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Treatment options for deciduous molar hypomineralization: a report of three cases Yasmy Quintero Manuel Restrepo Jenny Angélica Saldarriaga Alexandra Saldarriaga Lourdes Santos-Pinto Dental Update 2024 46:6, 707-709.
Authors
YasmyQuintero
DDS
PhD student at São Paulo State University (UNESP), School of Dentistry, Araraquara, Brazil
Deciduous molar hypomineralization (DMH) is an enamel defect of systemic and multifactorial origin that affects the second deciduous molar. Currently, its treatment is based on guidelines for Molar Incisor Hypomineralization (MIH), a disturbance that affects permanent molars and may or may not be associated with permanent incisors. To date, there are no guidelines for DMH. Therefore, three different therapeutic approaches are presented to treat DMH, emphasizing the relevance of early diagnosis, differential diagnosis and treatment options, and tailored to take into account each patient's and parents' specific needs, as well as the involved tooth, severity of DMH, patients' symptoms and behaviour.
CPD/Clinical Relevance: To understand the clinical implications of DMH since the diagnosis and delayed treatment of this enamel alteration could have important complications in both the primary and permanent dentition.
Article
Deciduous Molar Hypomineralization (DMH) is an enamel defect of multifactorial origin that affects 1 to 4 second deciduous molars, and may be associated with canines and first deciduous molars.1 Similar to Molar Incisor Hypomineralization (MIH), which affects enamel in 1 to 4 first permanent molars, and occasionally permanent incisors, enamel affected by DMH presents demarcated opacities that vary from white to yellowish or brownish colour, affecting part or all tooth surfaces. A typical feature of the affected teeth is an asymmetrical appearance, with one molar being severely affected while the contralateral tooth is unaffected.2
The aetiology of DMH and MIH is not fully understood, and the currently available scientific evidence is insufficient to establish causality.3, 4 The formation of the second deciduous molar, the first permanent molar, and the permanent incisor, which is initiated before birth and occurs between the first and third year of life, can be affected by environmental factors, including common childhood diseases, long-term breastfeeding and respiratory tract problems during the third trimester of pregnancy to up to three years of age.5, 6 Since the development of the second primary molars and first permanent molars overlap in time, a possible association between DMH and MIH has been previously proposed.6 While this association is not clear, children with DMH are 4 to 5 times more likely to present with MIH.7 Since the eruption of the second deciduous molar occurs approximately 4 years before the eruption of the first permanent molar, DMH could be a predictor of MIH.7
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