These teeth emerge into the mouth behind the last primary or baby molar tooth around the age of six, which gives a child more teeth to chew food with at the back of the mouth.
Unfortunately the first permanent molars have also been shown to be the most decay prone tooth in the mouth! Although decay is often due to poor diet or lack of good cleaning, some children experience significant decay and breakdown of their six-year-old molars due to poor mineral content in the structure of these teeth. This condition is known as ‘molar hypomineralisation’ with the six-year-old molars being the most commonly affected tooth.

Molar Hypomineralisation:
The Problems
‘Hypo’ means ‘beneath’ or ‘below’, therefore hypomineralisation describes a molar with less than normal mineral content. Studies show that approximately one in five Australian children have hypomineralised six-year-old molars. Hypomineralisation can be mild, moderate or severe and the upper and lower six-year-old molars can be affected to varying degrees, even in the same patient! Severely affected molars have a distinct yellow-brown discolouration and are also termed ‘cheese molars’. Such molars have much softer surface structure and therefore can deteriorate quickly and painfully.

Hypomineralised molars are:
– Sensitive to bite on and can be painful to hot/cold temperatures and everyday toothbrushing
– 14 times more likely to experience decay (compared to normal molars)
– More difficult to restore (e.g. with dental fillings)

What causes Hypomineralisation?
Recent research has shown that the cells which form the hard outer layer of the teeth (i.e. enamel) are very sensitive to changes in body temperature. It appears that children who have had high fevers between birth and three years of age (which is when the six-year-old molars are forming) are much more likely to have soft and poorly functioning enamel structure. Most parents will remember several times when their young baby or toddler was sick and this seems to explain why this condition is so common. Further research is being done in this very interesting area of dentistry.

What can you do?
Your family dentist can easily detect hypomineralised six-year-old molars in children around six years of age. If your child has sensitive back teeth, please see your family dentist for a check-up.
If severe hypomineralisation is found, a referral to a specialist Orthodontist is generally recommended. Fortunately there are many treatment options available to manage hypomineralised teeth. The options will depend upon the severity and may involve monitoring, simple restoration, full coverage restoration or removal.
Your Orthodontist will take into account many factors when recommending the most appropriate solution.
Early diagnosis and appropriate management of molar hypomineralisation reduces dental pain and anxiety and can significantly improve the quality of life of children with this condition. Therefore regular check-ups for children with your family dentist are very important.
A referral to an Orthodontist is recommended if any tooth is significantly compromised.
A specialist Orthodontist has the training, experience and expert knowledge to determine the best short and long-term management strategy for your child’s teeth.

Townsville Orthodontic Specialists
17 Martinez Avenue 
The Lakes Townsville
4775 4433
admin@tsvortho.com.au
www.tsvortho.com.au