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Hypomineralisation: Chalky Teeth

Hypomineralised teeth are common and occurs when the enamel (outer layer) has not developed properly. This means the enamel is softer, weaker, and more porous than normal. You may hear this condition referred to as Molar Incisor Hypomineralisation (MIH) when it affects adult molars and incisors.


The exact cause isn’t always clear, but it occurs during tooth development (before the teeth erupt).

Possible contributing factors include:

    • Childhood illness or high fevers
    • Respiratory conditions (e.g. asthma)
    • Antibiotic use in early childhood
    • Premature birth or low birth weight
    • Environmental or genetic factors

Often, there is no single identifiable cause, which can be frustrating for parents—but it’s important to know it is not due to poor brushing.

Hypomineralised teeth often appear different from healthy enamel:

    • White, cream, yellow, or brown patches
    • Chalky or opaque appearance
    • Enamel that may look rough or uneven
    • In more severe cases, enamel may break down easily

These changes are usually seen on:

    • First adult molars (back teeth)
    • Front teeth (incisors)

Children (and sometimes adults) with hypomineralised teeth may experience:

  • Tooth sensitivity (especially to cold, heat, or brushing)
  • Pain when eating or drinking
  • Difficulty brushing due to discomfort
  • Teeth that chip or crumble easily
  • Increased risk of tooth decay

Because the enamel is weaker, these teeth are more vulnerable and need extra care.

Treatment depends on the severity of the condition and the child’s symptoms.

Preventative care

    • High-fluoride toothpaste (as recommended by your dentist)
    • Professional fluoride applications
    • Fissure sealants to protect vulnerable molars
    • Dietary advice to reduce sugar intake

Sensitivity management

    • Desensitising toothpastes (e.g. those recommended by Oral-B or Colgate)
    • Topical treatments applied by your dentist

Restorative treatment

    • Tooth-coloured fillings to protect damaged areas
    • Stainless steel crowns (especially in children) for severely affected molars
    • In some cases, extraction and orthodontic planning

Your dentist will tailor treatment to your child’s needs, often taking a preventative, minimally invasive approach first.

  • Use a soft toothbrush and gentle brushing technique
  • Brush twice daily with fluoride toothpaste
  • Consider desensitising toothpaste if recommended
  • Limit sugary snacks and acidic drinks
  • Encourage regular dental check-ups

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