Tooth Condition: Molar Incisor Hypomineralisation (MIH)

A tooth condition affecting one or more permanent molars, molar incisor hypomineralisation dental disease occurs in one in six children around the world. Learn how to diagnose the condition early and manage it properly.

Molar Incisor Hypomineralisation

What is MIH?

Molar incisor hypomineralisation (MIH) is a dental condition that affects one or more of the first permanent molars (the adult molars that emerge when a child is six to seven years old), and occasionally, the incisors (front teeth) and the second baby molars. 

Affected teeth have white, yellow or brown patches. The molars with MIH are weaker, more porous, and tend to break down soon after they emerge in the mouth. These teeth are more susceptible to tooth decay and can be sensitive to hot or cold food and drinks.

Treating teeth with MIH can be challenging as these teeth are difficult to numb with a local anaesthetic, and fillings don’t adhere well to the defective tooth surface. Also, front teeth affected by this condition are not aesthetically pleasing. 

How Common Is MIH?  

MIH affects one in six children worldwide. Among Singaporean children, 12.5 percent of seven year olds have this condition.  

Causes of MIH  

To date, researchers are unable to pinpoint a specific cause of this problem. Many factors seem to act together to cause this condition. Illnesses and/or medication taken during infancy may be possible factors.   

Treatments for MIH

If the tooth is mildly affected without any breakdown, a fissure sealant can be placed to protect it. Applying a topical fluoride gel strengthens the tooth. 

Affected teeth with small regions of breakdown can be restored with a tooth-coloured filling material. If your child is seen by a dental therapist at the school clinic, the therapist may put temporary filling in your child's affected tooth and then give a referral to a specialist at School Dental Centre (Health Promotion Board) for management. 

Severely affected teeth may be extracted or may require stainless steel crowns for full coverage.                    

Ng JJ et al. Prevalence of Molar Incisor Hypomineralisation (MIH) in Singaporean Children. International Journal of Paediatric Dentistry 2015; 25: 73–78

Tooth Condition: Molar Incisor Hypomineralisation (MIH)

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