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Molar Incisor Hypomineralisation

Molar Incisor Hypomineralisation (MIH)/Molar Hypomineralisation (MH)

MIH is characterised by hypomineralised lesions on first permanent molars (FPMs) and incisors. If only FPMs are involved then the term MH is used. The hypomineralised lesions usually manifest as yellowish demarcated opacities on the affected teeth (Fig. 25.1). Prevalence in Europe is reported to be 6–14%.

Figure 25.1 Intra-oral photograph of upper arch showing hypomineralised upper first permanent molars.

Recognition

Children usually present with:

• demarcated opacities on molars and/or incisors (Fig. 25.2);
• posteruptive enamel loss (Fig. 25.3);
• atypical restorations on FPMs (Fig. 25.4);
• extraction of first permanent molars.

Figure 25.2 Intra-oral photograph showing demarcated opacities on an incisor, typical of MIH.

Figure 25.3 Enamel which is hypomineralised tends to break off after eruption, also known as posteruptive loss of enamel.

Figure 25.4 Atypical restorations of first permanent molars. Many dentists do not recognise this condition and try to treat it as they would a carious lesion.

Differential Diagnosis

It is important to differentiate MIH from other conditions manifest as hypomineralised disorders of enamel such as amelogenesis imperfecta (AI).

Aetiology

The aetiology is not completely understood so sometimes the term “idiopathic opacities” is still used. Most children with MIH presented with potential medical aetiological factors during the prenata/>

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