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PubMed This is a summary of 16 peer-reviewed journal articles Updated
Dentistry

Long-Term Care, Home Management, and Future Horizons

At a Glance

Long-term care for Dentinogenesis Imperfecta Type 2 (DGI-II) involves daily protection of fragile teeth using soft toothbrushes and non-abrasive toothpaste. While microscopic cracks can lead to 'silent' infections and tooth loss, DGI-II does not affect the jawbone, making dental implants an excellent long-term solution.

The journey with Dentinogenesis Imperfecta Type 2 (DGI-II) is a marathon, not a sprint. While the condition presents lifelong challenges, modern dental technology and proactive care make it possible to maintain a functional and beautiful smile throughout adulthood [1][2].

Daily Home Care Instructions

While your dentist handles the major restorations, protecting your fragile teeth at home is just as critical. The goal is to minimize stress on the weak enamel and avoid wearing away the dentin.

  • Use Soft-Bristled Brushes: Always use a soft or extra-soft toothbrush to avoid scrubbing away fragile tooth structure.
  • Avoid Abrasive Toothpastes: Whitening toothpastes or those with high abrasiveness (like baking soda or charcoal) act like sandpaper on weak dentin. Stick to gentle, non-abrasive fluoride toothpastes.
  • Dietary Adjustments: Avoid chewing ice, hard candies, or very crunchy foods, as these greatly increase the risk of the enamel shearing off [3][4].

The Mystery of “Hidden” Infections

A common and confusing complication in DGI-II is the appearance of a periapical abscess—an infection at the tip of the root—even when the tooth looks solid on an X-ray [5][6].

Because the pulp chamber (the nerve space) is “obliterated” or filled with dentin, one might assume infection is impossible [7]. However, the abnormal dentin in DGI-II is more porous and prone to microscopic cracks [8][9]. Bacteria can “leak” through these tiny pathways or enter through microscopic gaps at the gumline, eventually reaching the bone at the base of the tooth [6][10]. Because these teeth often lack a traditional nerve, these infections can be “silent,” showing no pain until they are quite advanced [6].

If a tooth becomes infected, standard root canals are often impossible because the canal is completely blocked by solid dentin [11]. In these cases, the tooth may need to be removed and replaced by your dental team [11][6].

Transitional Options for Young Adults

As children grow into young adults, their dental needs change. Keeping natural teeth is always the priority, but sometimes a transitional approach is needed while waiting for the jaw to finish growing [12].

  • Overdentures: For patients with severe wear, an overdenture is a removable appliance that fits right over the remaining natural teeth or roots [5][13]. This helps preserve the jawbone and maintains the “height” of the face (Vertical Dimension) without requiring the immediate removal of teeth [5].

Long-Term Prosthetics and Implants

In the long term, some patients may eventually require tooth replacement to achieve a stable bite.

  • Dental Implants: Implants are a common long-term solution for missing teeth [2]. It is important to know that DGI-II ONLY affects the teeth, not your bones. Your jawbone is just as strong as anyone else’s. Your surgeon will do a standard evaluation of your bone volume to plan for implants, just as they would for any patient replacing a lost tooth [14][2].
  • Full-Mouth Rehabilitation: Many adults with DGI-II eventually undergo a coordinated “rebuild” of their smile [1]. This often involves CAD/CAM (computer-designed) crowns that are engineered to handle the unique chewing forces of a DGI-II patient while providing a natural appearance [1][13].

Looking Ahead: The Prognosis

The prognosis for preserving a functional smile is very good when care is started early and managed by a multidisciplinary team [12][2]. While the natural teeth in DGI-II are structurally different, they can often serve as a foundation for high-tech restorations for many decades [1][15]. Consistent monitoring with advanced imaging allows your team to catch micro-cracks or silent infections before they become major problems [16][6].

Common questions in this guide

What is the best toothpaste for Dentinogenesis Imperfecta Type 2?
Patients with DGI-II should use gentle, non-abrasive fluoride toothpastes. It is important to avoid whitening toothpastes or those containing baking soda and charcoal, as they can act like sandpaper and wear away your fragile dentin.
How can a tooth with an obliterated nerve still get an infection?
The abnormal dentin in DGI-II is highly porous and prone to microscopic cracks. Bacteria can leak through these cracks to the root tip, causing an infection that is often painless because the tooth's nerve space is already completely blocked by solid dentin.
Can I get dental implants if I have Dentinogenesis Imperfecta Type 2?
Yes, dental implants are a very common and effective long-term solution. Dentinogenesis Imperfecta Type 2 only affects your teeth, not your bones. Your jawbone is just as strong as anyone else's and can safely support dental implants.
Can a tooth with DGI-II be saved with a root canal if it gets infected?
Standard root canals are usually impossible because the nerve canal is completely blocked by solid dentin. If a DGI-II tooth develops a deep root infection, it frequently needs to be extracted and replaced with an implant or bridge.
What is a transitional overdenture and how does it help DGI-II?
An overdenture is a removable appliance that fits directly over remaining natural teeth or roots. For young adults with DGI-II, it provides a functional bite, preserves the jawbone, and maintains facial height while waiting for adult jaw growth to finish.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.How can a tooth with an 'obliterated' nerve still develop an abscess, and what signs should I look for at home?
  2. 2.How often should we do 3D X-rays to check for silent infections?
  3. 3.If we eventually need implants, are there special considerations for my child's jaw, or is it treated like any other implant case?
  4. 4.Would a transitional overdenture be a good option for us to maintain 'face height' and bone while waiting for adult growth to finish?
  5. 5.Are there any specific mouthwashes or non-abrasive toothpastes you recommend to protect my fragile enamel at home?

