entirely, and a cavity appears.

Poor oral care is often the cause of demineralization of dental enamel. Patients who have their braces removed after orthodontic treatment might see white spots where the braces were attached to their teeth. When calcium loss is due to acid attacks, the teeth may respond to remineralization through pastes, creams, or fluoride treatments. This will help prevent further calcium loss and calcium development.  In amelogenesis imperfecta patients, hypocalcification cannot be cured. Full crown restorations fir defective teeth cover and protect the dentin, preventing decay and relieving tooth sensitivity these patients often experience.

This case illustrates a 22 year old patient with hypocalcifcation. She was unhappy with the appearance of her teeth. She does exhibit poor alignment of her teeth as well. She did not want to do orthodontics or braces so we did a combination of veneers and crowns to improve her smile and protect her teeth from further breakdown. As you can see her smile has changed dramatically and the health of her teeth has been preserved.