Molar-Incisor Hypomineralisation: Symptoms and Treatment

Molar-incisor hypomineralisation, frequently designated by the acronym MIH (Molar Incisor Hypomineralization), is a dental condition that more particularly concerns children. This mineralisation defect generates increased fragility of the affected teeth, first and foremost the first molars and the permanent incisors.

Without appropriate management, MIH may manifest itself through sensitivity, pain and a reinforced vulnerability to cavities.

Causes, symptoms and treatment: here is the essential information to know about dental hypomineralisation.

What is hypomineralisation of the teeth?

Molar-incisor hypomineralisation is a developmental disorder of the dental enamel. Enamel, which forms the protective outer layer of the teeth, is normally composed of minerals giving it its hardness and resistance. But in people with hypomineralisation, this layer of protection is poorly formed, less dense in minerals, which makes it more porous and more fragile.

Although in theory all teeth can be concerned, the most frequently affected are the first permanent molars and the incisors.

MIH can vary in severity. In the mildest forms, only a few white or yellowish spots appear on the affected teeth. In the most severe cases, the enamel may be very fragile, fracture easily and cause intense pain when chewing or in contact with hot or cold foods.

What are the factors that cause MIH?

While the exact causes of molar-incisor hypomineralisation are not yet fully elucidated, several factors seem to favour its appearance:

• infections contracted in utero or during early childhood as well as perinatal complications
• family history
• exposure to certain toxins or substances such as bisphenol A (BPA)
• repeated intakes of amoxicillin (antibiotic) during childhood
• endocrine dysfunctions
• nutritional deficiencies
• etc.

Symptoms and risks of molar-incisor hypomineralisation

While the manifestations of MIH can vary from one individual to another and depending on the degree of severity, several common symptoms nevertheless emerge: the appearance of white, yellow or brown spots on the teeth, a sensitivity to heat, cold or chewing, as well as more frequent cavities.

The porous and weakened enamel often breaks, further exposing the dentin to acid attacks and bacteria.

In advanced forms of hypomineralisation, the people concerned may feel sharp pains in the teeth, even without any external stimulation.

How to treat a mineralisation defect?

Prevention of MIH

As soon as a dentist in Cannes highlights a molar-incisor hypomineralisation, he will encourage you to adopt several prevention and oral hygiene measures to limit the consequences of this anomaly:

• Application of a fluoride varnish or fluoride gels to help strengthen the enamel of the affected teeth and reduce sensitivity;
• Regular brushing with a fluoride-rich toothpaste to protect the weakened teeth against carious lesions;
• Close medical follow-up in order to monitor the evolution of the teeth concerned and quickly identify any new complication.

Restorative treatment

When the damage is more significant, restorative treatments may prove necessary to protect the affected teeth.

If the enamel is damaged, your dentist may offer a composite resin filling to restore the tooth.

In more severe cases, when the enamel is too fragile, it is sometimes recommended to place a crown to cover and protect the tooth.

As a last resort, if the tooth is too damaged, the dentist may proceed with an extraction, generally followed by an orthodontic treatment in order to preserve the alignment of the teeth and the proper balance of the jaw.

Pain management

If your child complains of dental pain linked to MIH, occasional solutions such as analgesic gels or painkilling medications may be prescribed by the dentist while waiting for a possible more in-depth treatment.