During the last 15 years, we have started to understand tooth development at the gene level. The list of genes known to regulate the position, shape, or number of teeth is lengthening rapidly. Interestingly, so far all these genes have important functions in the mediation of cell communication, which is generally considered the most important mechanism driving embryonic development. The communication is mediated by small signal molecules that are sent to nearby cells, thereby affecting their behavior and advancing differentiation. There are dozens of different signals and their receptors and target genes, which together form complicated signaling networks. The defects in several human conditions affecting tooth development have been identified recently, and these genes have turned out to be necessary components of signaling networks. Experimental studies using transgenic mice as models for human syndromes such as ectodermal and cleidocranial dysplasia have pinpointed the exact roles of the disease genes and indicated ways for possible new therapies. It is also possible that by combining the knowledge of molecular regulation of tooth development with the recent breakthroughs in stem cell research, dreams of building new teeth in dental practice may come true in the future.