Molar incisor hypomineralisation

Dental condition affecting enamel

Molar incisor hypomineralisation (MIH) is a developmental condition affecting the enamel of first permanent molars and often incisors. It is characterized by qualitative defects in enamel mineralization, leading to enamel that is soft, porous, and prone to rapid wear and decay.

Pathophysiology

MIH occurs due to disruptions in the normal process of enamel mineralization during tooth development. The exact etiology is not fully understood, but it is believed to involve a combination of genetic and environmental factors. Potential causes include systemic conditions during the first years of life, such as respiratory diseases, high fevers, and exposure to certain medications.

Enamel mineralization process

The condition results in enamel that is less mineralized than normal, leading to its characteristic appearance and increased susceptibility to caries and mechanical damage. The affected enamel may appear opaque, white, yellow, or brown, and is often associated with increased sensitivity and pain.

Clinical Presentation

Clinically, MIH presents with demarcated opacities on the enamel of the first permanent molars and incisors. These opacities can vary in color from white to yellow-brown and are often associated with post-eruptive enamel breakdown. Affected teeth may be sensitive to thermal and mechanical stimuli, and children with MIH often experience dental anxiety due to the discomfort associated with the condition.

Diagnosis

Diagnosis of MIH is primarily clinical, based on the visual and tactile examination of the teeth. Dentists look for the characteristic opacities and assess the extent of enamel breakdown. Radiographs may be used to evaluate the extent of caries and to plan treatment.

Management

Management of MIH involves both preventive and restorative approaches. Preventive measures include the application of topical fluoride to strengthen the enamel and the use of desensitizing agents to reduce sensitivity. Restorative treatment may involve the use of dental sealants, composite resin restorations, or crowns to protect the affected teeth.

Dental veneer application

In severe cases, extraction of severely affected teeth may be necessary, followed by orthodontic treatment to manage the resulting space.

Prognosis

The prognosis for teeth affected by MIH depends on the severity of the condition and the effectiveness of the management strategies employed. Early diagnosis and intervention can help preserve the affected teeth and maintain oral health.

Related pages

• Tooth enamel
• Dental caries
• Amelogenesis imperfecta

Tooth extraction procedure