Hypophosphatasia may be described briefly as a condition mostly occurring in infants and children, in which there are rachitic bone changes with a variable degree of hypercalcaemia, and a lowered serum alkaline phosphatase (normal levels, adults 3-7-13-1 K.A. units/l00 ml., children 15-20 K.A. units/100 ml.). Urine analysis by paper chromatography shows the presence of a spot corresponding to phosphoethanolamine, which is excreted in smaUl amounts and is considered pathognomonic.While the bone lesions in hypophosphatasia have been extensively studied, the dental changes, which are equally striking, have been less so. We present here our conclusions from having observed 10 cases of hypophosphatasia, studied with particular reference to the teeth, of which 4 illustrative cases are briefly described.Case Reports Case 1. (A.H.). This boy was first investigated when 2i years old for bony deformities which had been present since birth. He had also had bouts of vomiting which occurred after meals, lasted two day and recurred at sixweekly intervals, and were accompanied by extreme fatigue. At this time he was able to walk, but with a pronounced roll and tended to drag his toes. Both arms and legs had been short since birth and both femora were bowed, the knees were not fully extended, and he had short trident hands. There was lordosis of the lower spine and sulci on either side of the sternum at the costochondral junction. The face was asymmetrical with left-sided proptosis, and the deciduous incisor teeth were reported lost. The coronal sutures of the skull were heaped up.Radiographs showed the cortices of the bones to be very thin and several long bones showed evidence of old fractures.Plasma alkaline phosphatase, 2-8 K.A. units,100 ml.Serum calcium, normal. Paper chromatography of urine showed a large excretion of phosphoethanolamine.FAMILY HISTORY. Both parents were alive and well, and were not related. The mother's alkaline phosphatase level was low, 2-9 K.A. units/100 ml., and urinary chromatogram revealed a definite slight excess of phosphoethanolamine. The father's alkaline phosphatase level was also low, 3 -8 K.A. units/100 ml., and his urine contained a small amount of phosphoethanolamine. Both parents were, therefore, considered to be heterozygotes foF the defect under discussion.There was one sib, a brother 6 years older than the patient who now at the age of 8 years was well, though at the age of 2 years he had for six months had intermittent bouts of vomiting. Clinically and radiographically his bones were normal, but his alkaline phosphatase level was low, 8-3 K.A. units/100 nll., and his urine contained considerable amounts of phosphoethanolamine.At 7 years the patient was referred for dental opinion with this typical history of infantile hypophosphatasia. He was now a small child for his age, with some frontal bossing. He was unable to run much, suffering pains in feet and legs. The alkaline phosphatase level, which had fallen to 0-7 units at the age of 54 years, had risen but was still at a low level, ...