Molar incisor hypomineralisation (MIH)

General information

This mineralisation disorder affects the outer layer of the tooth: the enamel.

A harmful influence prevents affected teeth from reaching their final hardness, leaving some areas softer. The upper central incisors and first permanent molars in both jaws are most commonly affected; lower central incisors are affected less often. Teeth show yellowish-white to brown discolouration, affecting individual areas or the whole tooth. They are usually very sensitive to heat and cold. Even daily oral hygiene can be painful. The resulting difficulty with dental care makes these teeth more susceptible to secondary decay.

Treatment

Professional dental care is essential. Regular cleaning is necessary because rougher tooth surfaces accumulate more plaque and tartar. For very small defects, fissure sealing of affected molars helps preserve the teeth. Greater loss of tooth structure requires crowns; smaller defects are treated with tooth-coloured resin. For very extensive defects, extraction may need to be considered after orthodontic assessment.

Clinical photographs