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Maternal and Child Health Bureau logoA Health Professionals Guide to Pediatric Oral Health Management
HomeModuleModule 1: An Introduction to Infants' and Young Children's Oral HealthModule 2: Managing Infants' and Young Children's Oral HealthModule 3: Oral Conditions and AbnormalitiesModule 4: Prevention of Oral DiseaseModule 5: Non-Nutritive Sucking HabitsModule 6: Oral InjuryModule 7: Infants and Young Children with Special Health Care NeedsContentsGlossaryEvaluationHelp
Module 3: Oral Conditions and Abnormalities
Module Contents
3.1 Recognizing Healthy Teeth, Soft Tissues, and Facial Bones
3.2 Healthy Teeth
3.3 Healthy Soft Tissues
Lips, Tongue, and
Oral Mucosa
Frena & Gingiva
Major Salivary Glands
3.4 Healthy Facial Bones
3.5 Tooth Conditions and Abnormalities
Dental Caries
Untreated Tooth Decay
Hypodontia & Anodontia
Hypocalcification (current page)
Amelogenesis Imperfecta (current page)
Dentinogenesis Imperfecta (current page)
Extrinsic and Intrinsic Enamel Coloration (current page)
3.6 Soft Tissue Conditions and Abnormalities
Epithelial Cysts
Congenital Epulis
Natal or Neonatal Teeth
Eruption Cysts
Fibroma & Papilloma
Key Points
Additional Resources

3.5 Tooth Conditions and Abnormalities, continued


photo of hypocalcification
  Fig 14. Hypocalcification

Hypocalcification (Figure 14) refers to a condition in which the enamel is normal, but the enamel quality is poor. This condition can be heritable or can be caused by local factors (e.g., habitual sucking on citrus fruits, frequent and prolonged consumption of highly acidic carbonated drinks, extensive plaque deposits that are not removed daily).


Amelogenesis Imperfecta

photo of amelogenesis imperfecta
  Fig 15.
Amelogenesis Imperfecta

Amelogenesis imperfecta (AI) (Figure 15) is a heritable defect in the enamel that occurs in between 1 in 4,000 and 1 in 14,000 individuals. The most widely accepted classification system for AI considers mode of inheritance and clinical manifestations. Autosomal dominant, recessive, and X-linked inheritance patterns of AI have been reported. The clinical appearance of the enamel ranges from normal in color to yellow or brown, and enamel thickness ranges from normal to thin (enamel that often chips and erodes easily). Depending on the AI type, the teeth can be extremely sensitive to thermal and chemical stimuli. Treatment of AI is based on the diagnosis.[5]


Dentinogenesis Imperfecta

photo of dentinogenesis imperfecta
  Fig 16. Dentinogenesis Imperfecta

Dentinogenesis imperfecta (DI) (Figure 16) is a heritable defect in the dentin that originates early during tooth development. In all three types of DI, the teeth have a variable blue-gray to yellow-brown discoloration that appears opalescent because of the defective, abnormally colored dentin shining through the translucent enamel. Because of the lack of support of the poorly mineralized underlying dentin, the enamel commonly fractures from the teeth, leading to rapid wear and attrition. Treatment of individuals with DI depends on severity of discoloration and propensity for enamel loss.[5]


Extrinsic and Intrinsic Enamel Coloration

photo of extrinsic coloration
  Fig 17.
Extrinsic Coloration

Enamel coloration can be extrinsic or intrinsic. Extrinsic coloration (Figure 17) is normally due to environmental stains and is likely to occur when teeth are covered with plaque and are inadequately brushed or when the stains adhere to calculus deposits. Black, green, and orange stains on the crowns of the teeth are common with this condition. Extrinsic coloration may occur when a child who is anemic is taking a liquid iron supplement or when a child is not brushing his teeth (or having his teeth brushed by a parent).

Intrinsic coloration is due to blood-borne pigments (e.g., congenital porphyeria, drug administration, ingestion of tetracycline during pregnancy or any time before age 8) or ingestion of excessive fluoride.

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