Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Mexican Schoolchildren

Causal effect of molar incisor hypomineralisation on oral health-related quality of life of Australian children aged 7-16 years

PURPOSE

Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel characterised by demarcated opacities. Aesthetic and functional sequelae of MIH may manifest as reduced oral health related quality of life (OHRQoL). This study aims to investigate the impact of the presence and severity of MIH on children's OHRQoL.

METHODS

This cross-sectional study recruited children aged 7-16 years-of-age attending specialist paediatric dental clinics in Melbourne, Australia. Clinical examination utilised the modified European Academy of Paediatric Dentistry index to quantify the presence and severity of MIH. OHRQoL data was collected via the Child Perception Questionnaire, Parent-Caregiver Perception Questionnaire and Family Impact Statement. Causal analysis used quantile regression and included poor medical health as a confounding variable. Sensitivity analysis used the same model and different strata of MIH lesion location and severity.

RESULTS

131 participants with complete self-reported OHRQoL data were included in the causal analysis. The estimated average causal effect after adjusting for poor medical health showed the estimated difference in medians of child-reported OHRQoL was 6 (CI = 2.62, 12.25, p = 0.02) in the MIH group compared to the unaffected group. The estimated difference in medians of self-reported OHRQoL after adjusting for poor medical health was 7 (CI = 1.87, 11.99, p = 0.01) for severe MIH group and - 1 (CI = - 5.16, 3.62, p = 0.63) for the mild group compared to those unaffected. The estimated difference in medians of self-reported OHRQoL after adjusting for poor medical health was 5.16 (CI = - 2.42, 10.99, p = 0.15) for participants with MIH-affected incisors compared to the rest of the cohort.

CONCLUSIONS

MIH impacts children's OHRQoL as reported by self and parent/caregiver.

Current Knowledge of the Etiology and Management of Molar Incisor Hypomineralization in Children: A Narrative Review

Molar incisor hypomineralization (MIH) is a developmental condition affecting the enamel, primarily targeting one to four permanent first molars, often with the involvement of permanent incisors. The condition is characterized by distinct white-yellow or yellow-brown opacities, with more severe cases exhibiting hypomineralized enamel that is prone to breakdown. Recent data highlights MIH as a widespread dental issue seen across the globe. Despite its prevalence, the exact etiology remains unclear due to the variety of potential contributing factors. Managing MIH is particularly challenging, requiring a holistic approach to address the broad spectrum of symptoms and the heightened sensitivity of the affected teeth. Given the unique challenges of MIH, it is essential to gather updated and thorough knowledge. This understanding is critical for exploring potential preventive measures and enhancing treatment outcomes. This review aimed to examine the underlying causes of MIH, assess various treatment strategies, and offer a thorough understanding of the condition based on the latest research.

Influence of maternal health status during pregnancy and the child´s medical history on molar-incisor hypomineralization in a group of Spanish children (aged 6-14 years): a retrospective case-control study

BACKGROUND

Molar-incisor hypomineralization (MIH) is a qualitative enamel defect that is highly prevalent in children. It has been reported that patients with MIH have higher caries occurrence with an increased need and frequency of dental treatment compared to patients without MIH. The objective of this study was to analyze the association between MIH and a series of factors related to maternal health status during pregnancy and children´s medical history in early childhood.

METHODS

A retrospective study of cases (patients with MIH) and controls (patients without MIH) was designed between 2023 and 2024. A total of 280 children (cases = 140; controls = 140) aged 6 to 14 years (138 boys and 142 girls) were examined according to the European Academy of Pediatric Dentistry (EAPD) criteria for MIH. A survey was carried out with mothers regarding the potential exposure of their children to etiological factors of MIH. Possible prenatal and postnatal etiological factors were obtained through a personal interview with the patients' mothers. The statistical analysis was carried out with the contrast test and the chi-square test.

