Clinical Challenges and Treatment Protocols of Molar Incisor Hypo Mineralization: A Review of Literature

Author(s):

Malaz M. Mustafa*, Arwa Ali Addus, Shatha Ahmed Alfaifi, Abeer Ali Alqarni, Amjad Mohammad Alasmari, Maha Saad Alabsi, Dhuha Ayedh Alkahtani and Elmaha Nasir Hidah

Hypomineralization of enamel is described as a defective quality of enamel characterized by reduced inorganic content and increased porosity, leading to structural defects of the physical properties and an increased risk of carious lesions. These lesions include Molar Incisor Hypomineralization (MIH) and Hypomineralized Second Primary Molars (HSPM).

Many clinical challenges are encountered by the treating dental practitioners, for instances, MIHaffected teeth may manifest with hypersensitivity to cold air, warm/hot beverages and food, in addition to tooth brushing, causing suboptimal oral hygiene which favours bacterial biofilm accumulation and subsequently increases vulnerability to carious lesions attack. In addition, difficulty to obtain profound local analgesia is another clinical challenge faced by the treating dentist, affected patients as well as their parents. Occasional eruption complications of affected- molars linked to enamel roughness were reported as well.

MIH-affected patients require more extensive dental treatments and, possibly, as a result, are commonly more apprehensive from the dental setting as related to their MIH-negative counterparts. Consequently, dental clinicians might encounter behaviour management complications in the form of fear and anxiety attributed to pain experienced during dental treatment. Furthermore, MIH-affected children require much more dental intervention as compared to unaffected ones.