MIH Flashcards
What is molar incisor hypomineralisation?
Hypo-mineralisation of systemic origin of 1-4 permanent molars frequently associated with affected incisors
How would you describe teeth affected by MIH?
- Hypomineralised
- Hypoplastic
Define hypomineralised?
Disturbance of enamel formation resulting in a reduced mineral content
Define hypoplastic?
reduced bulk or thickness of enamel
What is increased in the pulp horn in hypominarlised enamel?
- Significant increases in neural density in the pulp horn and subodontoblastic region - more sensitive to neural stimuli
- Increases in immune cell accumulation - more inflammation
- Significant increase in vascularity - more blood supply meaning more responsive to pain
3 ways of pain mechanisms related to MIH?
- Dentine hypersensitivity
- Peripheral sensitisation
- Central sensitisation
Explain Dentine hypersensitivity in MIH?
Porous enamel or exposed dentine facilitates fluid flow within dentine tubules to activate A delta fibres (hydrodynamic theory)
Explain peripheral sensitisation in MIH?
underlying pulpal inflammation leads to sensitisations of C-fibres
Explain central sensitisation in MIH?
from continued nociceptive input
How would you describe MIH lesions?
Demarcated
4 reasons why it is difficult to determine the aetiology of MIH?
- most parents cannot remember what happened before 10 years
- Unclear diagnostic criteria
- Study populations are small
What is the agreed critical period that may affect the aetiology of MIH and why?
- First year of life
- Enamel matrix of crown of FPM is complete by one year
What 3 periods you need to enquire about for MIH?
- Pre-natal
- Natal
- Post-natal
What would you ask mother about prenatal period?
- General health in 3rd trimester for example Pre-eclampsia or gestational diabetes
What 3 things would you ask mother about in perinatal period?
- Birth trauma or anoxia
- Hypocalcaemia
- Pre term birth
What 5 things you would ask mother about in postnatal period?
- Prolonged breast feeding - Dioxins in breast milk
- Fever and medications (childhood infections)
- Socioeconomic status
3 childhood infections that may contribute to MIH?
- Measles
- Rubella
- Chicken pox
What is the incubation period of measles
10-14 days
Duration of illness 7-10 days
4 symptoms of measles?
- Fever
- Rash
- Koplik’s spots
- Cough
How may the secondary infection of measles present? (4)
- Otitis media
- Bronchopeumonia
- Stomatitis
- Corneal ulcers
Duration of rubella?
8-10 days
4 Signs/Symptoms of rubella?
- Mild fever
- Rash
- Malaise
- Arthritis
Duration of illness in chicken pox?
6-10 days