RESULTS

During pregnancy, folic acid consumption, alcohol intake, systemic viral and/or bacterial infections, and gestational diabetes were statistically significantly related to MIH, as were breastfeeding, asthma, and corticosteroid consumption during childhood.

CONCLUSIONS

Although there are different factors that may have statistically significant relationships with MIH, they cannot be predicted. Therefore, longitudinal studies, with a large sample size, are needed to determine the influence of prenatal and postnatal factors on the prevalence and severity of MIH in children.

Molar incisor hypomineralization (MIH): The "Why, What and How" of decision making for orthodontists

Molar-incisor hypomineralization (MIH) presents a significant clinical challenge in orthodontics, with its complex etiology, variable presentation, and profound impact on enamel homeostasis. Utilizing Simon Sinek's "Golden Circle" method, this article systematically explores the implications of MIH within orthodontic practice. The "Why" emphasizes the critical need for orthodontists to understand MIH, given its prevalence and potential to disrupt treatment outcomes. MIH affects up to 40.2% of the global population, and its association with increased caries risk, hypersensitivity, and restorative failures necessitates an informed approach to management. The "What" section addresses the importance of recognizing the phenotypic variability of MIH and its influence on oral health-related quality of life. MIH impacts social and psychological well-being, particularly when anterior teeth are involved, and complicates orthodontic treatment due to challenges in bonding, banding, and restorative protocols. The "How" provides practical guidelines for orthodontic management, including diagnostic considerations, tooth restoration strategies, and the complexities of first permanent molar extractions. Strategic planning is essential to avoid complications such as mesial drift, overeruption, or space loss, with a multidisciplinary approach often required. This article highlights the importance of long-term monitoring and patient-centered care in managing MIH-affected teeth, underscoring the evolving nature of clinical protocols. By framing the discussion through the Golden Circle, this critical review offers a structured and impactful approach to understanding and addressing MIH within orthodontic contexts, aiming to enhance treatment outcomes and patient quality of life.

Molar-Incisor Hypomineralization Is Associated with the Prevalence of Thinness among Schoolchildren in Communities with Different Fluoride Levels in the Drinking Water

Objective

To examine the association between molar-incisor hypomineralization (MIH) and the prevalence of thinness among Mexican schoolchildren in communities with different fluoride levels in the drinking water.

Methods

A cross-sectional study on Mexican children (n = 488) selected from two communities presenting different concentrations of fluoride in the drinking water (1.0-1.40 ppm/F). The World Health Organization (WHO) growth standards were used to calculate BMI-for-age z-scores, with BMI z-score cutoff points of <-2.0, >+1.0, >+2.0 recommended for defining thinness, being overweight, and obesity. The presence and severity of MIH were evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria. Multiple logistic regression analyses were used to assess the association, adjusting for confounders.

Results

The proportion of children presenting thinness, being overweight, and obesity was 8.2%, 23.6%, and 28.7%, respectively, while 21.5% of the schoolchildren had MIH, classified, by severity, as 9.6% mild, 6.4% moderate, and 5.5% severe. Of those schoolchildren presenting thinness, 16.2% had MIH, and only 6.0% did not (p  < 0.001). Finally, schoolchildren presenting thinness were more likely to present MIH (OR = 2.76 (CI 95% 1.33-5.73); p=0.006) than children with a normal BMI.

Conclusion

The present study found a relationship between thinness and the presence of MIH in schoolchildren, indicating the need for strategies and interventions aimed at preventing and controlling micronutrient deficiencies in the child population.

