• Monday July 13,2020


Molar Incisional Hypomineralization (also known as MIH) is a developmental disorder of the teeth. However, the doctors - when it comes to the cause - are a mystery; So far, no real reasons have been found why molar incisional hypomineralization occurs.

What is molar incisional hypomineralization?

Molar incisional hypomineralization is a novel phenomenon that can occur in the first permanent molars or incisors. In a few cases, canines are also affected by molar incisor hypomineralization.

The physician determines yellowish-brownish defects or discoloration in the tooth enamel on the affected teeth; As a result, the teeth become sensitive to temperature, so that those affected report pain.


Children who suffer from molar incisor hypomineralization have lower enamel than those with healthy teeth. The reasons why molar incisional hypomineralization occurs is not known. Physicians suspect that sometimes several factors for the new phenomenon are crucial.

Possible causes and factors include infectious diseases such as otitis media, pneumonia, chickenpox or feverish infections, bisphenol A (so-called plasticizer, which is also found in pacifiers and vials), nutrient deficiency (such as calcium deficiency in children), dioxins in breast milk or hereditary factors,

Symptoms, complaints & signs

In the context of molar incisor hypomineralization, the physician observes defects in the enamel, which can occur in the molars, incisors or canines. The affected teeth turn yellowish-brownish or creamy-whitish. Due to the tooth load (such as when chewing), it is possible that even parts of the enamel can break off or flake off.

In many cases, the affected teeth are also highly porous. As a result, those affected complain about an extreme temperature sensitivity of their teeth, so that the so-called hot-cold change can cause quite severe pain. Even mechanical stimuli can cause pain. Subsequently, those affected complain about pain in dental care.

Diagnosis & disease course

The physician recognizes the molar incisional hypomineralization as part of the dental examination. The discolorations are a first indication; a very soft or porous enamel is another indication that molar incisional hypomineralization is present.

Molar incisional hypomineralization already occurs when the affected teeth are broken. How fast the defects progress or how intense the pain and symptoms are depends on the individual form of molar incisional hypomineralization.

If the molar incisor hypomineralization is not treated by a dental procedure, the enamel damage increases, resulting in caries. This means that the tooth substance carries further damage. A circumstance that is occasionally promoted by the fact that the sufferers - since they have pain in the context of dental care - neglect their teeth cleaning and refuse to "brush your teeth".

However, when molar incisor hypomineralization is discovered at an early stage, regular and very close monitoring may result in new enamel defects being detected and treated relatively quickly.


Molar incisional hypomineralization primarily causes discomfort to the patient's teeth. This can lead to various defects or malformations in the oral cavity, so that those affected have pain when taking food or liquids. Furthermore, teeth are often yellow or brown in color, resulting in reduced aesthetics.

Those affected feel uncomfortable with this color and may suffer from inferiority complexes or reduced self-esteem. The teeth break more often, so patients suffer from a reduced quality of life. Cold or heat can also cause pain or other unpleasant feelings. The care of the teeth is often associated with pain.

In general, molar incisor hypomineralization requires early treatment to prevent subsequent damage in adulthood. Various interventions are necessary, which care for the teeth and protect against external influences. As a rule, no special complications occur. In many cases, the teeth must be replaced by implants. The life expectancy of the affected person is not influenced or reduced by the molar incisional hypomineralization.

When should you go to the doctor?

If irregularities in the growth of the teeth are noticed, a doctor should be consulted. Pain, discomfort or an increasing sense of pressure indicate health problems of the person concerned, which should be investigated and treated. If the existing symptoms gradually increase in intensity, there is a need for action. In molar incisor hypomineralization, children are primarily affected who are in the growth phase of the second teeth. Changes in the enamel, discoloration of the teeth and flaking of the tooth substance are unusual and should be presented to a doctor. If it comes to pain in dental care, an appetite loss or weight loss, a doctor is needed.

Complaints of a change of food in hot and cold temperature indicate inconsistencies. They should be examined in good time before any further deterioration of health occurs. If the child suffers from a headache, refuses to eat completely or if the concentration is impaired, consult a doctor. Learning problems, attention deficits, behavioral problems and sleep disturbances are further signs of disagreement. A visit to a doctor is advisable as soon as the symptoms persist for several weeks. A retreat from the participation of social and social life, a strong crying, mood swings, fatigue and apathy are discussed with a doctor.

Therapy & Treatment

In addition to the treatment of the occurred tooth damage as well as the complaints, there are also other methods available to treat a molar incisional hypomineralization. However, there is no consistent treatment or treatment recommendation, so the physician must create individualized treatment plans based on the incidence of molar incisor hypomineralization.

