Enamel Hypoplasia in Relation to Caries in Guatemalan Children

Guatemalan children with anterior linear enamel hypoplasia (LEH) had a significantly greater caries experience in posterior dentition than their peers who did not have anterior LEH. The findings suggest that the synergistic mechanism of undernutrition and infection, w;hich may underlie the occurrence of anterior LEH, may also predispose clinically normal appearing deciduous molars to an excessive caries attack equal to that observed in the grossly hypoplastic anterior teeth. The nutri-tional implications merit further investigation. Linear enarrmel hypoplasia (LEH) of the de-ciduous maxillary incisors is commonly ob-served in undernourished children throughout the wvorld.1 ' The lesion is very rarely observed in the posterior dentition. Clinically, the lesion is characterized by a horizontal groove most frequently found on the labial surface of the middle third of the maxillary central incisors and on the incisal third of the maxillary lat-eral incisors. Although the etiology of this enamel defect is undetermined, factors associ-ated with the synergistic mechanisms of under-nutrition and infection5,6 common to popula-tions where the lesion is prevalent may be con-tributing factors.7-9 In children living in com-munities where caries prevalence is relatively high, the eruption of these defective teeth into the oral cavity is usually followed by a highly invasive caries attack. The teeth often become reduced to blackened stumps and chronic peri-apical abscess follows.3,4'8 Since a high caries attack in the posterior dentition of Apache In-dian children with anterior LEH had been ob