Last Updated on September 21, 2022 by Dr Gustavo Assatourians DDS

Hereditary Dental Problems can be classified according to the affected tissue (enamel or dentin), their inheritance pattern (autosomal dominant, autosomal recessive, and sex-linked), and whether they appear isolated (non-syndromic) or are a part of syndromes of multiple congenital anomalies (syndromic dental anomalies).

Whenever we talk about genetics and heredity, we think of physical traits; but other factors can manifest in later generations due to the eventual expression of genes. In short, while we repeatedly suffer from dental problems, the question arises: is it possible to inherit dental problems from our parents and/or grandparents? Alterations in embryonic development, that is, during gestation, are called anomalies.

When we speak specifically of the oral cavity, they are called dental anomalies or dental dysplasias, meaning that based on certain basic parameters, some are different, distinct, or unequal. These anomalies can affect any dental structure; however, the comparative standard characteristics vary depending upon race or ethnicity. A relevant factor is age and nutrition during pregnancy along with the dietary habits of the community.

8 hereditary dental problems

1. Disorders of amelogenesis

Amelogenesis imperfecta is a disorder of tooth development, causing tooth enamel to become thinner and abnormally formed. It is transmitted from parents to children as a dominant trait. If one parent has the gene, it will be easily expressed in the offspring.

By affecting the structure and appearance of the enamel, it causes teeth to look smaller, discolored, pitted, or grooved; because it is such a thin layer, they are prone to rapid wear, breakage, cavities, and/or premature loss.

Taking into account the compromise of the enamel and subsequent symptoms, amelogenesis imperfecta is classified as:

• Type I: with hypoplasty: thin, rough, irregular enamel, soft, small teeth
• Type II: with hypomaturation: white, brown, or orange appearance
• Type III: with hypocalcification: soft and brittle enamel, exposed dentin, yellow-orange color
• Type IV: with hypoplasia. Also known as taurodontism

The diagnosis of AI involves clinical, radiographic, histological, and genetic examination. The first two exams allow a presumptive diagnosis to be made while the last two allow a definitive diagnosis.

The mutation of some genes generates not only the appearance of these anomalies but connected or nearby organs and systems are also altered. A large number of diagnoses or syndromes are possible as determined by the specialist dentist in consultation. 

       Tricho-dento-osseous syndrome:

• Type II vitamin D resistant
• Type I vitamin D-dependent
• Polyglandular autoimmune syndromes

2. Genetic alterations of dentinogenesis

The expression of the mutation of the DSPP gene causes dentinogenesis imperfecta to occur. It doesn’t have the information needed for the proper development of teeth, making the teeth weaker, both milk and permanent teeth. In particular, this gene is responsible for directing proteins in the proper way to form dentin; but when mutated, this information does not arrive properly, and as a result the teeth are weak.

Within the visible symptoms, we find a blue-grayish or yellowish-brown enamel color. While weaker, the tooth also has a translucent appearance, making it easier to suffer from infections, breakage, wear, and other issues.

Taking into account the specific mutation of the gene, there are different types:

• Type I: also called dentin dysplasia: the most striking is the presence of very short, conical roots that do not adequately support the tooth, so there is premature loss of teeth. It may look a bit opalescent.
• Type II: the presence of light blue-brown translucent-opalescent teeth in the absence of bone abnormalities.
• Type III: Teeth exhibit amber discoloration, severe attrition, multiple pulp exposures, and a characteristic radiographic appearance of shell teeth.

Some associated syndromes are:

•  Ehlers-Danlos Syndrome (EDS)
• Goldblatt syndrome Familial hyperphosphatemic tumoral
• Calcinosis       
• Seckel’s syndrome

3. Cleft lip and palate

This craniofacial deformity is related to family history and is one of the most common hereditary dental problems. It occurs when the complete fusion of the lip or palate in the mouth does not occur during pregnancy, and they do not form properly. They are known as orofacial clefts.

This condition or birth pathology can be corrected through surgery; however, it can cause other problems:

• Speech: when an immediate solution is not sought
• Feeding: breastfeeding or bottle-feeding can be difficult since the child cannot form a vacuum seal to suck.
• Hearing: some children with this condition are more likely to suffer from ear infections or sticky ear since it is very easy for liquid to accumulate with food through the opening.
• Dental problems: There is inadequate development of dental pieces, which generates not only aesthetic problems but also functional ones.

4. Anodontia/ hypodontia

This congenital anomaly causes tooth loss since the permanent teeth do not develop and milk teeth may erupt occasionally. Between one and five missing teeth can be treated that affect one side of the mouth or both. Hypodontia alters the development of bones both in the upper and lower part of the mouth, generating space problems. There are three classifications:

• Isolated anodontia: affects only wisdom teeth
• Sectorial anodontia: located in a specific place in the oral cavity
• Dispersed Anodontia: affecting several spaces of the oral cavity

5. Malocclusion (bad bite)

Also known as the bad bite, this disorder causes the crowding of extra teeth or missing teeth. In either case, it causes the jaw to be misaligned. Cases not treated right away will progress to the temporomandibular jaw (TMJ), causing the person to have trouble chewing and speaking. It is possible to correct with surgery and restore function while reducing pain.

6. Gingival fibromatosis

Hereditary gingival fibromatosis (GHF) is a pathology that directly affects the gums, causing an excessive increase in the size of gingival tissue. It presents in a generalized way, with a fibrous appearance, firm consistency, and both non-bleeding and asymptomatic. It can affect both men and women. Exaggerated gingival growth causes functional and aesthetic problems, such as dental displacement, gaps, difficulty chewing, and delayed tooth eruption, among others. It is mainly presented by an overproduction of collagen.

7. Oral cancer

This is undoubtedly one of the most serious diseases. It is sometimes triggered by excessive consumption of alcohol and tobacco, usually in people over 40 years of age. But genetics can be involved. Initially, it may manifest as a red or white patch in the mouth. In families with a history of cancer, there is a probability of manifesting oral cancer since mutated genes can be expressed.

8. Caries and periodontal diseases

Sometimes, there is a greater genetic predisposition to present diseases or problems in the oral cavity. It is either due to a weak or deficient immune system, which makes it more difficult to fight bacteria, minimizing the adhesion of plaque to the teeth. Also, it is associated with diseases such as diabetes and cardiovascular or cerebrovascular diseases.

To minimize this impact, it is essential to maintain adequate oral hygiene, limit alcohol consumption, avoid smoking, and attend regular consultations for prevention. One must quickly identify the problem and undergo adequate and effective treatment.

Seeking treatment for hereditary dental problems

To have a beautiful and healthy smile, it is important to seek advice from a professional with experience and knowledge in this type of disease. They can guide you towards an appropriate treatment or direct you to a specialist. Although it may not seem so, these diseases are common. 

If you have any questions about this or other topics, you can contact us at Channel Island Family Dental as well as our Facebook page. We look forward to your visit and we will make a timely diagnosis. Our dentists in Oxnard, Saint Paula, Venture, Newbury Park, and Port Hueneme will be able to guide you towards the best treatment to take care of your health and give you back your best smile.

BIBLIOGRAPHY

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