Disclosure :: This post was written by Dr. Allyn Clause of Lafayette Pediatric Dentistry.
MIH: A Common Dental Condition
What is MIH?
Molar Incisor Hypomineralization (MIH) is a developmental dental defect that affects about 1 in 7 children. It occurs when there is disruption during the mineralization stage of tooth development, resulting in weakened or malformed tooth enamel. Affected teeth are are not as strong, and exhibit brittle and porous enamel that can breakdown easily under chewing forces. For these reasons, teeth with MIH are 14 times more likely to develop cavities than teeth without MIH.
MIH presents itself as chalky white, yellow, or brown discolored enamel that is often very sensitive. MIH can affect both baby and permanent teeth. It has been shown that a patient whose baby’s teeth are affected by hypomineralization may have a five-fold higher chance of having permanent teeth with hypomineralization.
MIH usually involves baby molars, and/or one or more of the permanent molars. The more severe types can also involve the permanent incisors in addition to the molars. Darker discoloration is related to more severe hypomineralization.
MIH Types
The European Academy of Pediatric Dentistry (EAPD) has developed the MIH Treatment Need Index (MIH-TNI). The MIH-TNI involves four separate types of MIH that range from mild to severe as shown in the picture below, with varying symptoms.
Causes of MIH
Even though MIH was initially identified in the 1970s, its actual cause is still unknown. Numerous research teams believe that a complex cause is most likely. It is known that MIH results from a disruption of tooth development either while in utero or in the early years.
Risk factors include:
- Fever
- Antibiotic use and/or illnesses early in life (e.g., bronchitis, otitis media, gastrointestinal problems, pneumonia, and asthma).
- Low birth weight
- Exposure to pollutants such as dioxin, bisphenol A, and polychlorinated biphenyl
However, it is important to note there is currently insufficient data to support these conditions as definitive causes of MIH.
Symptoms
The most common symptoms experienced with MIH include rapid development of cavities and rapid breakdown once the tooth is erupted. Teeth with MIH have also been shown to develop increased nerve formation within the tooth, which leads to hypersensitivity. As a result, these teeth may be difficult to numb during a dental appointment.
Treatment
- Sensitive teeth can be pre-treated for sensitivity using Silver Diamine Fluoride (SDF) and/or a toothpaste containing arginine.
- Asymptomatic teeth with mild MIH and no tooth breakdown can be protected with a sealant to help prevent cavities from forming.
- Smaller MIH defects may be able to be restored using a white restoration, but this is usually a temporary solution until a full-coverage crown is needed.
- It is recommended that for cases of severe MIH, which exhibit larger defects involving 2/3 or more of the molar surface be restored with full coverage crowns.
If you suspect that your child’s teeth may be affected by MIH, we here at Lafayette Pediatric Dentistry can help you! Call us to schedule a consultation! 337-443-9944.
Other Dental Related Topics that May Be of Interest ::
- Rethink Your Drink
- Why Does My Child Have White Spots on Their Teeth?
- Why Do Baby Teeth Matter?
- What if My Kid Freaks Out at the Dentist?
- Tips on Weaning Your Little One From Thumb & Finger Sucking
- Sleep Disordered Breathing: More Common Than You Think!
- Why Take X-Rays Routinely at the Dentist?
- Teething Toddler Woes: Tips and Tricks For Relief
- The Most Common Causes of Cavities
- Four Reasons Moms Should Reconsider Fruit Snacks
- Why Is My Child Grinding Their Teeth At Night?
- The Truth About Tongue and Lip-Ties
- The Most Common Causes Of Discolored Teeth
About the author
Dr. Allyn LaCombe Clause is a pediatric dentist at Lafayette Pediatric Dentistry. She is a 
native of Eunice and is thrilled to be living close to home again, serving the little patients of the Acadiana area! Dr. Clause received her doctorate from the LSU School of Dentistry in 2021 and completed an additional two years of a Pediatric Dentistry Residency at LSU afterward. Dr. Clause and her husband Adam are proud parents of their beautiful daughter Azalea! When she’s not occupied with being a mother or taking care of baby teeth, she enjoys playing tennis and pickle ball. She’s even working on a children’s book!
