Management of Molar Incisor Hypomineralisation (MIH): A 1-Year Retrospective Study in a Specialist Secondary Care Centre in the UK

Abstract

(1) Background: Molar incisor hypomineralisation (MIH) is an enamel defect that affects an estimated 14.2% of children worldwide. Care takes place in primary and secondary care facilities. (2) Aim: To investigate how children with MIH are managed within a specialist centre in the north of England. (3) Method: A retrospective service evaluation within the paediatric dentistry department was registered with the clinical governance unit. Children who attended consultant-led new-patient clinics between 1 January and 31 December 2015 with a diagnosis of MIH were included. The data collected concerned the pre-referral treatment, the history and diagnoses and the treatments completed. (4) Results: Out of 397 records reviewed, 48 (12.1%) had MIH, where 81.3% and 18.8% of patients had severe and mild MIH, respectively. The majority of patients (n = 44 (91.7%)) were referred appropriately. Treatment was completed at the specialist centre for 44 (91.7%) patients. Twenty-five (52.1%) patients had an extraction of one or more first permanent molar teeth. Sixteen patients had the extractions at between 8 and 10 years old and 2 had the extractions later as part of an orthodontic plan. (5) Conclusion: Most children had severe MIH and were referred at an appropriate time to facilitate the consideration of loss of poor prognosis of first permanent molars (FPMs). Most children required specialist management of their MIH.

Assessment of Genetical, Pre, Peri and Post Natal Risk Factors of Deciduous Molar Hypomineralization (DMH), Hypomineralized Second Primary Molar (HSPM) and Molar Incisor Hypomineralization (MIH): A Narrative Review

“…The decision on the choice of treatment must be made individually, taking into account the severity of the lesions, the symptomatology of the affected tooth, the age, and the aesthetic expectations of the patient [ 43 ]. The therapy must therefore include prevention, recovery, immediate treatment, and long-term planning; the following points are of particular importance in the prophylaxis program for low mineralized areas: regular professional oral hygiene, use of fluoride preparations (topical fluoride prophylaxis or three/four applications of sodium fluoride or fluoride varnish), and the use of CPP-ACP products and sealings [ 44 , 45 ]; it is also useful to use biomimetic nano-hydroxyapatite for the reduction of enamel hypomineralization. This has the greatest effectiveness if applied daily for a minimum of 2–3 min up to a maximum of 10 min for 10 days a month [ 46 ].…”

Management of compromised first permanent molars in a cohort of UK paediatric patients referred to hospital‐based services

“…In extraction cases, 127 were sampled in Phase I (69 used GA as a method of pain control during the extraction, 4 used inhalation sedation, and only one used LA alone), whereas 117 were sampled in Phase II (GA was used as a method of pain control). Regarding the number of cFPMs extracted per patient, 59.7% of children (120/201) had all FPMs removed, 8.5% (17) had three FPMs removed, 22.9% (46) had extraction of two FPMs, and 8.9% (18) had extraction of only one FPM.…”

“…Humphreys and Albadri (2020) investigated the management of molar-incisor hypomineralisation (MIH)-affected teeth in children and found that of the 48 sampled children, 25 (52.1%) patients had extraction of at least one MIH-affected FPM. 46 Taylor et al (2019) used clinical vignettes to investigate the management of the poor prognosis of FPMs by GDPs and specialists in paediatric dentistry. They revealed that GDPs would prefer to restore cFPMs in comparison with specialists, who were more likely to extract such teeth.…”

“…To the authors' knowledge, no previous published studies have investigated exclusively and in such depth the management of children with cFPMs in a hospital setting. Humphreys and Albadri (2020) investigated the management of molar‐incisor hypomineralisation (MIH)–affected teeth in children and found that of the 48 sampled children, 25 (52.1%) patients had extraction of at least one MIH‐affected FPM 46 . Taylor et al (2019) used clinical vignettes to investigate the management of the poor prognosis of FPMs by GDPs and specialists in paediatric dentistry.…”

Decision making regarding management of compromised first permanent molars in patients with molar incisor hypomineralisation: A comparison of orthodontists and paediatric dentists

“…Given that MIH-affected patients often benefit from multidisciplinary input (Elhussein and Jamal, 2020; Humphreys and Albadri, 2020; Lygidakis et al, 2010; Office of the Chief Dental Officer England, 2018), it was important to explore current MDT care provision. Approximately half of the respondents in both groups agreed that these patients should be managed through an MDT-type clinic.…”