Molar Incisor Hypomineralization in Pediatric Dentistry

Molar incisor hypomineralization (MIH) is a qualitative developmental defect of enamel affecting one or more first permanent molars and often permanent incisors. Clinically, MIH presents as well-demarcated opacities ranging from creamy white to yellow-brown, with variable posteruptive breakdown leading to sensitivity, rapid caries progression and aesthetic concerns. Its aetiology is multifactorial, involving prenatal, perinatal and early childhood systemic disturbances as well as genetic and epigenetic influences. The global prevalence is estimated at 10–15%, with considerable regional variation. MIH imposes a substantial burden on paediatric dental services: management spans prevention, micro-invasive treatments, restorative care and, in severe cases, timed extractions. Early diagnosis and individualised care pathways are critical to minimise pain, preserve tooth structure and maintain quality of life.

Research from Nature Portfolio

Recent studies have quantified prevalence and clinical patterns of MIH across diverse populations. A cross-sectional survey of Syrian children aged eight to eleven found a 39.9% prevalence, with demarcated opacities prevailing on molars and incisors. Severity correlated with higher caries indices and greater incidence of hypersensitivity, particularly among girls, highlighting the need for sex-sensitive screening protocols. A comprehensive systematic review and meta-analysis synthesised data from over a hundred observational studies to derive a pooled global prevalence of 13.5%. Subgroup analyses revealed that diagnostic criteria significantly influence prevalence estimates and that affected incisors occur in more than one-third of cases. These epidemiological insights offer robust parameters for prioritising public health strategies and standardising case definitions.

Molar Incisor Hypomineralization in Pediatric Dentistry publication trend

The graph below shows the total number of articles in molar incisor hypomineralization in pediatric dentistry across all publications each year (not limited to Nature Index journals).

Technical terms

Molar Incisor Hypomineralization (MIH): A developmental enamel defect of first permanent molars and often incisors, marked by qualitative hypomineralisation and demarcated opacity formation.

Demarcated Opacity: A well-defined discoloured region of enamel (white, cream or brown) indicating reduced mineral content without immediate surface loss.

Posteruptive Breakdown (PEB): Post-eruption loss of enamel in hypomineralised zones, predisposing to sensitivity and rapid carious lesions.

Resin Infiltration: A conservative technique in which low-viscosity resin penetrates porous enamel to stabilise structure and mask hypomineralised areas.

Proteomics: The large-scale study of proteins, here applied to analyse enamel composition and identify inclusions that characterise hypomineralisation defects.

References

1. Molar-Incisor Hypomineralisation: Severity, caries and hypersensitivity. Journal of Dentistry (2024).
2. Influence of different pre-treatments on the resin infiltration depth into enamel of teeth affected by molar-incisor hypomineralization (MIH). Dental Materials (2024).
3. Proteomic Analyses Discern the Developmental Inclusion of Albumin in Pig Enamel: A New Model for Human Enamel Hypomineralization. International Journal of Molecular Sciences (2023).
4. Prevalence and clinical characteristics of molar-incisor hypomineralization in Syrian children: a cross-sectional study. Scientific Reports (2023).
5. The prevalence of molar-incisor hypomineralization: a systematic review and meta-analysis. Scientific Reports (2021).