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At least 19 recordsLinked to original sources
PubMed1989

Developmental enamel defects in primary teeth in children with cerebral palsy, mental retardation, or hearing defects: a review.

Developmental enamel defects in primary teeth have been found at least twice as frequently in children with cerebral palsy or mental retardation as in control children, and frequently also in children with sensori-neural hearing deficits. The developing tooth germ is sensitive to a range of systemic disturbances, some of which may also affect neurologic development. Because the enamel cannot recover once it is damaged, it may provide a repository of information on the timing and nature of insults potentially affecting other ectodermally derived structures, including the brain. This paper reviews the literature on developmental defects of enamel in primary teeth, asking whether these might be useful as biological markers of the timing and in some cases the nature of insults. Among systemic factors related to development of enamel that might also have implications for neurologic development are certain genetic disorders including tuberous sclerosis, premature birth, neonatal nutritional disturbances (especially hypocalcemia), viral infections (such as rubella and cytomegalovirus during gestation), thyroid disorders, and maternal diabetes. It is concluded that further research is warranted concerning whether developmental defects of dental enamel can be useful markers for the timing of intra-uterine or perinatal events associated with certain neurologic and sensory disorders of children.

Cerebral Palsy↗
PubMed1982

The assessment of non-carious defects of enamel.

Developmental defects of dental enamel are very common with at least one in every three individuals having one or more teeth with obvious non-carious defect. The more common defects are opaque areas, hypoplasias (missing enamel) and discoloured enamel; the variety in form, severity and combination of defects is extensive. The lesions are sequelae of systemic, traumatic or genetic events during tooth development. A review of past and current terminologies, and classifications of developmental defects of enamel, reveals ambiguities, deficiencies and lack of uniformity in methods and criteria used in their study. The principal objective for collecting and recording observations on enamel defects is to determine their frequency, severity and distribution for the purpose of assessing the magnitude of the clinical problem they generate and their aetiology. Hence, an internationally recognized classification of developmental enamel defects and recording procedure would increase the value and comparability of future studies. An acceptable uniform terminology and a simple procedure for classifying the more commonly observed defects, defined by their visual characteristics, would achieve these aims. A classification is proposed which identifies and defines the type, number and location of developmental defects affecting tooth enamel on the buccal and lingual surfaces of all teeth. The procedure has been designed for easy interpretation and simple evaluation. It may be modified for use with much less extensive clinical examination.

Adolescent↗
PubMed1998

Developmental enamel defects in children with different fluoride supplementation--a follow-up study.

The intake of fluorides with water, food, dental fluoride preparations, or in particular fluoride supplements, such as NaF tablets, may lead to dental fluorosis. In the present study conducted in a nonfluoridated area in Germany, developmental enamel defects were examined using the Modified Developmental Defects of Enamel Index (Mod DDE Index), which subdivides enamel defects into the categories demarcated (Mod DDE score 1) and diffuse (Mod DDE score 2) opacities and hypoplasia (Mod DDE score 3). 158 children, between 8.5 and 10 years old, were assigned to three examination groups, defined by three different fluoride tablet programs. The children in all three examination groups, F1, F2, and F3, had received 0.25 mg F-/day up to the age of 2 years, F1 and F3 from birth on, F2 beginning with the 7th month of life. F1 and F2 received 0.5 mg F-/day during the 3rd and 0.75 mg F-/day during the 4th and 5th year of life. For F3, beginning with the 3rd year of life, no further recommendations were made. 158 sociodemographically matched children living in a neighboring town served as controls and did not take part in any structured fluoride supplementation program. The proportions of children with Mod DDE scores 1, 2, or 3 at least in one index tooth were significantly higher in the examination groups (40%) than in the control group (20%). Also, the proportions of children with Mod DDE score 2 at least in one index tooth were significantly higher in the examination groups (18%) than in the control group (8%). The proportions of children with Mod DDE score 1 at least in one index tooth were 25% in the examination groups and 17% in the control group. No Mod DDE score 3 was found. Not more than 5% of the children in each group had 50% of their teeth with Mod DDE score 1, 2, or 3. The proportions of teeth per child with Mod DDE score 2 were significantly higher in the examination group than in the control group. While uncontrolled variables cannot be excluded, the observed differences between the experimental and control groups may be attributed to the ingestion of fluoride tablets in the experimental group.