The Impact of Molar Incisor Hypomineralisation on Children and Adolescents: A Narrative Review

Molar incisor hypomineralisation (MIH) is a qualitative developmental enamel defect with a prevalence of 13% worldwide. This review aims to outline the current evidence regarding the impact of MIH on children's oral health and, more broadly, their day-to-day activities. MIH is associated with negative sequelae, including hypersensitivity, post-eruptive breakdown, the rapid development of carious lesions and poor aesthetics. Other concerns pertain to the clinical management of MIH and include difficulty in achieving local anaesthesia, increased dental fear and anxiety (DFA) and increased behaviour management problems. Oral health-related quality of life (OHRQoL) is the most standardised measure of patient impact; however, no instruments have been validated for use in MIH populations. The few existing observational studies investigating the impact of MIH on OHRQoL in children have produced conflicting results. Interventions to alleviate hypersensitivity and improve aesthetics had a positive impact on the OHRQoL of MIH-affected children. Multiple methodological issues make it difficult to measure the impact of MIH, including heterogeneity in the MIH severity classification, an overlap in the indices used to diagnose dental caries and MIH as well as the subjectivity of outcome measures for hypersensitivity and DFA.

Is there a rise of prevalence for Molar Incisor Hypomineralization? A meta-analysis of published data

Since Molar Incisor Hypomineralization was first described as a pathologic entity, public perception often suggests a considerable rise in prevalence of the respective disease. Since there are still considerable doubts regarding the etiology and-accordingly-prevention of MIH and respective therapeutic approaches are difficult this question is of considerable clinical and public interest. Accordingly, a systematic literature search in accordance with the PRISMA guidelines for systematic reviews on Medline, Cochrane Database, EMBASE, LILACS, Web of Science, Google scholar, Scopus was performed to retrieve original articles reporting the prevalence of MIH as defined by the European Academy of Pediatric Dentistry (EAPD). From initially 2360 retrieved titles, 344 full texts were assessed for possible inclusion and finally 167 articles of mainly moderate to high quality and based on data of 46'613 individuals were included in the meta-analysis. All studies published before 2001 had to be excluded since it was not possible to align the findings with the EAPD classification. Studies varied considerably regarding cohort size (25 to 23'320, mean 1'235)) and age (5.6-19 y, mean 9.8 y). Over all studies, the weighted mean for the prevalence for MIH was 12.8% (95% CI 11.5%-14.1%) and no significant changes with respect to either publication year or birthyear were found. A sub-analysis of eleven studies reporting on the prevalence in different age groups, however, revealed strong evidence for an increasing prevalence between the years 1992 (3%) and 2013 (13%).Therefore, based on data from cross-sectional studies a possible rise in prevalence of MIH remains unclear. Future prospective large-scale studies under standardized examination conditions with an emphasis on examiner calibration are needed to gain better understanding in the evolution of the prevalence of MIH.

Oral health-related quality of life and survival analysis after preventive and restorative treatment of molar-incisor hypomineralisation

The aim of this study was to assess the impact of molar-incisor hypomineralisation (MIH) on oral health-related quality of life (OHRQoL) in children and adolescents, including information on restorative care, tooth sensitivity, as well as sociodemographic factors. Thirty-five patients aged between 7 and 17 years underwent a comprehensive oral examination. Severity of MIH was graded using the MIH Treatment Need Index (MIH-TNI), OHRQoL using the Child Oral Health Impact Profile (COHIP-19). Clinical quality of restorations was assessed according to modified FDI-criteria, tooth sensitivity using the Schiff Cold Air Sensitivity Scale (SCASS). The mean age was 11.3 ± 3.0 years, 34% were female. On average, 6.9 ± 2.8 teeth were affected, 62,9% had hypersensitive teeth (SCASS ≥ 1). Eighty-nine percent of patients had received restorative care, with a mean of 3.3 ± 2.1 teeth restored, most often with composite, followed by fissure sealing. Nine percent of restorations failed by the FDI-criteria. Mean estimated survival times for success were 4.9 years (95% CI 3.5; 6.2) and 5.6 years (95% CI 5.0; 6.3) for fissure sealants and composite restorations, respectively. The mean COHIP-19 score was 64.3 ± 8.2 (max. possible score = 76). A higher severity of MIH-TNI correlated significantly with impaired OHRQoL (rs = - 0.38, p = 0.013). However, this was not mirrored in multiple regression analysis. Despite the high rate of restorative treatment with an acceptable failure rate, OHRQoL is reduced in children with MIH. Many teeth affected by MIH remain sensitive. Further studies are needed to assess the benefits of different restorative options.

