Vidal Gels & Chalky Teeth Centenary image

Pathogenesis Of Molar Hypomineralisation

A 100-year mystery about "chalky enamel spots" (demarcated opacities) – a principal risk factor for childhood tooth decay – is well on the way to being solved thanks to ground-breaking molecular investigations by D3G's lead researchers (see origins here & here). Until now, it has been difficult to understand why developmental disruption is limited to isolated spots or patches of enamel. Researchers have long believed that corresponding patches of enamel-forming cells must be selectively damaged in some way – but how such localised cellular injuries might link to "whole body" (systemic) disturbances such as infantile illness
remains an enigma.

Vidal Gels image

The new findings switch attention to the developing enamel itself (i.e. extracellular matrix, rather than injured enamel cells) and show that chalky spots arise from localised exposure to a prominent protein from blood called serum albumin. This extracellular pathomechanism, newly termed 'mineralisation poisoning', opens an exciting new direction for investigations into the medical prevention of Molar Hypomin and allied tooth decay.

(Where it all started)

Surface Integrity Governs the
Proteome of Hypomineralized Enamel pic

Surface integrity governs the proteome of hypomineralized enamel
Mangum JE, Crombie FA, Kilpatrick N, Manton DJ, Hubbard MJ (2010) J Dent Res, 89, 1160-65

Personal download here.

(Part 1)

Frontiers Article - Pathogenesis of Molar Hypomineralisation: Hypomineralised 6-Year Molars Contain Traces of Fetal Serum Albumin pic

Pathogenesis of Molar Hypomineralisation: Hypomineralised 6-year molars contain traces of fetal serum albumin
Williams R, Perez VA, Mangum JE, Hubbard MJ (2020) Frontiers Physiol, 11, 619

Free download here.

(Part 2)

Frontiers Article - Pathogenesis of Molar Hypomineralisation: Aged albumin demarcates chalky regions of hypomineralised enamel pic

Pathogenesis of Molar Hypomineralisation: Aged albumin demarcates chalky regions of hypomineralised enamel
Perez VA, Mangum JE, Hubbard MJ (2020) Frontiers Physiol, 11, 579015

Free download here.

(Part 3)

Frontiers Article - A breakthrough in understanding the pathogenesis of molar hypomineralisation: The mineralisation-poisoning model pic

A breakthrough in understanding the pathogenesis of molar hypomineralisation: The mineralisation-poisoning model
Hubbard MJ, Mangum JE, Perez VA, Williams, R (2021) Frontiers Physiol, 12, 802833

Free download here.

WOW, we got huge media attention: 99th percentile score in Altmetric, and 80+ news mentions at PlumX, plus heaps more in other languages. More details below (D3G in the News).

See also: Articles commemorating the centenary of this
research problem are here and here.



Several articles outlining D3G, the Chalky Teeth Campaign, the "Molar Hypomineralisation problem" and the Chalky Teeth Centenary appeared in highly regarded academic journals recently. These advances were bolstered by feature articles in a national dental publication (2019, 2023) and, together with the scientific breakthrough (above) they inspired a translational article collection co-hosted by 4 Frontiers journals (Physiology, Dental Medicine, Paediatrics, Public Health).

Importantly, these cross-referenced articles have broken new ground by introducing D3G's "translational terminology" ("D3s", "chalky teeth", "chalky molars" etc) to the academic and professional literature following successful road-testing on the public and practitioners. This advance provides a rare example of "reverse translation" – most talk today is about the other direction (converting academic advances to public good), but clearly both directions matter. For more information see D3G News Sept 2018 and May 2018.

NZDA News Front Cover Pic

NZDA+D3G mini-symposium on Molar Hypomineralisation and Chalky Teeth
Hubbard MJ, Natarajan A, Firth F (2023) NZDA News, 213, 27-33

Free download here (thanks to NZDA).

Learn more about this groundbreaking event here.

Frontiers pic

100 years of chalky teeth research: From pioneering histopathology to social good
Hubbard MJ, Perez VA, Ganss B (2021) Frontiers Dent Med, 1, 632534

Free download here.

Paediatric Dental article pic

Molar hypomineralization: What is the U.S. experience (revisited)?
Hubbard MJ (2020) Pediatr Dent, 15, 414-5

Personal download here.

JADA article pic

Chalky teeth 100 years on: What comes next?
Hubbard MJ (2020) J Am Dent Assoc, 151, 803-5

Personal download here

NZDA News image

The Molar Hypomineralisation problem: translational science, paediatric and orthodontic perspectives (3 articles)
Hubbard MJ, Natarajan A, Antoun A, Firth F (2019) NZDA News, 195, 35-60

Free download here (thanks to NZDA).

JADA image

Molar Hypomineralization: What is the US experience?
Hubbard MJ (2018) J Am Dent Assoc, 149, 329-30

Free download here.

