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White Structure

Dental Professionals

Diagnosis of amelogenesis imperfecta (AI) forms the first step in managing this condition along with clear explanation and counselling for the family. AI is sometimes an already known condition to the family and taking a family history can help in the diagnosis. Please see our resources on this area including pedigree charts to accurately record a family history. Generally, all teeth are affected, but in some cases the permanent dentition is more affected than the primary which can delay recognition.

Types of Amelogenesis Imperfecta

Classification of AI is evolving to include genetic descriptors as well as clinical phenotypes. AI can be categorised into three main clinical types which include:

Management in Primary Care

Many patients with AI can be managed solely in primary care if the condition is mild, or in a shared care arrangement with specialist services. Reaching a diagnosis can also be supported by local specialist care services or to offer advice regarding management. The newly available option for families to seek genetic testing would be another reason to refer to specialist care.

Enhanced prevention protocols are recommended for this patient group. All patients should be on an age appropriate, high strength fluoride toothpaste. Toothbrushing may be particularly uncomfortable due to sensitivity and so warm water can be recommended and in selected cases a soft toothbrush. Sensitive toothpaste can be recommended and tooth mousse can be advised as an adjunct to toothpaste (ensuring no milk allergies). Fluoride varnish and mouthwash can also form part of the patient’s care plan. Fissure sealants are an excellent option to further protect the teeth and more complex treatment planning may include preformed metal crowns, onlays and composite coverage restorations. These aspects of care are often assisted by specialist services.

Referral to specialist care

There are currently a number of specialist units throughout the UK who have dedicated anomaly or AI clinics. Please see our contacts page for details of your nearest specialist centre if you are looking for further advice. Patients should speak to their General Dental Practitioner about their suitability for a specialist care assessment and referral should be through normal means of primary care referrals into specialist care.

Management in specialist care

Specialist care can assist with a number of aspects in the care of AI patients:

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  • Confirming a diagnosis +/- offering of genetic testing

  • Specialist led treatment planning

  • Access to MDT planning

  • Access to other treatment modalities such as General Anaesthetic

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