MIH: A Common Dental Condition 

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.  

MIH: A Common Dental Condition 
Reference and photo credit to Dr. Katrin Bekes, DMD, PHD.

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.  


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.


  • 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 ::

About the author

Dr. Allyn LaCombe Clause is a pediatric dentist at Lafayette Pediatric Dentistry. She is a Dr. Allyn LaCombe Clause is a pediatric dentist at Lafayette Pediatric Dentistrynative 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!

Lafayette Pediatric Dentistry
Lafayette Pediatric Dentistry is one of Acadiana’s premier pediatric dental practices, specializing in treating infants to adolescents. We are a boutique-style office that is known for quality, customized care for your child, focusing on making the dental experience fun, comfortable, and fear-free! Dr. Anita J Gouri has had extensive training in laser dentistry, sedation/hospital dentistry, and special needs dentistry. She is also one of the area’s recommended providers for diagnosis and treatment of tongue and lip ties. She graduated from the LSU School of Dentistry in 2006, completed her residency in pediatric dentistry at Children’s National Medical Center in Washington DC in 2008, and became a board certified diplomate of the American Board of Pediatric Dentistry in 2009. She has been practicing in Lafayette for over 11 years. Dr. Gouri, her husband Brian, and their two children enjoy travel, Saints football, good food and good friends.


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