Knowledge, experience, and perception of molar incisor hypomineralisation among dentists in the metropolitan area of Mexico City: a cross-sectional study

BACKGROUND

Molar-incisor hypomineralisation (MIH) is the most common developmental abnormality observed in teeth. Being a relatively new condition, its treatment can present a challenge for the dentist. There is currently no study available that has evaluated the knowledge of Mexican dental personnel. This study aimed to evaluate the knowledge, experience, and perceptions of dental surgeons regarding the detection, assessment, and treatment of MIH in the metropolitan area of Mexico City.

METHODS

A cross-sectional study was designed. Dentists from Mexico City and its metropolitan area were invited through social networks to answer a questionnaire of 30 questions related to MIH. Participants were classified into general practice dentists, paediatric dentists, and other speciality dentists. Pearson's chi-square test was used for data analysis.

RESULTS

The questionnaire was answered by 391 dentists. A total of 86% (338 out of 391) of them identified MIH lesions, while 84% of them reported having observed MIH lesions in their practice. The most frequently observed lesions were yellow-brown opacities which accounted for 47% of the lesions, 46% were white opacities, while only 7% were observed as post-eruptive fractures in the enamel as part of the manifestations of MIH. The most frequently reported problem in the management of teeth with MIH was insufficient training for treating children with MIH. A total of 84% of dentists stated that they would like more information on the treatment of MIH lesions.

CONCLUSIONS

Most of the surveyed dentists recognised MIH and reported having observed MIH lesions in their practice. Most of the dentists indicated that the main problem for the management of the MIH is the lack of training.

[Effect of molar incisor hypomineralization on oral health-related quality of life in children and adolescents: a systematic review]

Introduction

Hypersensitivity, altered dental appearance and fractures are common problems in molar incisor hypomineralization that generate functional and socio-emotional problems.

Objective

to evaluate the effect of MIH on oral health-related quality of life in children and adolescents.

Materials and methods

A systematic bibliographic search was carried out in electronic databases (Pubmed, Epistemonikos, Dentistry & Oral Sciences Source and Virtual Health Library). Observational studies in English or Spanish conducted between 2016-2022 that evaluated the quality of life of children and adolescents with molar incisor hypomineralization were identified. Most studies were of good methodological quality.

Results

Of 96 identified studies, thirteen were included in the synthesis. The most frequent diagnostic criterion for hypomineralization of molar incisors was the index of the European Academy of Pediatric Dentistry and nine studies reported the severity of the disease. The most widely used scale to measure quality of life was the Child Perception Questionnaire (CPQ). According to the children's perception, the most affected dimensions were "Oral Symptoms" and "Emotional Well-Being", according to the parents they were "Oral Symptoms" and "Functional Limitations". Girls with molar incisor hypomineralization had worse oral health-related quality of life.

Conclusions

The negative effect of molar incisor hypomineralization on children's oral health-related quality of life seems to vary between the perception of parents and children.

Impact of molar incisor hypomineralization on oral health-related quality of life in 8-10 years old children: A systematic review and meta-analysis

OBJECTIVES

This study aimed to evaluate the impact of molar incisor hypomineralization (MIH) and its different severities on various aspects of oral health-related quality of life (OHRQoL) in children between 8 and 10 years of age.

DATA SOURCES

The search terms were chosen according to the Medical Subject Headings (MeSH) and non-MeSH. Potentially eligible studies involved the OHRQoL evaluation in 8-10 years old children with MIH. An electronic search of published studies was carried out in August 2022 on Scopus, Web of Science, and PubMed databases. Of 130 papers retrieved initially, 21 were eligible to be included in the systematic review, of which 8 were excluded. The OHRQoL questionnaires used in the studies included Caregivers Perceptions Questionnaire (CPQ) 8-10, Child Oral Health Impact Profile questionnaire, and Child Oral Impacts on Daily Performances questionnaire. Nine studies using CPQ8-10 contributed to the meta-analysis.

