Teeth Without Complete Enamel

My seven-year-old daughter had beautiful baby teeth. Now some of her permanent teeth are erupting without complete enamel. Our dentist is treating the affected teeth with a temporary veneer. She informs us that a permanent solution is not yet appropriate.

What are the options available for treating permanent teeth that are missing enamel?


It is a good idea to postpone a permanent treatment until: 1) the nerves of the permanent teeth have completely developed; and 2) the extent of enamel malformation is known. Enamel forms the hard outer surface of the tooth. When enamel is missing, it is difficult to complete some dental procedures. This is because successful composite bonding and procelain veneer procedures require a healthy enamel surface. It may be possible to bond to the dentin layer. Dentin is the layer under enamel. Using these techniques leaves the tongue side of the tooth exposed. Dentin bonding will usually only cover the front and chewing edge of the tooth. Any exposed dentin is more susceptible to sensitivity and tooth decay.

Depending on the severity and location of exposed dentin, it may be possible to place composites or porcelain veneers on the anterior teeth. If full coverage is needed, a porcelain jacket crown may be a good choice. Less tooth structure is removed with porcelain jacket crowns. They are often more esthetically pleasing than the porcelain with metal crowns. However, if the posterior teeth require crowns, the porcelain with metal crowns or gold crowns would be the best option.

Until your daughter is old enough for permanent treatment, meticuluous oral hygiene is imperative. If your water is not fluoridated, I recommend chewable fluoride tablet supplements. If your water is fluoridated, I recommend using a fluoride rinse or fluoride gel to help reduce sensitivity and dental caries.

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