What is molar incisor hypomineralisation (MIH)?
MIH is a tooth condition where the outer layer (enamel) doesn’t form properly. Teeth affected may look creamy, yellow or brown. This can lead to sensitivity, dental decay or a crumbly tooth.
MIH is a common condition affecting one in eight children in the UK
MIH is usually noticed when children are around 6 or 7 years old when the adult front teeth (incisors) or back teeth (molars) come into the mouth. Other adult teeth are less likely to be affected.
MIH can affect one, some, or all first adult molars and adult incisors. There are different levels of severity.
It can sometimes affect the back baby molar teeth too and in these cases, it can be seen in the mouth from 2 to 3 years old. This may mean it is more likely that the adult teeth will also be affected.
What causes MIH?
The cause is not fully understood. It affects 11 to 14% of children, which means there will probably be other children in your child’s class in school who have this too.
This is not yours or your child’s fault.
It is caused by a disturbance in tooth enamel development around the time of birth or in the first three years of life. Childhood illnesses, high fevers and premature birth have all been suggested as possible causes. There is probably some element of genetic inheritance too.
What problems does MIH cause?
Teeth affected by MIH are more prone to dental decay and the soft, poorly formed enamel can crumble. They can often be very sensitive and can be more difficult to numb with a local anaesthetic for dental treatment.
What can be done at home to help manage MIH?
Tooth decay is almost always preventable. Sugary foods and drinks should be limited and restricted to mealtimes. Especially in children affected by MIH, who are more prone to decay than other children.
Brushing twice daily with a fluoride toothpaste. High fluoride toothpaste or fluoride mouthwashes may be recommended for some patients by a dentist.
Toothpaste that contains “stannous fluoride” like Sensodyne Rapid Relief or Colgate Total have been shown to help reduce sensitivity. It is important that you attend regular check-ups with your dentist. Early detection of MIH is important for it to be monitored and treated.
A referral to a specialist dentist may be necessary for those who are most severely affected by MIH.
What treatment does MIH require?
Molar teeth (Back teeth)
The dentist will consider how old your child is, how decayed or crumbly the teeth are and whether they are likely to last long term.
Some treatments that may be suggested are:
- Regular fluoride varnish: to prevent decay and reduce sensitivity
- Fissure sealants: to seal and protect mildly affected teeth
- Fillings: to treat decay or stabilise a tooth until a child is a bit older
- Stainless steel crowns: a silver-coloured cap for more decayed/crumbly teeth to stabilise them until a child is a bit older
- Taking the tooth out (extraction): if the tooth enamel is very poor quality, or causing symptoms, it may need to be removed. Extractions done at the right time can allow other adult teeth to move to minimise gaps. Sometimes removal of healthy opposing teeth might be recommended to avoid future problems with the bite.
Incisor teeth (Front teeth)
Front teeth are sometimes treated to improve appearance/roughness. Your dentist will tell you which of the following options is suitable in your child’s own particular case.
- Regular fluoride varnish: to reduce sensitivity.
- Microabrasion: removes a very thin layer of the enamel to improve appearance.
- Resin infiltration: (eg using ICON) involves pressing a thin resin into the front surface of the tooth to change the way the tooth looks and to make white spots less visible.
- White fillings: a layer of a white filling is added over part or all of the surface of the tooth the hide the discolouration.
What happens if I do not get treatment?
The molar teeth may break down further. This could cause sensitivity, pain or infection. Removal of the tooth may be required.
Contact us:
Opening hours:
Monday to Thursday 8.30am to 5.00pm
Friday 8.30am to 4.30pm
St Catherine’s Health Centre Dental Clinic – call 0151 514 6420
Victoria Central Health Centre Dental Clinic – call 0151 514 6266
Leasowe Dental Clinic – call 0151 514 2340
Out of Hours:
Out of Hours Service – call 111
Revive Dental Care – call 0161 476 9651
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If you would like this information in another format or language, please contact the Your Experience Team on freephone 0800 694 5530. Alternatively you can email [email protected]