RESULTS

According to meta-analysis, the results revealed that in MIH children a significant increase was observed in the total score of CPQ 810 with the pooled mean of 15.89 (95% confidence interval [CI]:8.95-22.84; P-value = .001) and in oral symptoms, functional limitation and emotional well-being domains with the pooled means of 6.25 (95% CI:4.01-8.50; P-value = .001), 3.88 (95% CI:1.93-5.83; P-value = 0.001), and 3.24 (95% CI:0.96-5.52; P-value = .01), respectively. While the increase in social well-being with the pooled mean of 1.65 (95% CI: -0.47 to 3.76; P-value = .13) was not significant. Subgroup analysis based on MIH severity showed no significant difference in OHRQoL means for all variables.

CONCLUSION

Suffering from MIH, negatively affected the total score and all domains of the CPQ 8-10 questionnaire, except for social well-being. Furthermore, different severities of MIH had no significant impact on OHRQoL in children.

MIH and Dental Caries in Children: A Systematic Review and Meta-Analysis

(1) Background: Molar-incisor hypomineralization (MIH) is a clinical condition affecting permanent teeth in children, with a documented rising trend in the last two decades. The aim of the present study was to analyze and synthesize the available evidence on caries experience (dmft/DMFT) and MIH in children. (2) Methods: A systematic review and meta-analysis were conducted according to the PRISMA statement. (3) Results: 59 papers published between 2007 and 2022 were included in the qualitative synthesis and 18 in the meta-analysis. The total sample of subjects was 17,717 (mean: 896), of which 2378 (13.4%) had MIH (mean: 119), with a girl/boy ratio of 1:1. The mean age of the enrolled participants was 8.6 (age range 7-10 years). Meta-analysis showed that MIH has a positive correlation with both dmft (effect size of 0.67, 95% CI [0.15, 1.19]) and DMFT (effect size of 0.56, 95% CI [0.41, 0.72]); (4) Conclusions: Children with MIH should be diagnosed correctly and on time. Treatment and management options for moderate and severe forms of MIH should consider prognosis based on known risk factors, and secondary and tertiary prevention policies should also consider the multifactorial nature of caries etiology.

Association of dental hypersensitivity and anxiety in children with molar-incisor hypomineralisation (MIH)

AIM

The objective of this study was to investigate whether dental hypersensitivity and dental fear were linked to the presence and severity of MIH.

METHODS

For this cross-sectional study, 1830 students between the ages of 6 and 12 years were recruited from four randomly selected schools. The Children's Fear Survey Schedule-Dental Subscale questionnaire was used to assess dental anxiety and fear. The children's self-reported dental hypersensitivity resulting from MIH was evaluated using the Wong-Baker Facial Scale and the Visual Analog Scale (VAS).

RESULTS

MIH was correlated with tooth hypersensitivity, particularly in severe cases. Dental fear was present in 17.4% of the children with MIH, but it was not associated with dental hypersensitivity, gender, or age.

CONCLUSION

No association was found between dental fear and dental hypersensitivity in children with MIH.

Changes in oral health-related quality of life before and after dental treatment in 8-12-year-old Costa Rican schoolchildren

Aims

The aims of this study were to (1) evaluate oral health-related quality of life (OHRQoL) in 8-12-year-old Costa Rican schoolchildren before and after dental treatment and (2) collect clinical and sociodemographic characteristics.

Methods

Schoolchildren completed the Child Oral Health Impact Profile-Short Form (COHIP-SF-19) questionnaire before and after dental treatment. One of the parents was asked to complete a sociodemographic survey. Patients were treated for caries, hypomineralizations, and dental malocclusions. The prevalence of these conditions was assessed from the patient's electronic dental record.

