Enamel cracks. The role of enamel lamellae in caries initiation

Lamellae or cracks are distributed throughout tooth enamel in both deciduous and permanent dentitions. While earlier authors postulated that lamellae may be pathways of entry for caries, no evidence was adduced and the theory appears to have been discounted. The present study seeks to show that, at least in some cases, lamellae are permeable to dyes, may be associated with caries initiated in the dentine, supporting the hypothesis of Hardwick and Manly of lamellae penetration by Streptococcus mutans and lactobacilli. The enamel lamellae are shown to be a permeable pathway allowing caries-producing bacteria access to the dentine-enamel junction. Caries can thus be established within the tooth without visible evidence at the surface.