Molar-Incisor Hypomineralization

Abstract

Molar-incisor hypomineralization (MIH) describes a qualitative defect in the enamel of both primary and permanent teeth. Due to inadequate mineralization, teeth affected with MIH are vulnerable to breakdown of tooth structure, caries, sensitivity, tooth loss. and subsequent orthodontic problems. This best practice document discusses the clinical presentation, sequelae, prevalence, etiology, classification, diagnosis, and management of MIH. Care pathways for children and adolescents who present with MIH require an understanding of the condition, its severity, and interventions to prevent or manage symptoms, caries, and post-eruptive breakdown of tooth structure where possible. Preventive measures, including sealants and fluoride use, are presented along with suggestions for treating hypersensitivity. A discussion of short-term, intermediate, and definitive treatment options is provided. When restorative treatment is not feasible, options for the timing of planned extraction and molar substitution are discussed. Pediatric dentists should familiarize themselves with the diagnosis as well as preventive and restorative options available for children and adolescents who present with MIH in order to optimize their oral health and reduce their care burden over their lifetime.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and recommendations for dental professionals regarding the management of molar incisor hypomineralization. 

^{KEYWORDS:  CHILD; MOLAR-INCISOR HYPOMINERALIZATION; MOLAR HYPOMINERALIZATION; HYPOMINERALIZED TEETH; HYPOMINERALIZED SECOND PRIMARY MOLARS; DENTAL DEVELOPMENTAL DEFECTS}