Age Factors↗
PubMedDate not supplied

Prevalence of developmental enamel defects in mentally retarded children.

Developmental defects of enamel (DDE) are commonly observed in children with neurological disorders. However, information related to these patients is very scarce. The purpose of this study was to determine the prevalence of DDE in mentally retarded children and to correlate it with specific perinatal factors and childhood diseases. A total of 170 retarded children between 4 and 17 years from a nonfluoridated area were examined. Teeth with defective enamel were seen in 37% of the patients. Permanent central incisors were the most affected teeth (68.38%). White/single opacities were present in 48.38% and white/diffuse patchy opacities in 28.38% of the patients. There was a significantly higher prevalence of DDE in patients with history of bacterial diseases. No statistically significant relation was found between presence of DDE and sex, nutritional status of the mother, use of alcohol and tobacco during pregnancy, presence of syndromes, neonatal disturbances and viral diseases.

Adolescent↗
PubMedDate not supplied

Polychlorinated biphenyls cause developmental enamel defects in children.

The aim of this study was to evaluate the effects of long-term exposure to polychlorinated biphenyls (PCBs) on developing dental enamel. 202 8- to 14-year-old children who were pre- and post-natally exposed to PCBs in the contaminated region of Bela Krajina, Slovenia, were studied. 202 controls from Brsljin were matched for age and sex. Risk assessment was based on the concentrations of toxic PCB congeners in the diet. Levels of PCBs in dentine were used to validate exposure. PCB levels were analysed by high-resolution gas chromatography. The prevalence of developmental defects of enamel was assessed using the FDI Index. Developmental defects of enamel in permanent teeth were found in 71.3% of exposed children, compared to 49.5% in the control group. The enamel was abnormal in 21.9% of the permanent index teeth of exposed children and in 12.7% of the control children. The difference was statistically significant (chi(2) = 84.18; p = 0.0019), mostly on account of demarcated opacities and hypoplasia. The extent of the defects was also greater in the exposed group (chi(2) = 61.3; p = 0.0001). No significant correlations were found between PCB exposure and developmental defects in deciduous teeth. In conclusion, our results showed that long-term exposure to PCBs may cause developmental defects of enamel.

Adolescent↗
PubMed2003

[The study on the clinical manifestation of developmental enamel defects in primary dentition].

OBJECTIVE: To study the clinical manifestation and its pathogenesis of the developmental enamel defects in primary dentition of children with low birth weight and premature birth history. METHODS: One hundred and seventy-six children (aged 3-8 years old) were studied about the clinical manifestation of the developmental enamel defects in the primary dentition and its relationship with their medical history. RESULTS: The prevalence of enamel defects in primary dentition in these children was 77.3%. There was no significant correlation between enamel defects and gender. Enamel opacity mostly affected the upper and lower second primary molars. Enamel hypoplasia mostly affected the maxillary and mandibular primary incisors and the maxillary first primary molars. CONCLUSION: Enamel defects mainly result from children's general disorder at birth or within one year after birth.

Child↗
PubMedDate not supplied

Breast-feeding and other mother-child factors associated with developmental enamel defects in the primary teeth of Brazilian children.

