Hypomineralization (MIH)

What is hypomineralization?

Hypomineralization is a condition that affects tooth enamel (outer layer) and affects up to one in seven children, its frequency increasing over the last twenty years. The causes of hypomineralization are of systemic origin and one or more disruptive factors can be criminalized, both in the prenatal and postnatal period.
The disorders can be caused by taking antibiotics during pregnancy, premature birth, severe respiratory infections in the first two years of life, prolonged febrile episodes, pollution or can occur without a known reason. There may also be a genetic component.
Hypomineralization makes tooth enamel softer and brittle, therefore, depending on the degree of damage, more prone to damage and caries.
The most common form of hypomineralization is Molar-incisive hypomineralization syndrome (MIH), but other forms of hypomineralization such as imperfect amelogenesis, fluorosis (occurring as a result of excess fluoride administration) or unidental hypomineralization, which occurs as a result of trauma or infection of the temporary tooth.

Will all my child’s teeth be affected?

In the primary dentition (milk teeth), secondary molars may be affected. If the child has hypomineralization in temporary molars, it is possible—though not certain—that some degree of hypomineralization may also be present in the permanent teeth.

Most commonly, hypomineralization affects the first permanent molars and incisors (front teeth). This condition is known as molar-incisive hypomineralization syndrome (MIH). Permanent molars can degrade rapidly due to the force of mastication, while the issues affecting the incisors are primarily aesthetic. Depending on the degree of damage, the appearance of the enamel may show opaque, yellowish white spots, to brownish, with or without lack of substance.

MIH treatment is difficult because of

Hypersensitivity and the accelerated development of dental caries
Difficulty in achieving effective anesthesia during treatment
Limited cooperation from young patients
Frequent fracture of restorations
The need for multiple dental visits to manage MIH without overwhelming the child during a single appointment

What treatment options are available?

Treatment options depend on the severity of the symptoms and the discomfort felt by the child. The pediatric dentist will do a full clinical consultation and may request x-rays for a more accurate diagnosis.

If your child’s teeth are very sensitive, the dentist will recommend a toothpaste with a higher concentration of fluoride or a special gel to reduce sensitivity.

What happens during your visit to DENT ESTET 4 KIDS?

MI Varnish with Recaldent (CPP-ACP) will be applied – a high-fluoride varnish that seals the dentinal tubules and reduces sensitivity, leaving a protective film on the tooth surface.

For temporary teeth, your dentist may recommend dental crowns to protect the healthy tooth structure and preserve the tooth until it falls out naturally.

The fillings can be used in mild cases, but are usually not ideal, as they do not adhere well to the teeth of the hypomineralization. In addition, they can easily peel off, and the teeth can further deteriorate around the filling.

Fillings can be used in mild cases, but they are typically not ideal, as they do not adhere well to hypomineralized teeth. Additionally, they may detach easily, and the teeth can continue to deteriorate around the filling.

For permanent molars, the treatment varies depending on the severity and may include:

Sealing of trenches and fossets
Regular fluoride applications
Fillings
Preformed metal crowns
Preventive extraction of affected molars – only in severe cases, as a last resort. This will be a joint decision between the parents, orthodontist, and pediatric dentist.

Although extracting permanent molars at an early age may seem like a difficult decision, your pediatric dentist will explain all the risks and benefits to establish the best treatment plan for your child.

For permanent incisors, treatment options include:

Microabrasion followed by resin infiltration – ICON. If there are also structural problems, it is reconstituted with obturations.

Your dentist will explain each option and recommend the most appropriate solution for your child.

Important to remember:

If your child shows signs of hypomineralisation:

Regular dental check-ups, cleanings, and fluoride applications are essential, as issues can arise and progress rapidly.
It is recommended to brush teeth twice a day with fluoride toothpaste.
Limit the consumption of sugary foods and drinks to main meals only, and not on a daily basis, to prevent cavities.

Discover other treatments