Hypocalcification

Hypocalcification is a term used to describe inadequate deposition of calcium salts in developing tissues, resulting in reduced mineral content and impaired calcification. It can affect different systems, most commonly dental enamel and the skeleton, and may reflect systemic nutritional, hormonal, or metabolic disturbances.

In dentistry, enamel hypocalcification refers to hypomineralization of the enamel that has already formed. The enamel is thinner and softer than normal, often presenting as chalky white to yellow-brown opaque spots or patches. Affected teeth may be more sensitive and prone to caries and wear. Causes are varied and can include systemic disturbances during tooth development (such as malnutrition, febrile illness, or vitamin D deficiency), local trauma to the enamel-forming cells (ameloblasts), or genetic factors. Diagnosis relies on clinical examination and dental radiographs; histologic confirmation is uncommon. Management focuses on protecting and remineralizing the enamel, followed by cosmetic or restorative procedures as needed. Preventive care and treatment of underlying nutritional or systemic issues are important to reduce progression or recurrence.

In bone, hypocalcification describes delayed or deficient mineralization of developing bone, commonly seen in conditions like rickets in children and osteomalacia in adults, typically due to vitamin D deficiency, insufficient calcium or phosphate, or renal disorders. Clinical features include bone pain, deformities, and increased fracture risk. Radiographs may show metaphyseal cupping and fraying. Treatment targets the underlying cause and typically involves vitamin D supplementation, calcium and phosphate correction, and management of any underlying disease.

Diagnosis generally includes clinical history, physical examination, laboratory tests of calcium, phosphate, alkaline phosphatase, vitamin D status, and targeted imaging.