PURPOSE: The purpose of this study was to examine the association between developmental defects in the enamel (DDE) of the primary teeth and low birth weight or prematurity. METHODS: A case-control study was carried out in Itajaí, Southern Brazil, involving 3- to 5-year-old children. The case group was composed of 102 children presenting at least 1 dental surface with DDE. The control group comprised 113 children without DDE matched by sex and age and enrolled in the same day care centers. All teeth were clinically examined using the Modified Index of Developmental Defects of Enamel. The outcome variable of the study was DDE in at least 1 dental surface, and the independent variables were: (1) birth weight; (2) gestational age; and (3) breast-feeding. Maternal schooling and health problems of the mother during pregnancy and of the child during the first year of life were collected as potential confounding factors. Simple and conditional multiple logistic regression analyses were performed, providing crude and adjusted odds ratio and 95% confidence intervals. RESULTS: Prematurity (OR=2.6; 95% CI=1.0-6.4) and children who did not breast-feed (OR=3.2; 95% CI=1.2-8.4) were associated with defects in tooth enamel after adjusting for possible confounding variables. CONCLUSIONS: In this study, premature children and those who did not breast-feed could be considered at risk for developing defects in tooth enamel.

Adolescent↗
PubMed1992

Prevalence of developmental enamel defects in children with cerebral palsy.

Enamel defects observed in primary anterior teeth of 123 children with congenital cerebral palsy (CP) born 1983 through 1985 in four northern California counties were categorized using an adaptation of the Developmental Defects of Enamel Index. Nineteen children (15%) had crowns or loss of tooth substance (LTS) due to attrition. Missing enamel (ME) including horizontal groove, was observed in 39 children (32%). Twenty-four children without ME (20%) had enamel pits, vertical grooves, or colored enamel opacities. Forty-one (33%) had clinically normal enamel. ME children did not differ significantly from those with normal enamel with respect to race, sex, singleton vs twin, severity or type of CP, or presence of dysmorphic features. ME children more often had shorter gestational ages than children with normal enamel. More ME children, even those who were not low in birth weight, were reported by parents to have required neonatal intensive care.

California↗
PubMed2004

Esthetic perception and psychosocial impact of developmental enamel defects among Malaysian adolescents.

The aim of this study was to investigate the prevalence and psychosocial impact of enamel defects among 16-year-old school children on the island of Penang. The data were collected through a self-administered questionnaire survey and an oral examination, using the Modified Developmental Defects of Enamel Index (FDI, 1992). In all, 1024 subjects were selected using a multistage random sampling technique. About two-thirds of the sample (67.1%) had at least one tooth affected by enamel defects. Enamel opacities accounted for 85.6% of the total condition. Diffuse-type opacity predominated (63.5%). Among subjects who expressed dissatisfaction, 18.8% reported covering their mouths when smiling, 8.7% avoided going out with friends and 39.1% had consulted their dentists. About 17% of the subjects reported that their parents had complained about the color of their front teeth but only 5.7% had experienced being teased by their friends about the problem. Two-thirds of the subjects were affected by enamel defects involving at least one tooth; however, the esthetic perception and psychosocial impact of those affected were minor.

Adolescent↗
PubMed1996

The association between developmental enamel defects and caries in populations with and without fluoride in their drinking water.

OBJECTIVES: The purpose of this study was to consider the association between developmental enamel defects and dental caries in children from areas with different levels of fluoride in their drinking water. METHODS: children (mean age = 14.1 +/- 0.3 years) were examined from areas with less than 0.1 ppm (n = 267) and 0.7 ppm (n = 196) in their drinking water. These areas were chosen to contain subjects with a similar social profile. Two types of enamel defect were considered: those consistent with the diagnostic criteria of the Thylstrup Fejerskov (TF) index and demarcated opacities. Dental caries was recorded for surfaces at the level of the dentinal lesion. RESULTS: Subjects with one or more demarcated opacities had more dental caries than those without these opacities present. Children with enamel defects scored with the TF index tended to have less dental caries than those without these defects present. However, the difference was only statistically significant in the area without fluoride in the drinking water. CONCLUSIONS: Developmental enamel defects may be useful markers of caries susceptibility, which should be considered in the risk-benefit assessment for use of fluoride. Further studies are required to clarify the relationship between developmental enamel opacities and dental caries and the reasons for any associations.