Frontiers image

Molar Hypomineralisation: A call to arms for enamel researchers
Hubbard MJ, Mangum JE, Perez VA, Nervo GJ, Hall RK (2017) Frontiers Physiol, 8, 546

Free download here.


CDA Oasis Interview pic

Video interview on Pathogenesis of Molar Hypomineralisation

(Canadian Dental Association, Oasis Discussions)

August 2022

Following his group's three breakthrough publications in 2020 and 2021 (above), Mike Hubbard is interviewed about their significance for dental practitioners and how the profession might get involved.

See the blogpost here or go straight to the video here (11 minutes).

Colgate image

Continuing education webinar on Molar Hypomineralisation

(Colgate Oral Health Network, USA)

November 2018

'Molar Hypomineralisation – A guided tour from clinical challenge to public health opportunity'

Colgate America kindly hosted this free webinar in support of D3G's Chalky Teeth Campaign. The uniquely "D3-flavoured" lecture by Erin Mahoney and Mike Hubbard attracted a record live attendance and is now used by dental schools and self-learners around the world.

For more information, see the webinar outline and Colgate's
pre-webinar poll
about practitioners' awareness of Molar Hypomin.

WOW image

Watch here (70 minutes)

Contact us for 1 hour CE quiz (free for D3G members)

2023 update: After an amazing 11,500 views over 4 years, Colgate stopped hosting the webinar due to CE regulations. We thank them for enabling "the show to go on" here at D3G.

Podcast image

Continuing education podcast on Molar Hypomineralisation

(ADA-NSW, Australia)

March 2019

Kindly hosted by the New South Wales branch of the Australian Dental Association, Mike Hubbard talks about clinical aspects of Molar Hypomineralisation through a translational lens.

Listen here (23 minutes).

Continuing education lecture image

Continuing education lecture on Molar Hypomineralisation and The Chalky Teeth Campaign

(DHSV, Australia)

June 2016

At the Public Oral Health Innovations Conference hosted in Melbourne by Dental Health Services Victoria, Mike Hubbard talks about Molar Hypomin and The Chalky Teeth Campaign.

Watch here (14 minutes).

Grace Suckling image

How it all started – a unique conversation with D3 pioneer, Grace Suckling

(The D3 Group)

August 2013

More than anyone, Grace Suckling defined our field. How did she get interested in D3 research, what led to the clinical classifications (DDE Index) still used worldwide today, how were the pathological differences between hypoplasia, hypomineralisation and fluorosis established? These and many more questions are answered in a wonderful conversation with modern-day researcher and paedodontist, Erin Mahoney.

Watch here (36 minutes). An edited version (4 minutes) and much
more information about Grace's work is available here.


Channel 10 News Item

Media campaign about breakthrough research

December 2021

Publication of D3G's breakthrough insights to the pathology of chalky enamel (see above: Breakthrough Science, Part 3) was accompanied by an international media campaign led by our colleagues at Science in Public. As exemplified below, the story attracted widespread attention across the sector, leading to a major surge in website traffic and communications.

Medscape Medical D3G News Item


Medscape Medical D3G News Item


EDSA logo

European Dental Students Association interview

November 2021

Mike Hubbard is interviewed by Christa Serban (EDSA Research Officer and Romania-based D3er) about D3G's translational attack on Molar Hypomineralisation and chalky teeth. Read here.

ABC image

ABC Radio Australia interview

February 2019

Mike Hubbard talks about "chalky teeth", Molar Hypomin and the Chalky Teeth Campaign. Listen here (12 minutes).

Bite magazine image

Australian Bite Magazine feature on dental innovators

December 2018

The D3 Group and Mike Hubbard are featured in an article about "5 visionary Australians transforming dentistry". Read here.

RNZ image

Radio New Zealand interview

October 2018

New Zealand D3G representative Dorothy Boyd and Mike Hubbard talk about "chalky teeth", Molar Hypomin and the Chalky Teeth Campaign. Listen here (10 minutes).

Bite image

Article in Bite magazine

September 2014

D3G founder, Mike Hubbard, relays his vision and experiences in establishing D3G as a world-first translational research and education network centred on understanding and care of people with D3s. Read here.

D3G's "Chalky Teeth" campaign launch

August 2013

D3G's Chalky Teeth Campaign was launched alongside our new online education resource and medico-dental initiative (see D3G News, August 24 2013 and Past Events). Pleasingly, our adoption of "chalky teeth" as a public-friendly term for Molar Hypomin (and other D3s) seemed to gain immediate acceptance from the broader media and public. Within a week, the "1-in-6 kids have chalky teeth" story had been picked up nationally (TV, radio, papers) and internationally, leading to >40 reports worldwide. This exposure led to a major surge in website traffic and correspondence received from across the sector.

Channel 10 image

ABC News Pic

The Australian pic


MedXpress Pic