Results

Eighty participants (39 male and 41 female, average age: 9.4 ± 1.0 years) were recruited. The prevalence of dental caries was 56.1% with a mean deft and DMFT score of 3.15 ± 0.96 and 2.22 ± 0.77, respectively. The prevalence of hypomineralization and dental malocclusions was 53.7% and 82.9%, respectively. The Simplified Oral Hygiene Index before treatment was 1.45 ± 0.45 and after was 1.42 ± 0.43. The mean COHIP-SF-19 total score decreased from 53.7 ± 7.8 before dental treatment to 31.4 ± 4.2 after treatment. Improvements in all subdomains were also observed. Regarding sociodemographic characteristics, 65% of the patients lived in San José, Costa Rica's capital city, and 56.3% of the studied population belonged to a low-income family. Most parents did not complete high school. Regarding the number of family members living in the same house as the patient, an average of four people was reported. In relation to family structure, 58.8% of the children's parents lived together, either married or free union. As for household ownership, 53.8% of parents reported owning their house, 36.3% lived in a rented house, and 10% lived in a borrowed home.

Conclusion

The prevalence of caries, hypomineralizations, and dental malocclusions were high before dental treatment. Reported sociodemographic characteristics unlikely changed after dental treatment, suggesting dental care played a pivotal role in improving self-perceptions of oral health and quality of life in our clinical setting.

Determination of dental caries, molar-incisor hypomineralization, and oral health-related quality of life in schoolchildren: A structural equation modeling approach

BACKGROUND

Some oral conditions can have psychosocial consequences that affect children's daily life and well-being.

AIM

To create a structural model for the determination of dental caries, molar-incisor hypomineralization (MIH), and the impact of these conditions and socioeconomic status on schoolchildren's oral health-related quality of life (OHRQoL).

DESIGN

A representative cross-sectional study was conducted in Lavras, Brazil, with 1181 female and male schoolchildren 8-9 years of age. OHRQoL was measured using the Brazilian version of the CPQ8-10. Clinical examinations were performed by a calibrated dentist for the diagnosis of dental caries (WHO) and MIH (EAPD). Parents/caregivers answered questionnaires addressing the child's medical history and socioeconomic status. Data were analyzed using structural equation modeling.

RESULTS

The model revealed that greater MIH severity (β = .874; p < .001) and worse socioeconomic status (β = -.060; p = .001) were associated with a greater number of teeth with caries experience. The higher the number of teeth with caries experience (β = .160; p = .007) and worse socioeconomic status (β = -.164; p < .001), the greater the negative impact on OHRQoL.

CONCLUSION

The model created showed that dental caries and socioeconomic status had a direct negative impact on the OHRQoL of schoolchildren and MIH had an indirect impact mediated by the occurrence of caries experience.

Hypomineralized Teeth and Their Impact on Oral-Health-Related Quality of Life in Primary School Children

BACKGROUND

Molar-incisor hypomineralization (MIH) has a strong negative effect on oral-health-related quality of life (OHRQoL). Malformed teeth can be hypersensitive, and the discoloration might affect children's appearances, reducing their well-being. The purpose of the study was to investigate how hypomineralized incisors and molars differ in children's perceived OHRQoL.

MATERIALS AND METHODS

252 children aged 7-10 years old were included and subdivided into three equal groups (n = 84). Group A included children with asymptomatic molars and affected incisors. Group B included children presenting only affected molars. Group C was the control group, with children showing no MIH. All participants were asked to complete the German version of the Child Perceptions Questionnaire (CPQ-G8-10) to measure OHRQoL.

RESULTS

Participants in the posterior group showed a median total CPQ of 13.4 (±1.7), which was significantly higher than scores in the anterior and control group, which showed a median total CPQ of 8.4 (±1.4) and 4.2 (±0.7), respectively. Children in the posterior group suffered more from oral symptoms and functional limitations, whereas the anterior group dealt more with social and emotional well-being problems.

CONCLUSIONS

The position of the MIH-affected teeth causes different influences on perceived OHRQoL.