Adolescent↗
PubMed2005

Prevalence and distribution of developmental enamel defects in the primary dentition of pre-school children.

Developmental defects of the enamel (D.D.E.) are changes in the deciduous dentition that have been little studied in Brazil, although they lead to aesthetic problems, dental sensitivity and may be predictors of dental caries. The objective of this study was to estimate the prevalence and distribution of D.D.E. in the deciduous dentition of pre-school children in the municipality of Itajaí, Santa Catarina, in 2003. A cross-sectional study was carried out with a sample of 431 children aged 3 to 5 enrolled in public day care centres. All of the teeth were examined and the enamel defects were assessed according to the Modified DDE Index (FDI, 1992). The prevalence of D.D.E. was 24.4% (CI 95% 20.3-28.5). Diffuse opacities were the most common defects found (17.9%), followed by hypoplasia (11.1%) and demarcated opacities (6.1%). The most affected teeth were the second molars (44.4%), followed by the first molars (23.5%). Defects were observed more frequently in the upper arch (58.2%). Assessing enamel hypoplasia separately, a prevalence of 15.1% (CI 95% 11.7-18.5) was observed, with the most affected teeth being the canines (33.6%) and second molars (33.6%). One quarter of the pre-school children presented enamel defects, with diffuse opacities being the most prevalent ones.

Brazil↗
PubMed1996

Prevalence of developmental enamel defects and dental caries in rural pre-school Thai children.

The prevalence of developmental enamel defects and dental caries was assessed in 344 Karen children aged 1-4 years who were chronically (70 per cent) and acutely malnourished (9.3 per cent) The teeth were cleaned with gauze to facilitate detection of hypoplastic lesions on labial surfaces of maxillary incisors. At least one tooth with defective enamel was seen in 31.9 per cent of children, while enamel hypoplasia was present in 22.7 per cent of children. Enamel defects were found in 21.2 per cent of teeth, with hypoplasia and opacities occurring in 14.6 and 6.6 per cent of teeth, respectively. Gender did not alter the prevalence of defects. The upper central incisors were affected more than lateral incisors. The prevalence of dental caries was 31.9 per cent with a mean dt of 1.1. The prevalence of caries associated with enamel hypoplasia was significantly greater than that associated with opacities and sound enamel (P < 0.0005).

Acute Disease↗
PubMed1986

Prevalence of enamel developmental defects in a group of 11- and 12-year-old children in South Wales.

The prevalence of enamel developmental defects was assessed in 579 children aged 11 and 12 yr using the DDE Index. The teeth were dried prior to the examination and a normal dental operating light was used for illumination. Teeth with some type of defective enamel were seen in 48.9% of children. White/single opacities were present in 26.4% of children and white/diffuse, patchy opacities in 9.9% of children. The enamel was abnormal in 5.74% of all teeth with white/single opacities and white/diffuse, patchy opacities occurring in 1.89% and 1.18% of teeth respectively. There was a significantly higher number of teeth affected by enamel defects in boys (P less than 0.01) and boys tended to have a higher prevalence of yellow opacities compared to girls.

Child↗
PubMed2002

The prevalence of developmental enamel defects in permanent molars in a group of English school children.

AIM: An epidemiological study was designed to determine the prevalence of enamel defects in first permanent molars in English children of ethnic backgrounds. MATERIALS AND METHODS: A population of school children aged seven years, living in the low water fluoride City of Leeds (UK) were examined for the presence of developmental enamel defects in first permanent molars. The examination criteria were based on the DDE index for screening surveys. The ethnic background to the children examined was determined by school records, name and visual assessment. RESULTS: The results for 307 children (154 females) showed an overall prevalence of defective enamel in first permanent molars of 14.5% and tooth prevalence of 7.2%. There were effects of gender or tooth site. There was no significant difference in prevalence between White-Caucasian (17%) or Asian-Caucasian (10%) children. The demarcated opacity was the most frequent type of defect seen, followed by diffuse opacities and hypoplasia. The occlusal and buccal surfaces were the most commonly affected. CONCLUSION: As there were no significant differences in prevalence between children of different ethnic groups it was concluded that the aetiology of enamel defects in permanent molars was most likely affecting all children.

