Managing Young Patients with Molar Incisor Hypomineralization

Molar incisor hypomineralization (MIH) is a developmental anomaly that affects the first permanent molar teeth and often the permanent incisors. Hypomineralization is a qualitative defect, ie there is a reduced mineral content in the enamel. MIH is a relatively common condition and it has a prevalence of 14.5% in the UK.¹

There is considerable variation in how MIH presents, from small areas of discoloration (Figure 1) to extensive post eruptive breakdown (PEB) (Figure 2).

Paediatric patients with MIH often present with difficulties eating or brushing their teeth due to sensitivity. They also tend to have cosmetic concerns and can often be bullied or teased at school.

The aetiology of MIH is unknown but multiple factors have been implicated:²

Both preventive and interceptive treatment may be required, depending on the severity of the condition.