Questions For You

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References

References (16)
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    Dentinogenesis imperfecta: case report with nanoceramic resin crowns restorative treatment.

    Casaña-Ruiz MD, Frechina N, Estrela F, Catalá-Pizarro M

    The Journal of clinical pediatric dentistry 2024; (48(2)):189-195 doi:10.22514/jocpd.2024.047.

    PMID: 38548649
  2. 2

    A multidisciplinary approach to the functional and esthetic rehabilitation of dentinogenesis imperfecta type II: A clinical report.

    Fan F, Li N, Huang S, Ma J

    The Journal of prosthetic dentistry 2019; (122(2)):95-103 doi:10.1016/j.prosdent.2018.10.028.

    PMID: 30979433
  3. 3

    Dentinogenesis imperfecta type II- genotype and phenotype analyses in three Danish families.

    Taleb K, Lauridsen E, Daugaard-Jensen J, et al.

    Molecular genetics & genomic medicine 2018; (6(3)):339-349 doi:10.1002/mgg3.375.

    PMID: 29512331
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    Dental Management of a Child with Dentinogenesis Imperfecta: A Case Report.

    Akhlaghi N, Eshghi AR, Mohamadpour M

    Journal of dentistry (Tehran, Iran) 2016; (13(2)):133-138.

    PMID: 27928242
  5. 5

    A novel approach to full-mouth rehabilitation of dentinogenesis imperfecta type II: Case series with review of literature.

    Zhang Y, Jin X, Zhang Z, et al.

    Medicine 2024; (103(4)):e36882 doi:10.1097/MD.0000000000036882.

    PMID: 38277536
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    Cone-Beam Computed Tomography (CBCT)-Guided Non-surgical Management of Type II Dens Invaginatus in Maxillary Lateral Incisors Using Calcium Silicate-Based Materials: A Case Series.

    Priya P

    Cureus 2026; (18(1)):e101205 doi:10.7759/cureus.101205.

    PMID: 41669597
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    Dentinogenesis imperfecta type 2: a case report.

    Mohan KR, Narayanan M, Ravikumar PT

    General dentistry 2021; (69(6)):74-76.

    PMID: 34678748
  8. 8

    Nanoscopic wear behavior of dentinogenesis imperfecta type II tooth dentin.

    Mao J, Wang L, Jiang Y, et al.

    Journal of the mechanical behavior of biomedical materials 2021; (120()):104585 doi:10.1016/j.jmbbm.2021.104585.

    PMID: 34010797
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    A novel hypothesis based on clinical, radiological, and histological data to explain the dentinogenesis imperfecta type II phenotype.

    Turkkahraman H, Galindo F, Tulu US, Helms JA

    Connective tissue research 2020; (61(6)):526-536 doi:10.1080/03008207.2019.1631296.

    PMID: 31284784
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    Endodontic management of type II dens invaginatus with open apex and large periradicular lesion using the XP-endo Finisher: A case report.

    Rodrigues EA, Belladonna FG, De-Deus G, Silva EJ

    Journal of clinical and experimental dentistry 2018; (10(10)):e1040-e1044 doi:10.4317/jced.55031.

    PMID: 30386511
  11. 11

    Regenerative Endodontic Treatment in Dentinogenesis Imperfecta-Induced Apical Periodontitis.

    Liao Y, Pan T, Xing X

    Case reports in dentistry 2024; (2024()):5128588 doi:10.1155/2024/5128588.

    PMID: 38223911
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    Dentinogenesis imperfecta type II: Diagnosis, functional and esthetic rehabilitation in mixed dentition.

    Kaur R, Karadwal A, Sharma D, Sandhu MK

    Journal of oral and maxillofacial pathology : JOMFP 2021; (25(Suppl 1)):S76-S80 doi:10.4103/jomfp.JOMFP_172_20.

    PMID: 34083977
  13. 13

    Full Mouth Rehabilitation of Two Siblings with Dentinogenesis Imperfecta Type II Using Different Treatment Modalities.

    Alrashdi M, Schoener J, Contreras CI, Chen S

    International journal of environmental research and public health 2020; (17(19)) doi:10.3390/ijerph17197029.

    PMID: 32992978
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    Dental Management of Genetic Dental Disorders: A Critical Review.

    Dujic H, Bücher K, Schüler IM, et al.

    Journal of dental research 2025; (104(4)):369-379 doi:10.1177/00220345241305330.

    PMID: 39905279
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    Dentinogenesis Imperfecta Type II in Children: A Scoping Review.

    Garrocho-Rangel A, Dávila-Zapata I, Martínez-Rider R, et al.

    The Journal of clinical pediatric dentistry 2019; (43(3)):147-154 doi:10.17796/1053-4625-43.3.1.

    PMID: 30964718
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    Guided Endodontics in Managing Root Canal Treatment for Anomalous Teeth-A Narrative Review.

    Sabanik P, Samiei M, Avval ST, Cavalcanti B

    Australian endodontic journal : the journal of the Australian Society of Endodontology Inc 2025; (51(3)):836-848 doi:10.1111/aej.70007.

    PMID: 40792425

This page provides educational information on the long-term management of Dentinogenesis Imperfecta Type 2. Always consult your dentist or prosthodontist for personalized home care and treatment recommendations.

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