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Introduction: The precise diagnosis of dental structural anomalies is an essential step preceding our restorative and orthodontic therapies. First of all, we need to identify the type of structural anomaly and to determine if it is an isolated or a syndromic form: the dental anomaly could be included in a more complex clinical picture combining other clinical signs. Moreover, the establishment of the diagnosis will allow the practitioner to adapt his or her clinical protocol according to the observed dental structural anomaly. The choice of bonding material, the type of preparation (no prep, less prep, complete eviction), and the application of a deproteinization protocol with sodium hypochlorite depend on the structural defect. Materials and method: The diagnosis of dental structural anomalies is based on several key points described in this article in order to facilitate the practitioner’s diagnostic approach. Conclusion: The diagnosis of amelogenesis or dentinogenesis imperfecta should justify the search for other signs to determine whether the anomaly of tooth structure is isolated or syndromic.