"Knowledge, clinical experience, and perceived need for training regarding molar-incisor hypomineralization among a group of Egyptian dental students: a cross-sectional study"

BACKGROUND

Molar-Incisor Hypomineralization (MIH) is a common oral health condition that can lead to difficulties and complications for both dental professionals and patients. It also has a negative impact on the oral health-related quality of life. The present study aimed to assess the knowledge, clinical experience, and perceived need for training of a group of Egyptian dental students regarding MIH.

METHODS

Paper-based survey administration method was used to collect the responses of dental students regarding their knowledge, clinical experience, and perceived need for training about MIH. The survey consisted of two sections of questions regarding clinical features, etiological factors, prevalence, materials used in treating these teeth, factors affecting the choice of restorative materials, and their preferences regarding clinical training of MIH. Descriptive statistics was used for the data analysis by using SPSS® Statistics Version 26.

RESULTS

About two-thirds of the respondents were familiar with MIH (69.2%). The vast majority of students (87.8%) had difficulty distinguishing MIH as a developmental defect that differs from other tooth conditions (p < 0.001); most commonly enamel hypoplasia. The most common defects seen by the respondents were yellow/brown opacities (59.1%). Nearly half of the students (45.2%) choose composite resin as the material of choice for the treatment of MIH-affected teeth with aesthetics being the most common factor affecting the selection of restorative material. Almost all students expressed their needs for further clinical training on MIH, especially on treatment aspects.

CONCLUSIONS

Most students are familiar with MIH theoretically. However, there is an urgent need to include clinical training on MIH diagnosis in the practical sessions of pediatric dentistry courses.

Prevalence, Caries, Dental Anxiety and Quality of Life in Children with MIH in Brussels, Belgium

Molar incisor hypomineralisation (MIH) is a dental enamel pathology responsible for unfavorable functional and aesthetic implications. The objective of this study is to assess the prevalence, dental anxiety, and quality of life related to oral health in children with MIH. In 14 schools in Brussels, Belgium, 290 children aged 8 to 9.5 answered Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Child-Oral Impact on Daily Performance (C-OIDP) questionnaires to assess dental anxiety and quality of life related to oral health (OHRQoL). Oral examinations allowed us to detect MIH according to standardized criteria. The MIH prevalence was 18.6%. The Decayed, Missing and Filled Teeth index (DMFT index) of MIH patients was significantly higher than non-MIH patients (p < 0.001), mainly due to more restored teeth. There was no significant association between MIH and dental anxiety or OHRQoL. Caries in the deciduous dentition was significantly associated with impaired quality of life. The MIH prevalence in Brussels is comparable to other European countries. MIH had no significant impact on dental anxiety and OHRQoL in this sample. The dynamic nature of MIH lesions requires early diagnosis and management to limit the evolution of the severity of the lesions and their implications. It is possible that older age groups may present more symptoms, however, this would require a longitudinal study.

Impact of early childhood caries severity on oral health-related quality of life among preschool children in Mexico: A cross-sectional study

BACKGROUND

Information is scarce on Early Childhood Caries (ECC) in Mexican preschool children and its impact on quality of life.

AIM

To evaluate the ECC prevalence and its impact on OHRQoL in 3-5 years-old Mexican children according to disease severity.

DESIGN

Caries was determined at two thresholds: (1) children with at least one caries lesion (ICDAS-1-6) and (2) children with at least one lesion in dentin (ICDAS-3-6). OHRQoL was assessed through the Mexican Early Childhood Oral Health Impact Scale (M-ECOHIS). Associations among caries severity, M-ECOHIS, and other variables were assessed by ordinal logistic regression.

