Healthcare | Free Full-Text | The Impact of Molar Incisor Hypomineralisation on Children and Adolescents: A Narrative Review

Molar incisor hypomineralisation (MIH) is a qualitative developmental defect of enamel characterised by demarcated opacities affecting one or more permanent first molars and often permanent incisors [1]. It is a common dental condition with a global prevalence of 13% [2]. The aetiology of MIH is not fully elucidated; however, it is purported to be multifactorial, involving systemic and environmental exposures during prenatal and perinatal periods, early childhood illnesses and genetic and epigenetic factors [3]. A higher prevalence of MIH has been reported in children with systemic diseases, including common conditions, such as fever [4], and congenital defects, such as cleft lip and palate [5]. The most frequent presentation of MIH is enamel opacities, and the severity of lesions is positively correlated with an increased number of affected teeth [6]. Negative sequelae associated with MIH include hypersensitivity, post-eruptive breakdown (PEB), rapid development of carious lesions and poor aesthetics. Affected molars experience PEB either shortly after eruption or following exposure to masticatory forces, with the application of an assessment tool in a population cohort reporting 14% of MIH-affected teeth had PEB [6]. There is an increased prevalence of incisor involvement with increasing severity of MIH [7], with anterior lesions reported to occur in 37–72% of MIH-affected children [2,8]. The potential burden of MIH for affected children may include increased risk of caries lesion development in those at increased caries risk, hypersensitivity, dental fear and anxiety, behaviour management problems and reduced oral health-related quality of life (OHRQoL). The experiences of affected children will vary according to the severity of MIH and subsequent treatment needs. It is important to recognise the impact of MIH on affected children to facilitate more patient-centred delivery of care and improve outcomes. This review therefore aims to outline the impact of MIH on children’s oral health and, more broadly, their daily activities. Electronic databases PubMed and Embase were searched using the MeSH terms “molar incisor hypomineralisation”, “health-related quality of life” and “child” and the keywords “impact”, “hypersensitivity”, “caries”, “dental fear and anxiety” and “behaviour management”.