How to Fix Teeth Without Enamel (Amelogenesis Imperfecta)

Your teeth are complex structures made up of many different components. The tooth’s enamel is the visible outer layer that protects the inner parts of the teeth and gives your smile its white appearance. But did you know that sometimes, children develop teeth that don’t have this protective layer? Keep reading to learn more about this dental condition and available treatment options for teeth without enamel or weak enamel.

What Is Amelogenesis Imperfecta?

Amelogenesis Imperfecta is a developmental defect that results in inadequate enamel. It can affect both baby teeth and permanent teeth. In severe cases, no enamel forms on the teeth, and in standard cases, the tooth enamel is thin and weak.

Healthy enamel has many uses, in particular it acts as a protective buffer against tooth decay. This hard exterior shields the inner layers of the teeth from the effects of acids and plaque. It also prevents tooth sensitivity that can be caused by extremely hot or cold foods and beverages. So if someone lacks this protective barrier it can cause many teeth problems.

What Does It Look Like?

Amelogenesis imperfecta affects the strength and appearance of teeth. Teeth would appear small, discolored, pitted, and prone to breaking. There are four classifications of amelogenesis imperfecta, with each presenting various different symptoms:

  • Hypoplastic: This type of AI is characterized by small or normal dental crowns (the top of the teeth), misalignment in the upper and lower teeth, and tooth discoloration. The enamel can be thin, smooth, or normal, with grooves, lines, and/or pits.
  • Hypomaturation: Type 2 AI also affects teeth alignment. People with this type of amelogenesis imperfecta often have an open bite where the upper front teeth and lower teeth don’t touch when the mouth is closed. The tooth’s surface may have a creamy white or yellow-brown, rough texture that may be tender or sore. Generally, the enamel will be normal in thickness but may look chipped or scraped.
  • Hypocalcified: Type 3 is also associated with an open bite and creamy white to yellow-brown tooth surface that may be tender and sore. Like type 2 AI, people with type 3 tend to have chipped tooth enamel.
  • Hypomaturation/Hypoplasia/Taurodontism: Type 4, also known as enamel hypomaturation or taurodontism, occurs when teeth have a white to yellow-brown look, with spots. The enamel is thinner and softer than normal.

What Problems Can It Cause?

Teeth with thin, soft, or no enamel are at risk of issues such as early tooth decay, gum disease, and tooth sensitivity. Healthy enamel protects your teeth against these dental problems. Without this protection, the sensitive parts of teeth are left exposed. Dentin is the second layer of the tooth, which contains thousands of microscopic tubules that lead to the tooth’s pulp (which consists of nerve endings and blood vessels). When these parts of the tooth are exposed to hot or cold foods and beverages, it results in sensitivity, discomfort and pain.

How Can It Be Treated?

Treatment will depend on the type of amelogenesis imperfecta you are diagnosed with. Your dental professional may recommend restorative treatments like sealants, crowns, implants, and bonding. These will restore the size, shape, strength, and appearance of the affected teeth. Malocclusion (an abnormal alignment of the upper and lower teeth when the jaws are closed) is a common characteristic of AI. People with AI should see an orthodontist who can advise about treatment that can correct a misaligned bite.

Teeth with no or little enamel is a condition that can affect you or your child’s self-confidence, as it impacts the appearance and functionality of the teeth. If you or your child experience a rough tooth surface, discoloration, and sensitivity, you shouldn’t hesitate to speak to a dental professional. They can find the best treatment options to improve your oral health and return your confidence in your smile.

Last updated on February 7, 2024

Dr. Deepak Aulak

Dr. Deepak Aulak is a London-based dental practitioner with a special interest in cosmetic dentistry. Having graduated from King's College London in Dentistry, Dr. Aulak was decorated with over a dozen awards and scholarships along the way, which notably include the Jelf Medal, Malleson Prize for research and GKT Hospital's Full Shields.


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