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How to Get a Pretty Smile with Enamel Hypoplasia

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I haven’t smiled in years. I have enamel hypoplasia, which makes me look a bit like a meth addict, minus the unnaturally skinny part. Are there any cosmetic solutions for someone in my place?  My son is getting married in about six months and I’d love to smile in the wedding pictures.


Dear Emily,

I’m going to start by explaining enamel hypoplasia for those who may not be aware of what it is. This is a teeth defect where the enamel of the teeth have not fully formed. Sometimes it is caused by a genetic defect. Other times it’s root cause is a disease during the formation of the patient’s teeth. Depending on the severity of the hypoplasia, there are different treatments.

A side by side images showing both mild and severe enamel hypoplasia on teeth

On the left is mild enamel hypoplasia. It leaves the teeth with white spots that mottle the smile. Dental bonding is a good solution for this. The dentist will drill or use an abrasive to remove all the mottled parts. Then, he or she will cover the area with direct composite bonding.

On the right, is a more severe case of enamel hypoplasia. Notice the teeth are pitted and in some cases the dentin is exposed, placing the patient at risk for decay. The best solution for this is porcelain veneers. This will cover the entire front surface of the tooth. This has the additional benefit of allowing you to get a complete smile makeover. Porcelain veneers can do more than just mask flaws. They can change the shape, size, and color of your teeth. This is the go-to procedure for celebrities who want that Hollywood smile.

Who Should Treat Your Enamel Hypoplasia

Both of these procedures are considered advanced cosmetic dentistry. Additionally, your particular case is more advanced than most. I would be very careful who you choose to do the work. Dental school alone is not enough. Because cosmetic dentistry is not a recognized specialty, patients are in the unfortunate position of not knowing who has that training and who does not.

Because of that, I am going to suggest you only have an accredited dentist with the American Academy of Cosmetic Dentistry (AACD)  do this. Being AACD accredited is different from membership. Any dentist can be a member. To become accredited, a dentist must pass stringent exams demonstrating their technical knowledge. They also have to prove their artistry before a board of examiners showing a large number of cases they have done themselves. These dentists are the best cosmetic dentists in the world. In fact, they are in the top 3%. They can give you a stunning smile.

This blog is brought to you by Naples, FL Cosmetic Dentist Dr. Long.