Abstract
Enamel defects and discolorations are common clinical findings and may represent both a biological concern and a significant esthetic complaint for patients. Their appearance can vary considerably according to etiology, depth, color, and structural characteristics, making correct recognition and documentation essential before treatment.
This lecture will provide a practical overview of the most common enamel alterations, including hypomineralization defects such as molar-incisor hypomineralization (MIH), fluorosis, post-traumatic defects, and white spot lesions, with particular attention to their clinical appearance, differential recognition, and esthetic impact.
Many of these conditions are closely linked to daily oral hygiene. White spot lesions develop where plaque accumulates, and hypomineralized teeth are often sensitive, which can discourage effective brushing. Effective mechanical plaque control is therefore the first line of prevention and the foundation of long-term maintenance. Current evidence comparing oscillating-rotating, sonic, and manual toothbrushes will be reviewed. The role of the dental hygienist in risk assessment, monitoring, patient education, and self-care coaching will be highlighted as part of a shared pathway with the dentist.
Particular attention will be dedicated to minimally invasive and additive strategies for improving enamel discolorations. Resin infiltration will be discussed both as a stand-alone treatment and as part of combined approaches that may include tooth bleaching, superficial microabrasion or macroabrasion, and, when necessary, selective use of direct composite resin.
Clinical cases will demonstrate how different techniques can be selected and combined according to lesion characteristics and esthetic expectations. The treatment philosophy is progressive: it begins with prevention and the least invasive option, preserves as much healthy tooth structure as possible, and relies on effective daily self-care to maintain results over time.
Learning Objectives
- Recognize the main enamel defects and discolorations, including MIH.
- Discuss their clinical appearance and possible etiologies, including the role of plaque in white spot lesion formation.
- Explain preventive, monitoring, and documentation strategies, including effective mechanical plaque control and long-term self-care maintenance.
- Discuss the indications of resin infiltration.
- Explain combined approaches using bleaching, micro/macroabrasion, and composite resin.
