Molar Incisor Hypomineralisation

Question 1

what is MIH (molar incisor hypomineralisation)?

Answer 1

hypomineralisation of systemic origin of 1-4 permanent molars, frequently associated with affected incisors

Question 2

what is meant by hypomineralisation?

Answer 2

disturbance of enamel formation resulting in a reduced mineral content

• secretory phase fine
• mineralised phase failure!

Question 3

what do hypomineralised teeth look like?

Answer 3

• very yellow

- patches of white, yellow or brown

Question 4

what is the prevalence of molar incisor hypomineralisation?

Answer 4

10-20%

Question 5

what is meant by hypoplastic?

Answer 5

reduced bulk or thickness of enamel

Question 6

what are the different types of hypoplastic teeth?

Answer 6

True = enamel never formed 
Acquired = post-eruptive loss of enamel bulk

Question 7

in true hypoplastic teeth, how are the formation stages of enamel altered?

Answer 7

• secretory phase failure

- mineralisation phase fine

Question 8

what pain mechanisms are usually present in a patient with Molar Incisor Hypomineralisation?

Answer 8

• dentine hypersensitivity
• peripheral sensitisation
• central sensitisation

Question 9

what is meant by dental hypersensitivity?

Answer 9

porous enamel or exposed dentine facilitates fluid flow within dentine tubules to activate Adelta nerve fibres (HYDRODYNAMIC THEORY)

Question 10

what is peripheral sensitisation of the teeth?

Answer 10

underlying pulpal inflammation leads to sensitisation of C-fibres

Question 11

what is meant by anoxia at birth?

Answer 11

lack of oxygen at birth

Question 12

what perinatal issues may contribute to Molar Incisor Hypomineralisation?

Answer 12

• birth trauma
• birth anoxia
• pre term birth

Question 13

what postnatal issues may contribute to molar incisor hypomineralisation?

Answer 13

• prolonged breast feeding
• dioxins in breast milk
• fever & medication

Question 14

what is the incubation period of measles?

Answer 14

10-14 days

Question 15

what are some signs and symptoms of measles?

Answer 15

• fever
• rash
• Koplik’s spots
• conjunctivitis
• coryza (runny nose)
• cough

Question 16

what is the clinical name for an ear infection?

Answer 16

otitis media

Question 17

what are the signs and symptoms of rubella?

Answer 17

• mild fever
• maculopapular rash
• generalised lymphadenopathy
• malaise
• URTI (upper respiratory tract infection)

Question 18

what are the symptoms of chicken pox?

Answer 18

• low grade fever
• rash
• crops of spots progressing from macula-papule-vesicle

Question 19

what are some clinical problems of molar incisor hypomineralisation?

Answer 19

loss of tooth substance

• breakdown of enamel
• tooth wear
• secondary caries

sensitivity & appearance

Question 20

what are some treatment options for molars that have molar incisor hypomineralisation?

Answer 20

• composite/GIC restorations
• stainless steel crowns
• adhesively retained copings
• extraction (8.5 - 9.5 years)

Question 21

when looking to extract hypomineralised teeth in children what needs to be considered?

Answer 21

• age
• skeletal pattern
• future orthodontic needs
• quality of teeth

Question 22

what radiographic finding can aid in knowing when you are able to extract lower first primary molars?

Answer 22

when there is calcification of the bifurcation of the lower 7s

Question 23

what treatment options are there for affect MIH incisors?

Answer 23

• acid pumice microabrasion
• resin infiltration
• external bleaching
• localised composite placement
• full composite veneers