Julian Huxley is a new patient in your practice. What is his condition?
He finds it extremely difficult to maintain oral hygiene - why? How would you help Julian?
His mother is pregnant with her second child, and is very worried that it may have teeth like Julian's. What advice can you offer?
4 comments:
Dental Fluorosis-Pitting type
Difficulty in Oral hygiene probably due to accumulation of plaque due to the lack of a smooth surface
Treatment-Extract all the teeth(just kidding)
Treatment varies from simple OHI instruction ,microabrasion ,bleaching to composite veneering and restorative management
Advice for the mother-Patient education,check out local fluoride levels in water,toothpaste and the like
I think that the clinical appearance of Julian’s teeth could be due to Amelogenesis imperfecta the hypoplastic type. Defective enamel matrix production as opposed to defective mineralization in hypomineralized type could lead to this clinical appearance.
The hypoplastic type of Amelogenesis imperfecta gives enamel of normal hardness but of varying thickness causing variable clinical appearances. It can present with variable pitting (in Julians Case), vertical grooving, or generalized thinning. Pitting results from localized areas of hypoplasia randomly distributed over the surface of the teeth.
Julian would find it very difficult to maintain good oral hygiene due to the sensitivity of his teeth caused by the inadequacy of the thin enamel. Treatment depending on the cause of the pitting could include crowns to cover the thin enamel.
The hypoplasia could also be due to severe dental fluorosis.
AI is a hereditary condition so if there is a family history it may be suspected. Autosomal dominant inheritance is the most common form of inheritance, but it can also be x linked or occur through spontaneous mutation. If AI can be excluded the possible causes of fluorosis should be explored so appropriate advice can be given to the mother.
P.S this article was quite helpful J Dent Educ 65 (9): 896-905.
i agree with anonymous.
If Julian is positive for Amelogenesis Imperfecta, a genetic testing for the unborn child can be done. Depends on which form of inheritance, the risk of the unborn child getting the same condition will vary.
I would like to know if we got it right or not. anyone? Mr. Julius K? XP
does the M in 'M Addy' stand for Martin? thanks.
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