A practical method for use in epidemiological studies on enamel hypomineralisation

Abstract

With the development of the European Academy of Paediatric Dentistry (EAPD) judgment criteria, there has been increasing interest worldwide in investigation of the prevalence of demarcated opacities in tooth enamel substance, known as molar–incisor hypomineralisation (MIH). However, the lack of a standardised system for the purpose of recording MIH data in epidemiological surveys has contributed greatly to the wide variations in the reported prevalence between studies. The present publication describes the rationale, development, and content of a scoring method for MIH diagnosis in epidemiological studies as well as clinic- and hospital-based studies. The proposed grading method allows separate classification of demarcated hypomineralisation lesions and other enamel defects identical to MIH. It yields an informative description of the severity of MIH-affected teeth in terms of the stage of visible enamel destruction and the area of tooth surface affected (i.e. lesion clinical status and extent, respectively). In order to preserve the maximum amount of information from a clinical examination consistent with the need to permit direct comparisons between prevalence studies, two forms of the charting are proposed, a short form for simple screening surveys and a long form desirable for prospective, longitudinal observational research where aetiological factors in demarcated lesions are to be investigated in tandem with lesions distribution. Validation of the grading method is required, and its reliability and usefulness need to be tested in different age groups and different populations.

Foetal, neonatal and child vitamin D status and enamel hypomineralization

“…In patients with MIH incisors of the upper jaw can also be involved and in rare cases incisors of the lower jaw . Although hypomineralization is not restricted to those few index teeth and can be diagnosed in any tooth of both dentitions, a patient can only be diagnosed with HSPM/MIH if he or she has at least one affected second primary molar or first permanent molar, respectively . The prevalence of HSPMs is about 4.9% in 6‐year‐old Dutch children .…”

Validity and reproducibility testing of the Molar Incisor Hypomineralisation (MIH) Index

“…The present study was undertaken to develop an index that overcomes deficiencies of previous MIH criteria and indices and is simple to administer. The instrument was conceived, based on previous criteria (ie EAPD and mDDE) with two forms . Validation outcomes indicated promising results, and overall, the MIH index demonstrated adequate reliability and validity for group comparisons.…”

Definition and scoring system of molar incisor hypomineralization: A review

“…The usefulness of the early EAPD criteria should also be reevaluated due to the fact that it only categorizes the enamel conditions but does not quantify them. Ghanim et al [17], following the 2014 EAPD Congress in Poland, developed a complex scoring system to quantify the severity of MIH based on the number of involved teeth as well as the type and extent of the enamel defect.…”

“…Other Non-European prevalence data also demonstrate extreme variations with a prevalence rate as low as 2.8 % in Hong Kong [12] and a rate as high as 40.2% in Brazilian children [13]. The extensive variation in the described rates is suggested to be either due to actual differences in MIH prevalence between different populations, variations in age cohorts, masking of MIH by other conditions, or most importantly, due to the different clinical examination protocols used to define this condition and the non-uniform methods of classification and scoring indices [14][15][16][17]. The objective of the current review was to systematically evaluate the studies on MIH to determine the consistency of the use of the current definition and scoring systems.…”