Molar incisor hypomineralisation: A review of its current concepts and management

Investigation of Oral Health in Children from Urban Slums of Nairobi, Kenya

For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral health status of children living in Nairobi slums. A cross-sectional study on school-aged subjects was conducted in June 2022 in three urban slum areas of Nairobi through a pediatric dental screening. The PI (Plaque Index), CPITN (Community Periodontal Index of Treatment Needs), and dmft (decayed, missing, and filled teeth index-deciduous) were considered as primary outcomes of dental health. Multivariate statistical analysis, based on ordinal and zero-inflated negative binomial regression models, was conducted to identify determinants of the oral outcomes in a wide set of potential predictors. A sample of 359 children aged 2-17 was examined. The PI was significantly associated with age, the type of bite, and the use of a toothbrush. The CPITN is influenced by different types of malocclusions, abnormal frenulum, dental trauma, and fluorosis. Dietary habits were found to significantly impact the susceptibility to dental caries. Fluorosis and a dental visit in the last year were highlighted as risk and protective factors, respectively, against higher rates of caries. The oral health features of children living in Nairobi slums are differently affected by socio-demographic conditions, dietary habits, dental characteristics, and oral care practices.

The Prevalence of Developmental Enamel Defects in Israeli Children and Its Association with Perinatal Conditions: A Cross-Sectional Study

Molar incisor hypomineralization (MIH) and deciduous molar hypomineralization (DMH) affect the first permanent molars and second primary molars, respectively, causing a greater dental treatment burden and worse oral health quality of life among affected children. We assessed the prevalence and risk factors of MIH and DMH among 1209 children aged 3-13 years who attended a university dental clinic in Israel in 2019-2020. Clinical examinations were conducted to assess the presence of DMH and MIH. Potential etiological factors of MIH and DMH, including demographics, the mother's perinatal health, and the child's medical history during the first three years of life, were retrieved using a questionnaire. To examine the associations between the demographic and clinical variables and the prevalence of MIH and DMH, continuous variables were tested using the Kruskal-Wallis test with Bonferroni corrections. Categorical variables were analyzed by chi-squared test. Multivariate logistic regression was conducted to evaluate which of the significant variables found in the univariate analysis could predict a diagnosis of both MIH and DMH. The prevalence of MIH and DMH was 10.3% and 6.0%, respectively. Age ≥ 5 years, taking medications during pregnancy and severe lesions were associated with a greater risk for a diagnosis of DMH + MIH. Multivariate logistic regression with adjustment for age showed that the severity of hypomineralization was positively and significantly associated with a diagnosis of MIH + DMH with an odds ratio of 4.18 (95% confidence interval 1.26-17.16), p = 0.03. MIH should be diagnosed and monitored in young children to prevent further deterioration. Moreover, a preventive and restorative program for MIH should be established.

Molar incisor hypomineralization (MIH): prevalence and degree of severity in a Mexican pediatric population living in an endemic fluorosis area

OBJECTIVE

To estimate the prevalence and severity of molar incisor hypomineralization (MIH) in 8 years old children living in an endemic fluorosis area.

METHODS

MIH prevalence rate was determined from a study sample comprising 613 participants. They were recruited from 11 urban public schools with similar socio-economic status. Oral evaluations were performed and diagnosed MIH teeth were classified under Ghanim et al.'s criteria. Statistical descriptive and comparative analyzes were carried out.

RESULTS

First permanent molars were the tooth group most affected, followed by the upper central incisors, lower central incisors, lower lateral incisors, and upper lateral incisors. There was no significant statistical difference by gender and by maxillary/mandible arches (P = 0.82 and 0.26, respectively). The frequency of MIH was more in molars compared to incisors (P < 0.02).

CONCLUSIONS

The MIH prevalence in this study was 12.4 percent. According to the MIH severity, degree 2 was the most frequently detected (76.4 percent).

Influence of customized therapy for molar incisor hypomineralization on children's oral hygiene and quality of life

OBJECTIVE

The aim of this clinical follow-up study was to demonstrate the effects of different therapeutic strategies for hypomineralized teeth on patients' oral health. The treatment results were characterized by changes in the extent of hypersensitivity and plaque accumulation, as well as reductions in nutritional restrictions.

MATERIAL AND METHODS

The impacts of therapy, including the use of fluoride varnish, fissure sealants, fillings, and stainless steel crowns, were evaluated in 78 children (mean age 8.5 years). We followed recommendations according to the Molar Incisor Hypomineralisation Treatment Need Index for customized treatment. The Quigley Hein Index, the Schiff Cold Air Sensitivity Scale, Wong-Baker Faces Scale, and dietary-limiting parameters were assessed before and after therapy for comparison.

