What Causes Enamel Pearls? According to an article in the Journal of Dental Sciences, enamel pearls form when enamel cells — called ameloblasts — travel below the gumline to the root and start producing enamelWhat Causes Enamel Pearls? According to an article in the Journal of Dental Sciences, enamel pearls form when enamel cells — called ameloblasts — travel below the gumline to the root and start producing enamel