Journal Article↗
PubMed1997

The protein composition of normal and developmentally defective enamel.

The development of human enamel involves a complex series of events including the secretion and degradation of a unique extracellular matrix. Ameloblasts progress through a succession of cellular phenotypes executing specialized secretory and regulatory functions. When performing optimally, ameloblasts produce a highly structured and mineralized tissue. Given the elaborate developmental events required for normal enamel formation, it is not surprising that a variety of enamel malformations arise from defects in matrix synthesis, secretion and extracellular processing. Normal matrix secretion and post-secretory processing by ameloblasts can be affected by a variety of hereditary and environmental conditions. These disturbances can result in an abnormal amount and/or composition of matrix proteins, and subsequently, an altered enamel structure and/or mineral content. For example, abnormal matrix removal during enamel maturation apparently contributes to hypomineralization associated with dental fluorosis. Incomplete matrix removal can also occur in several different forms of the hereditary condition amelogenesis imperfects. Specific types of this condition can have retention of substantial enamel protein (e.g. 5% by weight) that is, at least in part, composed of amelogenin and/or its breakdown products. Characterization of the enamel proteins in teeth affected by developmental disturbances can provide insight into the pathogenesis and normal formation of this highly specialized tissue.

Adult↗
PubMed1995

Prevalence and distribution of developmental enamel defects in primary dentition of Chinese children 3-5 years old.

A total of 1344 children, 3-5 yr old, from two rural counties, Haidian and Miyun, close to Beijing, China, were examined in 1992. A modified DDE Index was employed in this study, and a pre-designed formula was used to calculate an enamel defect score (EDS) for each individual in the study. Oral examination was performed by one dentist under natural light using a standard mouth mirror and dental probe. Developmental enamel lesions were diagnosed without drying or cleaning the teeth prior to examination. Results from this study showed that primary teeth with defective enamel were seen in 23.9% of the children examined, opacity in 1.6%, and hypoplasia in 22.2%. Among the teeth, maxillary central and lateral incisors were affected by enamel hypoplasia most often (40.8% and 39.2%), followed by maxillary canines (25.7%), maxillary 1st molars (22.1%), and mandibular 1st molars (18.5%). The enamel defects occurred more frequently on the buccal surfaces of teeth than on any other surface. The study did not find a significant association of the children's age, family socioeconomic status, and anthropometric measurements with the distribution of enamel defects. However, there was a significantly higher prevalence of teeth with defects in males compared to females (P < 0.001), as well as mean tooth surfaces with defects (P < 0.05), and mean EDS (P < 0.05). Children born prematurely were shown to have four times more enamel lesions than children who were full term (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1997

Developmental enamel defects in tuberous sclerosis: a clinical genetic marker?

Ten probands with tuberous sclerosis (TS) and 20 first degree relatives were examined for evidence of pitted enamel hypoplasia; 100% of TS patients had pitting, compared to 65% of relatives and 72% of 25 controls. We found that 70% of TS cases had more than 14 pits per person compared with only 5% of relatives and 4% of controls; 85% of relatives and 84% of controls had fewer than six pits per person. Our results confirm that significantly increased numbers of dental enamel pits are found in persons with TS compared to controls. These results suggest that examination for the presence or absence of dental enamel pits is not a useful screening test for first degree relatives to detect otherwise unsuspected subjects with tuberous sclerosis. However, the lack of pits in first degree relatives in our study is probably largely because none of the relatives appeared to carry the TS gene.

Dental Enamel↗