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Standard of Care Treatment and Restoring Your Smile

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Treating Amelogenesis Imperfecta requires a lifelong, staged approach by a team of dental specialists. Care begins with protective crowns in childhood and progresses to permanent ceramic or zirconia restorations in adulthood to rebuild the bite and restore the smile.

Key Takeaways

  • • Managing Amelogenesis Imperfecta requires a multidisciplinary team of specialists, including pediatric dentists, orthodontists, and prosthodontists.
  • • Treatment is staged by age, using protective stainless steel crowns in childhood and transitioning to permanent ceramic or zirconia crowns in adulthood.
  • • Dentists often use a specialized deproteinization protocol to help fillings and crowns stick better to weak, defective enamel.
  • • The ultimate goal of treatment is to restore the natural height of the bite, which reduces pain and improves overall quality of life.

Managing Amelogenesis Imperfecta (AI) is a lifelong journey that requires a team of specialists working together to protect your teeth and restore your smile [1][2]. Because the enamel is naturally weak or thin, the goal of treatment shifts from simple “patching” to a comprehensive plan that preserves the height of your bite and improves your overall quality of life [3][4].

A Multidisciplinary Approach

Effective care for AI is rarely the work of just one dentist. It typically involves several specialists:

  • Pediatric Dentist: Manages the early years, focusing on prevention and interim protection of primary (baby) teeth [1][5].
  • Orthodontist: Corrects bite issues, which are common in AI, often in the teenage years once the permanent teeth have emerged [6][7].
  • Prosthodontist: Specializes in replacing and restoring teeth, often leading the “full-mouth” reconstruction phase in adulthood [3][6].
  • Periodontist: Focuses on gum health, as patients with AI are prone to gum inflammation and overgrowth [8][3].

Treatment Through the Stages of Life

Treatment is “staged” to match the growth of the patient and the emergence of their teeth.

  • Childhood: The priority is reducing pain and preventing rapid wear. Stainless steel crowns (SSCs) are often used on back teeth to provide durable, long-term protection for baby teeth and early permanent molars [9][1].
  • Adolescence: As permanent teeth come in, the focus shifts to aesthetics and function. Direct composite resin (bonding) or veneers may be used as temporary measures to improve confidence and reduce sensitivity [10][11].
  • Adulthood: Once growth is complete, definitive restorations are placed. Ceramic and zirconia crowns are the gold standard for long-term success [12][13]. All-ceramic restorations, such as lithium disilicate (IPS e.max), have shown excellent longevity, with survival rates of over 90% after 10 years [14][6]. However, it is important to know that even these “gold standard” restorations require lifelong maintenance and may eventually need to be replaced as the years go by [4].

Overcoming Bonding Challenges

One of the biggest hurdles in treating AI is getting dental materials to stick (bond) to the defective enamel. This is especially true for the hypocalcified subtype, where the enamel is soft and contains too much protein [8][15].

To improve bond strength, dentists may use a specialized “deproteinization” protocol:

  1. Etching: The tooth is treated with a standard dental acid.
  2. Deproteinization: The surface is treated with a 5.25% sodium hypochlorite (NaOCl) solution for 60 seconds [15][16]. This removes the excess proteins that block the bond.
  3. Bonding: The filling or restoration is then applied.

Studies show this extra step can significantly improve how well fillings stay attached to “soft” AI teeth [15][16].

Restoring Function and Confidence

The ultimate goal of treatment is to restore the occlusal vertical dimension—the natural height of your bite—which is often lost as AI teeth wear down [4][17]. Successfully completing this treatment does more than just fix teeth; it has been shown to significantly improve Oral Health-Related Quality of Life (OHRQoL), reducing pain and giving patients the confidence to smile and eat comfortably [18][19].

