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Proper anamnesis of clinical practice in giving clear diagnosis is important for specific possible dental care. Disturbance in tooth development by any aetiological factors result in dental anomalies. The variation aetiologies of the dental anomaly are diverse but mainly caused by three main factors which are genetic, epigenetic, and environmental. From genetic mechanisms, where parents or siblings have a specific pattern of tooth, a bigger probability for an individual to have the same tooth pattern with his relatives, included gender differences. Based on epigenetic mechanisms, environmental chemicals, pharmaceuticals, aging, and dietary intake are a few factors that made up a tooth pattern. Repeated signaling molecules which received by protein receptor and induced by transcription factors between epithelial and mesenchyme in tooth development stages are relayed to transcript continued process of tooth development and become tooth anomalies. Orthodontists can be the ones to first diagnose and aware of the etiology and related characteristics with dental anomalies and further can cause malocclusion. An optimal and efficient integrated treatment plan of these anomalies should include the genetic profile of an individual to understand the developmental process and the aetiological factors for specific possible dental care. This paper aims to inform about the genetic, epigenetic, and environmental factors that involve in dental abnormalities development.