One in five children have chalky tooth enamel—visible as discoloured enamel spots—which often causes severe toothache and decay, and sometimes leads to abscesses, extractions and orthodontic problems.
Now, researchers from The D3 Group (based at The University of Melbourne, Australia) and the University of Talca in Chile, have discovered the mechanism causing molar hypomineralisation, the commonest type of chalky teeth.
In their research—published in Frontiers of Physiology—that describe how chalky molars arise when developing enamel is contaminated by albumin, a protein found both in blood and in the tissue fluid surrounding developing teeth. The trigger appears to be childhood illnesses.
“The result is a sort of ‘mineralisation blockage’, which is highly localised to the areas on individual teeth that become chalky enamel spots,” lead author Professor Mike Hubbard said.
“This discovery allows us to correct 40 years of medico-dental dogma which blamed defective enamel-forming cells. What this dogma couldn’t explain is why chalkiness affects only one or a few teeth in a child’s mouth.”
“We’ve shown instead that albumin leaks in occasionally at weak spots, binding to enamel-mineral crystals and blocking their growth. It’s not a system-wide problem, but a very localised one.”
The researchers suspect that the albumin leakage is triggered by routine baby illnesses such as a fever.
“We can’t yet prevent chalky teeth from developing in the first place, but if health professionals catch them early—when they first enter the mouth—then we dentists can usually save them,” Dr Vidal Perez said.
There are several types of chalky teeth reflecting different causes such as genetic anomalies and problems with nutrition.
The team is particularly concerned about molar hypomineralisation as it carries the most social and economic impact.
“Molars are particularly prone to damage,” Dr Vidal said. “They are hidden away at the back of our mouths, with grooves that catch food, and they’re harder to clean.”
A tooth with severe hypomineralisation is 10 times more likely to decay than one without. It is very much a silent epidemic, causing lots of suffering.