Dr. Suham Alexander speaks to Dr. Bob Schroth in this third segment about hypophosphatasia (HPP) and the dental implications and management of patients with this condition.
Children with HPP have some definite dental challenges. The developing teeth in these children lack cementum on the roots which leads to premature exfoliation. Additionally, large pulp chambers and irregular dentin and enamel defects increase the extent and risk of caries development.
Radiographic tell-tale signs in HPP include: enlarged pulp horns, lower bone height interproximally as well as bony defects. Prudent use of dental radiographs is recommended in these patients as determined on a case by case basis and in conjunction with a caries risk assessment.
Recommendations for children with HPP
- Use fluoridated toothpaste to brush with parental assistance as soon as a tooth erupts
- Establish a dental home by the age of 1
- Limit sugary snacks/drinks between meals
- Dental sealants on primary molars as well as premolar/molars in the permanent dentition
- Consider dental appliances that replace missing teeth for esthetics/function
- Regular dental follow-ups throughout life