MIH

Question 1

What is MIH?

Answer 1

Molar Incisor Hyomineralisation
The enamel (hard, outer layer) on the first adult molars and sometimes the front teeth doesn’t develop properly
This makes the teeth weaker, discoloured (yellow or brown) and more sensitive

Question 2

What causes MIH?

Answer 2

Happens while the teeth are still developing early in childhood
Possible factors include:
- illnesses or high fevers in first few years of life
- premature birth weight or low birth weight
- use of antibiotics or medications
- poor nutrition

Question 3

What questions should be asked to parents about MIH?

Answer 3

Was your child born prematurely or low birth weight?
Did your child have any early illnesses, fevers or infections
Were any medications especially antibiotics used during this time?
When did you first notice the discolouration or sensitivity
Does your child have any difficulty brushing or complain of pain?\
Gestational diabetes or preeclampsia during pregnancy?
Traumatic birth?

Question 4

What are the symptoms of MIH?

Answer 4

Teeth look creamy, white, yellow or brown
Increased sensitivity
Teeth chip or break easily
Tooth decay may develop more easily

Question 5

What are the management options for MIH?

Answer 5

Fluoride - varnish 4x yearly, FS, duraphat if over 10
Diet advice and OHI at every visit
Consider GI restorations over sensitive parts
If hopeless 6s consider XLA
SS crowns on 6s

Question 6

What are the aesthetic tx options for MIH?

Answer 6

Microabrasion - polishing them off, clear fluoride varnish after - proflurid
Resin infiltration
External vital bleaching - if lesions are white to whiten tooth to match
Localised composite additions
Composite veneers
Porcelain veneers