Frequently Asked Questions

What kind of dentists treat Amelogenesis Imperfecta?
Effective care usually requires a multidisciplinary team approach. This typically includes a pediatric dentist for early childhood care, an orthodontist to correct bite issues, a prosthodontist for permanent tooth restoration, and a periodontist to manage gum health.
How are children with Amelogenesis Imperfecta treated?
In childhood, the main goal is to reduce pain and prevent rapid wear of the teeth. Pediatric dentists often place stainless steel crowns on baby teeth and early permanent molars to provide durable, long-term protection while the child grows.
Why do fillings easily fall out of teeth with Amelogenesis Imperfecta?
AI often causes the enamel to be soft and contain too much protein, which prevents standard dental adhesives from bonding properly. Dentists may use a specialized deproteinization step with a sodium hypochlorite solution to clean the enamel and improve bond strength.
What are the best permanent crowns for adults with AI?
Once a patient's growth is complete in adulthood, ceramic and zirconia crowns are considered the gold standard for long-term success. All-ceramic restorations have excellent survival rates, though they require lifelong maintenance and may eventually need replacement.
What does it mean to restore the vertical dimension of my bite?
Teeth affected by AI often wear down significantly over time, causing a loss in the natural height of your bite. Restoring this vertical dimension involves using crowns and other treatments to rebuild the teeth to their proper height, improving chewing function and comfort.

Questions for Your Doctor

  • • Which multidisciplinary specialists (orthodontist, prosthodontist, etc.) should be involved in my/my child's care, and when should they start seeing them?
  • • For my/my child's specific subtype of AI, would you recommend a 'deproteinization' step with sodium hypochlorite (NaOCl) before placing any bonded restorations?
  • • What interim measures, such as stainless steel crowns or composite veneers, can we use to protect the teeth until permanent crowns can be placed in adulthood?
  • • How much tooth structure needs to be removed for ceramic versus zirconia crowns, and which material offers the best long-term outlook for my/my child's bite?
  • • Is there evidence of loss in my/my child's 'vertical dimension' (bite height), and what is the plan to restore it?

Questions for You

  • • How has the condition of my/my child's teeth affected daily activities like eating, speaking, or social confidence?
  • • Are there areas of the mouth where fillings or 'bonding' seem to fail or fall out repeatedly?
  • • What are my long-term goals for treatment: is it primarily to stop pain, improve the appearance of the smile, or ensure the teeth last a lifetime?
  • • How comfortable am I/is my child with the idea of multiple appointments and phases of treatment over several years?

Want personalized information?

Type your question below to get evidence-based answers tailored to your situation.

References

  1. 1

    A UK-based consensus on clinical decision flowcharts for managing childhood amelogenesis imperfecta in the permanent dentition.

    Lakhani S, Monteiro J, Agel M, et al.

    European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry 2026; (27(1)):135-145 doi:10.1007/s40368-025-01127-1.

    PMID: 41225134
  2. 2

    Mini-implant assisted palate expansion and digital design in junctional epidermolysis bullosa and amelogenesis imperfecta: Case report.

    Véliz S, Olivares A, Krämer S

    Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry 2024; (44(6)):1572-1580 doi:10.1111/scd.13044.

    PMID: 39034598
  3. 3

    Full-Mouth Reconstruction in Amelogenesis Imperfecta: A Case Report.

    Marghalani AA

    The American journal of case reports 2026; (27()):e951835 doi:10.12659/AJCR.951835.

    PMID: 41725193
  4. 4

    Full-mouth rehabilitation with lithium disilicate ceramic crowns in hypoplastic amelogenesis imperfecta: a case report and review of literature.

    Chen R, Lin Y, Sun Y, et al.

    BMC oral health 2024; (24(1)):1139 doi:10.1186/s12903-024-04929-9.

    PMID: 39334018
  5. 5

    Esthetic Rehabilitation of a Patient With Amelogenesis Imperfecta Using the Composite Injection Moulding Technique: A Case Report.

    El Mesbahi N, Hachami I, Jouhadi EM, Moussaoui H

    Cureus 2025; (17(7)):e87507 doi:10.7759/cureus.87507.

    PMID: 40777710
  6. 6

    Full Mouth Rehabilitation with All-Ceramic Restorations in a Patient with Amelogenesis Imperfecta: A Case Report with 10-Year Follow-Up.

