Thin enamel layer covering the dentine(sp?)?

[blankguy]

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Has anybody run into a case where the patient has weak teeth because of the outer enamel layer protecting the teeth is unusually thin or weak hence the teeth is susceptible to being worn down.

 

[aphistis]

Not personally, but amelogenesis imperfecta, dentinogenesis imperfecta, and regional odontodysplasia are a few of the diseases that can give that presentation.

 

[45540]

like he said, any example of hypocalcification is generally associated with fracture or premature wear.

 

[blankguy]

How would a case like this be treated? How rare is it?

 

[aphistis]

If the dentin is healthy, and the problem is just the deficient enamel, doing restorative prosthodontic treatment is a pretty uncomplicated matter, and highly effective in restoring function. It's expensive, though--the fee for a 28-crown case isn't going to come from between your sofa cushions.

As for frequency, amelogenesis imperfecta and dentinogenesis imperfecta each occur once out of every few thousand births (the exact number depends on which source you use), and I can't remember the frequency for regional odontodysplasia. Anybody else know?

 

[blankguy]

Can this be caused by years of hard brushing with a hard toothbrush or is it just genetic?

 

[45540]

you can have a patient who has worn away layers of enamel through various means; but those disorders posted above are genetic and involve formation of enamel that isn't near as hard as it should be.

 

[Jack Worthing]

Can this be caused by years of hard brushing with a hard toothbrush or is it just genetic?

Just off the top of my head and personal experience, I think years of hard brushing usually result in erosion of the DEJ below the normal anatomical level, resulting in partial exposure of the roots and some sensitivity to temperature.

The "amelogenesis imperfecta" affects the enamel development before and during tooth eruption. Later on, enamel attrition can be caused by your own teeth (grinding or malocclusion) and enamel erosion usually by chemical agents.

I remember seeing a powerpoint slide in our Dental Morphology lecture of a patient with "amelogenesis imperfecta" who had stumps for teeth... absolutely no occlusal anatomy left on the molars.. sometimes the teeth would be worn down all the way to gums. This jives with the earlier post that said "amelogenesis imperfecta" results in enamel that is not "near as hard as it should be" and thus there is "fracture or premature wear"

 

[lnn2]

Amelogenesis imperfecta:
Hypocalcification of the enamel

Dentinogenesis imperfecta:
Hypomineralization of the dentin. The enamel is normal. The teeth usually wear down rapidly, leaving short, brown stumps

 

[Jack Worthing]

Amelogenesis imperfecta:
Hypocalcification of the enamel

Dentinogenesis imperfecta:
Hypomineralization of the dentin. The enamel is normal. The teeth usually wear down rapidly, leaving short, brown stumps

I love the avatar. X-ray of Homer. I was wondering what was wrong the mouth and then it came to me.