The formation of a tooth is a remarkable process. The exact mechanisms involved in this process are not fully understood but we know that they are regulated by several genes. Amelogenesis imperfecta is a condition created when the formation of enamel, the hard outer material of the tooth, does not happen properly. There have been found 14 different deviations which are grouped under the name of Amelogenesis imperfecta and they are distinguished by their specific enamel changes and by their pattern of inheritance. The reason Amelogenesis imperfecta happens is that there have been changes in the genes that encode for the creation of enamel. These changes can affect only the enamel or they can be a part of a syndrome that affects many parts of the body.
Usually the amelogenesis is uncovered when the first baby teeth erupt and they either start to break or their appearance is odd. To establish that the appearance of the teeth is due to a genetical factor we first need to rule out any environmental or other factors, establish a likely inheritance pattern, ascertain the phenotype and check the correlation with the dates of tooth formation to exclude a chronological developmental disturbance. Only after all these variables have been established we can establish that it is Amelogenesis imperfecta.
The treatment of the condition is based on the principles of prevention before intervention. Because there is a large range of defects associated with this condition there is a need to individually tailor the treatment to the age and needs of the patient.Usually during childhood, while the “baby” teeth are present, we concentrate on providing the child with the ability to develop his speaking, a good aesthetic appearance and help with nourishment. At the age of 6 years of age when the permanent teeth start to erupt, begins the important stage of protecting and supporting the erupting teeth. Treatment provided for young children needs to balance the needs of the child with the benefits and risk of treatment. Usually the long-term care for the teeth affected by Amelogenesis Imperfecta, revolves around either crowns or, more frequently composite restorations. The choice between the different solutions is based on the condition of the teeth.