    Kourtis S

    Dentistry journal 2025; (13(12)) doi:10.3390/dj13120546.

    PMID: 41440304
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    Orthodontic management of amelogenesis imperfecta: A case report.

    Jha K, Adhikari M, Shrestha S, Pandey A

    Clinical case reports 2024; (12(8)):e9329 doi:10.1002/ccr3.9329.

    PMID: 39144064
  8. 8

    Gingival inflammation, enamel defects, and tooth sensitivity in children with amelogenesis imperfecta: a case-control study.

    Quandalle C, Boillot A, Fournier B, et al.

    Journal of applied oral science : revista FOB 2020; (28()):e20200170 doi:10.1590/1678-7757-2020-0170.

    PMID: 32997085
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    Amelogenesis Imperfecta, Facial Esthetics and Snap-On Smile.

    Wilson L, Bradshaw JP, Marks MK

    The Journal of the Tennessee Dental Association 2015; (95(1)):18-21; quiz 22-3.

    PMID: 26433999
  10. 10

    Clinical Performance of Direct Composite Restorations in Patients with Amelogenesis Imperfecta - Anterior Restorations.

    Tekçe N, Demirci M, Tuncer S, et al.

    The journal of adhesive dentistry 2022; (24()):77-86 doi:10.3290/j.jad.b2838105.

    PMID: 35322945
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    Amelogenesis Imperfecta: Case Study.

    Leevailoj C, Lawanrattanakul S, Mahatumarat K

    Operative dentistry 2017; (42(5)):457-469 doi:10.2341/13-256-S.

    PMID: 28829932
  12. 12

    Dental treatment approaches of amelogenesis imperfecta in children and young adults: A systematic review of the literature.

    Rhaiem M, Chalbi M, Bousaid S, et al.

    Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] 2024; (36(6)):881-891 doi:10.1111/jerd.13191.

    PMID: 38258433
  13. 13

    Restorative Treatment in Patients with Amelogenesis Imperfecta: A Review.

    Strauch S, Hahnel S

    Journal of prosthodontics : official journal of the American College of Prosthodontists 2018; (27(7)):618-623 doi:10.1111/jopr.12736.

    PMID: 29377372
  14. 14

    Complete rehabilitation of compromised full dentitions with adhesively bonded all-ceramic single-tooth restorations: Long-term outcome in patients with and without amelogenesis imperfecta.

    Klink A, Groten M, Huettig F

    Journal of dentistry 2018; (70()):51-58 doi:10.1016/j.jdent.2017.12.011.

    PMID: 29275170
  15. 15

    Etching Patterns of Sodium Hypochlorite Pretreated Hypocalcified Amelogenesis Imperfecta Primary Molars: SEM Study.

    Ahmed AM, Nagy D, Elkateb MA

    The Journal of clinical pediatric dentistry 2019; (43(4)):257-262 doi:10.17796/1053-4625-43.4.6.

    PMID: 31094633
  16. 16

    How to optimize bonding procedures on healthy and hypomineralized enamel in orthodontics?

    Dursun E, Attal JP

    L' Orthodontie francaise 2023; (94(3-4)):477-483 doi:10.1684/orthodfr.2023.137.

    PMID: 37930347
  17. 17

    Managing vertical dimensions in patients with Amelogenesis Imperfecta: A case report.

    Farao W, Roomaney IA

    Clinical case reports 2022; (10(8)):e6135 doi:10.1002/ccr3.6135.

    PMID: 36017113
  18. 18

    Oral health-related quality of life before and after crown therapy in young patients with amelogenesis imperfecta.

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    Health and quality of life outcomes 2015; (13()):197 doi:10.1186/s12955-015-0393-3.

    PMID: 26651486
  19. 19

    Advances in clinical diagnosis and management of amelogenesis imperfecta in children and adolescents.

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    PMID: 38909645

This page provides educational information about Amelogenesis Imperfecta treatment options. Always consult with your specialized dental care team for a personalized treatment plan.

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