RESULTS

Plaque accumulation and hypersensitivity decreased after completion of therapy. The improvements were greater for individual teeth (Quigley Hein Index for teeth treated with stainless steel crowns from 4.19 to 2.54) than for those of the whole dentition (high-severity category from 2.67 to 2.20). Problems with food intake were minimized via therapy, with the greatest influence observed for patients who were also in the high-severity category.

CONCLUSIONS

Therapy for affected teeth in children has positive effects on oral health and quality of life.

The severity and degree of hypomineralisation in teeth and its influence on oral hygiene and caries prevalence in children

AIM

The purpose of this study was to investigate the relationship between the severity of hypomineralised teeth, plaque accumulation, hypersensitivity, associated caries risk, and oral health-related quality of life limitations of affected children.

MATERIALS AND METHODS

A total of 250 children (mean age 9.0 years) presenting with at least one hypomineralised molar or incisor were included in the study. The hypersensitivity of the teeth was evaluated using the Schiff Cold Air Sensitivity Scale and the Wong-Baker Faces Scale. Furthermore, the Decayed, Missing, and Filled Teeth Index was documented, the Quigley Hein Index was obtained, and personal questioning was used to document the patients' limitations with intake of food. These data were analysed using general linear models that control influencing factors such as age and sex.

RESULTS

The Quigley Hein Index increased with the severity of the hypomineralised teeth (1.64 in the unaffected, 2.77 in the moderately, and 3.63 in the severely affected teeth). Problems with intake of food were only observed in subjects with severe hypomineralisation. There was no immediate effect on dental caries.

CONCLUSION

Increased severity of tooth hypomineralisation leads to increased hypersensitivity, which resulted in inadequate oral hygiene among children and limitations to their daily life.

Developmental defects of the enamel and its impact on the oral health quality of life of children resident in Southwest Nigeria

BACKGROUND

Developmental defects of the enamel (DDE) increase the risk for diseases that impact negatively on the quality of life. The objective of this study was to compare the oral health quality of life of children with molar-incisor-hypomineralisation (MIH) and enamel hypoplasia; and assess if caries worsened the impact of these lesions on the quality of life.

METHODS

This study recruited 853 6 to 16-years-old school children. They filled the Child-OIDP questionnaire. The MIH, enamel hypoplasia, caries and oral hygiene status was assessed. Poisson regression was used to determine the impact of MIH and enamel hypoplasia on the oral health quality of life, after adjusting for the effect of sex, age, socioeconomic class, oral hygiene and caries status.

RESULTS

The prevalence of MIH and enamel hypoplasia was 2.9% and 7.6% respectively. There was no significant difference in the mean child-OIDP scores of children with or without MIH (p = 0.57), children with or without enamel hypoplasia (p = 0.48), and children with enamel hypoplasia with and without caries (p = 0.30). Children with enamel hypoplasia and caries had worse outcomes for speaking (p = 0.01). Children with middle (AOR: 2.74; 95% CI: 1.60-4.67; P < 0.01) and low (AOR: 1.75; 95% CI: 1.04-2.95; p = 0.03) socioeconomic status, and those with caries (AOR: 2.02; 95% CI: 1.26-3.22; p = 0.03) had their oral health quality of life negatively impacted.

CONCLUSION

MIH and enamel hypoplasia had no significant impact on the overall oral health quality of life of children resident in southwestern Nigeria. However, children with caries and those from middle and low socioeconomic classes had poorer oral health quality of life.

Prevalence and characteristics of MIH in school children residing in an endemic fluorosis area of India: an epidemiological study

AIM

This was to study the prevalence of molar incisor hypomineralisation (MIH) among school children residing in a fluorosis endemic area in Tamilnadu (Salem, India).

METHODS

A target sample of 5000 children of age ranging between 9 and 14 years, comprising 250 children from each of 20 blocks of Salem, participated in this study. The examination was completed in their respective schools by a calibrated examiner using EAPD criteria.

RESULTS

Of 4989 children examined, 384 children had MIH. A prevalence of 7.3 %. The MIH found in girls was 8.9 % compared with 6.1 % in boys. Single-tooth involvement of MIH was seen predominantly in incisors (2.24 %), whereas with molars usually three teeth were involved (1.1 %). MIH with caries involvement was found in 51 % of the teeth.

CONCLUSION

The prevalence of MIH in the endemic fluorosis district was found to be 7.3 %. A gradual increase in MIH was seen with age due to post enamel breakdown. Caries involvement was also seen in more than 50 % of the MIH-involved teeth. This prevalence study for molar incisor hypomineralisation (MIH) is rare in the literature, especially in a fluorosis endemic district in Tamilnadu.