38 Dentinogenesis imperfecta
Siobhan is 9 years old. She and her parents are concerned because her permanent teeth are darker than normal and she is getting teased at school. What is the cause of the discoloration? How would you treat it?
Siobhan’s mother says she noticed that when the permanent teeth erupted they looked darker. Siobhan is very unhappy at school and refuses to smile for any photographs. When she talks she has the habit of covering her mouth with a hand so it is impossible to see her teeth. What can you see in Figure 38.1A? What key questions do you need to ask?
Siobhan’s brother and her father have a problem with their teeth. Siobhan’s brother is 14 and he has needed crowns on his back teeth and veneers on his front teeth. Siobhan’s father needed a lot of treatment when he was younger and has had some teeth crowned. Many of his posterior teeth, however, were extracted.
Even before you have examined the mouth, the history suggests that Siobhan has an inherited defect. Figure 38.1A confirms your suspicion that this is dentinogenesis imperfecta (DI).
The enamel is poorly adherent to the underlying dentine and easily chips and wears. The remaining primary canines and molars in Figures 35.1A, B are worn to gingival level and have a translucent opalescent appearance.