Article
Molar-incisor hypomineralization is a common developmental dental condition, and we encounter referrals from general dental practitioners for further management of these patients in a secondary care setting. Early recognition of this condition in young children is important to prevent unnecessary delays in its management.
Despite increased knowledge of the possible aetiologies for molar-incisor hypomineralization, the exact causes of this condition remain unknown.1 Clinical presentation ranges from creamy white/yellow/brown opacities to post-eruptive breakdown, and management of the affected teeth is largely dependent on its severity and associated symptoms, as well as the patient's age. Furthermore, factors, such as the patient's occlusion and cooperation, also play a role in treatment planning. This highlights the significance of appropriate referral to a specialist at the right time, and liaison between different dental specialties in providing care for these patients.
Tooth sensitivity is one of the most common symptoms associated with the affected teeth. The use of products containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), such as GC Tooth Mousse (GC Corporation, Japan) has been advocated for relieving sensitivity and remineralizing the teeth.2 The caries-preventive potential of fluoride varnish has been shown to be enhanced by incorporation of CPP-ACP.3
As these hypomineralized teeth are more prone to caries and post-eruptive breakdown, it is crucial to ensure that a rigorous preventive regimen is in place for these patients. Fluoride varnish should be applied in these patients every 3 months in a primary care setting. It is also recommended that the affected permanent molars should be fissure-sealed once they have fully erupted. Referral to a specialist should be considered when a second opinion is required in managing these patients.