Australian and Chilean researchers have solved a centuries-old mystery. One in five children has the tooth enamel calcareous, with white, yellow, or brown spots, which often causes toothache and cavities, and sometimes leads to abscesses, extractions, and orthodontic problems. But it was not clear what the origin of this problem was. Now, researchers from The D3 Group, based at the University of Melbourne (Australia), and the University of Talca in Chile, have discovered the mechanism that causes the molar hypomineralization, the most common type of calcareous teeth.
The results of the work, published in the journal “Frontiers of Physiology”, indicate that calcareous molars arise when the developing enamel is contaminated by albumin, a protein found in both the blood and the tissue fluid that surrounds developing teeth.
The trigger seems to be some childhood illness.
“The result is a kind of ‘mineralization blockage,’ which is highly localized in the areas of individual teeth that become chalky enamel stains,” explains Mike Hubbard, a research professor at the University of Melbourne and lead author of the report.
The expert assures that this discovery “makes it possible to correct 40 years of medical-dental dogma that blamed defective enamel-forming cells. What this dogma could not explain is why stains affect only one or a few teeth in a child’s mouth.
“We have shown, instead, that albumin occasionally seeps into weak spots, adhering to enamel mineral crystals and blocking their growth. It’s not a system-wide problem, but a very localized one, ”says Mike Hubbard.
Researchers suspect that the albumin spill is caused by routine baby health problems, such as fever.
The next objective of the authors of this work is to determine the specific underlying causes, such as environmental factors or pathogens; and promote their findings to dentists, other child health professionals, and parents, so everyone is on the lookout for chalky teeth.
«We still can’t prevent calcareous teeth from developing In the first place, but if health professionals detect them early, dentists can generally save them, ”says Vidal Pérez, pediatric dentist and researcher at the University of Talca.
There are several types of calcareous teeth that reflect different causes, such as genetic abnormalities and nutritional problems. The team is particularly concerned about the molar hypomineralization, since it has the greatest social and economic impact. “Molars are particularly prone to damage,” says Vidal. “They are hidden in the back of the mouth, with grooves that trap food and are more difficult to clean,” he adds.
The problem is that a severely hypomineralized tooth has 10 times more likely to have cavities than one without it.
The scale of the problem became apparent to Mike Hubbard when he noted that fluoridation of community water supplies led to a large but incomplete reduction in tooth decay in children. A substantial proportion of youngsters with unexplained cavities remained. To understand what was happening, he founded a research and education network, The D3 Group for developmental dental defects. The fluorine, which protects against cavities in normal enamel, has little or no effect on calcareous molars.
The enamel of calcareous teeth was first studied by the Austrian and later American medical researcher Bernhard Gottlieb, who in 1920 reported the mystery that only parts of some teeth were affected.
“Based on this research breakthrough, and with adequate resources, the D3 Group can now move towards a medical strategy to prevent this global problem,” says the lead author of the report. «This new avenue of investigation could one day remove about half of cavities dental children, along with their worrying costs for affected people and society, “he concludes.