1043974-Royalty-Free-RF-Clip-Art-Illustration-Of-A-Cartoon-Businessman-Dressing-In-Front-Of-A-Mirror What you might be looking at in the mirror when you smile may actually be the physical expression of a congenital anomaly that affects the way your teeth look, feel and function.

In the past few years, a significant number of new patients seen in our practice whom have been told by their previous dentist that they have "soft-teeth" and are genetically predispositioned to getting cavities, actually have a genetic deficiency of enamel formation known as Amelogenesis Imperfecta (AI). AI is a genetic defect of tooth enamel formation.  If diagnosed early enough, total loss of enamel can be prevented with the implementation of certain dental adjuncts.


Mary Came In To See us About 3 Years Ago, With This Question:

Q:  "I have been told by my dentist that I have "soft teeth" because every time I go in for a checkup, I have at least 3 cavities.   I brush twice a day, floss and am not a snacker.  Is there such a thing as having genetically bad teeth?"

Mary is not alone, and this one of the most common questions we hear from patients.  Indeed, it is possible that cavity-causing bacteria in our mouths can be transferred to our children, specifically, from mother to child in the early stages of life.  If your mother has a particularly virulent strain of these cavity-causing bacteria and she "tests" baby food prior to giving it to the child, her bacteria are immediately transferred to the child.  Over time, these bacteria colonize the mouth and learn to live in harmony with the child's immune system (sometimes, not a good thing!).

Dietary factors are also extremely important in affecting the health of tooth enamel.  You would think that pretzels are a healthy snack option, but for teeth, pretzels like to "stick around" in deep crevices normally found in healthy tooth structure.  The carbohydrates from the pretzels are consumed by the bad bacteria in our mouths.  The bacteria produce acid as a by-product which eventually begins to disintegrate tooth enamel, causing a "cavity".

 causes of decay


Amelogenesis Imperfecta (AI) is a genetic defect of tooth enamel formation that is often under-diagnosed and actually quite common.   There are 3 basic types of AI:

  1. Hypoplastic AI
  2. Hypocalcified AI
  3. Hypomaturation AI

The hypoplastic type of defect is one in which the enamel structure is imperfect; teeth may appear yellow with white or brown spots (called "mottling") and the enamel can flake away from the tooth surface. 

Soft Teeth:  Hypoplastic Enamel AI

In the hypocalcified type, tooth enamel structure is less calcified.  Teeth may appear yellowish-white, and they become more prone to dental cavities.  The lack of calcification may be so severe that it causes deformation of tooth structure.

AI Hypocalcified


In the hypomaturation type, the enamel essentially never "matures" and as a result, teeth are malformed and the enamel covering is very thin or non-existant.  Teeth may appear more yellowish-brown, sensitivity is common, and teeth are extremely prone to cavities. 

AI Hypomaturation



First and foremost, consult with a dental specialist who has experience treating individuals with Amelogenesis Imperfecta.  Based on the severity of your situation, it may be necessary to restore some or all of the affected teeth with full-coverage ceramic crowns.  In early stages of AI, prescription-based cremes and topical agents will help prevent further destruction and loss of tooth enamel.

Usually, individuals with Amelogenesis Imperfecta have a "trifecta" of symptoms that accompany soft teeth:  dry, brittle hair; dry skin (sometimes with eczema and/or psoriasis); and dry eyes/mucous membranes.  When these signs are clinically apparent, DNA testing is usually not necessary.  NYC dentists Dr. Cordoves and Dr. Gulizio work with medical specialists who will evaluate you for Amelogenesis Imperfecta.  Along with a strongly-worded written narrative, photographs and x-rays, it is possible to have your medical insurance cover dental work related to the disease.  


Schedule an appointment today!