It is important that early treatment takes place. This is the only way to protect your teeth from even worse damage. This means that regular visits are important. Only then is it possible that new damage not only be detected quickly, but also dealt with promptly. One possibility is fluoridation.

The physician can treat the hot-cold sensitivity of the teeth and make the affected teeth less sensitive to pain. Incidentally, the person concerned should use a toothpaste with high fluoride content and also use fluoride-containing mouthwashes.

By means of fissure sealing a very light form of molar incisional hypomineralization can be treated. The physician seals the resulting fissures; the depressions that have occurred in the chewing surfaces can be closed with a special material. Thus, an implantation of any caries bacteria can be prevented.

By means of dental fillings, the physician can also treat any tooth defects. It is important that consideration be given here to those affected; Such treatments can be painful, so the fillings should only be placed under local anesthesia. It is important that the dentist prevents any painful treatments, since the person otherwise still gets a "dental fear". This could mean that he or she will not be aware of further treatments and therapies, which will lead to an enormous deterioration of the teeth.

Dental crowns are another treatment option for molar incisional hypomineralization. The method is only possible if the molars are affected. Many dentists consider the crowns to be a relatively straightforward solution, as they not only protect the hard tooth substance but also make any problems with sensitive teeth a thing of the past.

Furthermore, crowns are also long-lasting and provide a long-term solution to the problem. The method can not be applied to incisors or canines. However, if the enamel breaks down again and again or if the tooth is so sensitive that the affected person suffers permanent pain, in many cases only the extraction of the tooth remains. The tooth is subsequently pulled.

Outlook & Forecast

The treatment of molar incisional hypomineralization succeeds through various therapeutic measures. The prognosis is accordingly positive. Insofar as the dental disease is diagnosed early, the treatment can be effective and the condition completely resolved. The prognosis is based on the condition of the teeth and the chosen therapy procedure.

Decisive is the comprehensive education of the parents. In addition, the dentist must be sufficiently informed about the little-researched disease. Inasmuch as caries and pain fractures can be avoided, the prognosis is positive. In addition, the condition should be diagnosed during the first four years of life of the child. If this succeeds, the prospect of a full recovery is given. A prerequisite for a good prognosis, however, is also that the child carefully treats the teeth from now on and informs the parents about pain or other complaints.

The prognosis provides the dentist with regard to the condition of the teeth, the timing of the diagnosis and the cooperation of the parents. Life expectancy is not limited by molar incisive hypomineralization. The well-being can be limited until the end of treatment, since sometimes severe pain and the external abnormalities in the child trigger feelings of shame.


Preventive measures are not known. This is because so far the cause of why a molar incisional hypomineralization occurs is not known. It is advisable to pay attention to the oral hygiene and / or if the first symptoms appear, which indicate a molar incisional hypomineralization, immediately a dentist is consulted, so that any negative disease courses can be prevented.


The specific measures for follow-up with molar incisional hypomineralization usually depend on the success of the treatment. The affected patients must always be treated intensively, as they have a higher susceptibility to tooth decay and other diseases of the teeth. It is important to regularly check the restorations that usually supply the defective teeth.

In young patients, often only interim therapeutic restorations that need to be closely monitored are used. Sometimes it is necessary to replace them several times before a definite solution is possible. Adhesion is generally much worse for all forms of restorations on hypomineralized enamel than for healthy enamel.

Therefore, it often leads to further complications. In addition, those affected have an increased risk of further defects. In addition to a close-meshed dental check, intensive daily dental care is necessary. Patients must adhere strictly to the instructions of the treating dentist.

Ideally, they should examine the results themselves on a regular basis. In addition, it is advisable to have a dental oral hygiene done every few months. Another follow-up is keeping a tooth-friendly diet. This is especially necessary in children with molar incisional hypomineralization.

You can do that yourself

Although there is no universally valid method or procedure for the treatment of molar incisor hypomineralization, and the condition is not fully understood, some of the symptoms may be limited by self-help.

In the foreground, however, is an early diagnosis of the disease, as this further complications and damage to the teeth can be avoided. The person concerned should consult a doctor at the first sign of the disease. Furthermore, the person affected should use a toothpaste that contains a lot of fluoride and is indicated for pain-sensitive teeth. Likewise, mouthwashes which have a high fluoride content can also be used here. This strengthens the teeth.

However, the means of self-help do not replace a visit to the dentist. For pain or other unpleasant sensations on the teeth, therefore, always consult a doctor. If the patient is suffering from a fear of the dentist, a specialist should be consulted. A visit to a psychologist or a detailed conversation with a familiar person can have a positive effect on the anxiety. In many cases, the complaints can be permanently alleviated by using the crowns.

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