RESULTS

A total of 409 children participated (53.8% girls, 46.2% boys). Caries prevalence was 82.2% considering all lesions, and 45.0% for dentinal lesions. Significant linear trends (p < .05) among caries levels and categories of exposure were found for socioeconomic variables, dietary habits, and toothbrushing habits. Attending rural private schools (OR = 1.39, 95%CI = 1.11-1.72; p < .01), two main meals/day (OR = 2.75, 95%CI = 1.26-6.03; p = .01) and unsupervised toothbrushing (OR = 3.20, 95%CI = 1.96-5.24; p < .01) increased the risk to have high caries severity levels. M-ECOHIS scores were statistically significant associated with caries levels (χ² ₍₄₎  = 175.85, p < .01; trend across groups z = 12.63 Prob > |z| < 0.01).

CONCLUSIONS

M-ECOHIS was significantly associated with caries severity. Type of school, age groups, parents' educational level, family income, and living conditions were correlated with caries, showing how distinctive risk indicators were associated with different caries stages.

The association between molar incisor hypomineralization and oral health-related quality of life: a cross-sectional study

Objectives

We aimed to assess the association between molar incisor hypomineralization (MIH) and the oral health-related quality of life (OHRQoL) in a group of 7- to 14-year-old children in Berlin, Germany.

Materials and methods

The cross-sectional study consisted of a consecutive sample of 317 children, aged 7–14 years (49% girls, 51% boys; mean age, 8.71). Data were collected between June 2018 and December 2019. MIH was diagnosed using the criteria of the European Academy of Paediatric Dentistry. OHRQoL was assessed using the German 19-item version of the Child Oral Health Impact Profile (COHIP-G19). Differences in COHIP-19 summary scores between controls without MIH and MIH patients and with regards to MIH severity were tested for statistical significance using t test and analysis of variance (ANOVA), respectively.

Results

Data were obtained for 217 untreated MIH patients and 100 controls. OHRQoL of MIH patients was significantly more impaired than of controls indicated by COHIP-19 mean scores (60.9 ± 10.7 vs. 67.9 ± 7.8; p < 0.001). Patients with severe MIH (59.6 ± 11.0) reported significantly worse OHRQoL than patients with mild MIH (63.6 ± 9.1; p = 0.013).

Conclusions

MIH has a significant negative impact on the children’s OHRQoL. Patients with severe MIH experience a greater negative impact on OHRQoL than those diagnosed with mild MIH.

Clinical significance

MIH is one of the major dental problems of our time; pediatric dentists should be aware of its impact on the OHRQoL of the patient.

Can molar incisor hypomineralization cause dental fear and anxiety or influence the oral health-related quality of life in children and adolescents?-a systematic review

PURPOSE

Molar Incisor Hypomineralization (MIH) are first molars with developmental enamel defects and are common findings in many child populations. The porous nature of MIH enamel and the presence of post-eruptive enamel breakdown leads to the presence of hypersensitivity and pain, which is often the patient's main complaint and can result in dental fear and affect the quality of life. The present review aims to summarise the evidence for the ability of MIH to cause problems, such as dental fear and anxiety (DFA) and to summarise the evidence for a possibly negative impact on the oral health-related quality of life (OHRQoL) of MIH affected children and adolescents, in a systematic review.

METHOD

Two searches, (1) MIH AND dental anxiety and (2) MIH AND Quality of life, were performed in MEDLINE/PubMed and Scopus. Selection demands were fulfilling the MIH diagnosis criteria using validated instruments and questionnaires for assessing DFA and OHRQoL, respectively.

RESULTS

After removing duplicates and articles not fulfilling the selection demands, 6 studies concerning MIH and DFA and 8 studies concerning MIH and OHRQoL remained.

CONCLUSION

Children and adolescents with diagnosed MIH did not seem to suffer from increased dental fear and anxiety, but indicated an impaired oral health-related quality of life.

Dental Students' Knowledge, Attitudes and Beliefs Regarding Molar Incisor Hypomineralization (MIH): A Survey in Vienna, Austria

Purpose

Molar incisor hypomineralization (MIH) is a frequently encountered dental condition worldwide. The aim of this study was to evaluate the knowledge of Austrian dental students about MIH.

Methods

A validated paper-based survey was distributed among 100 final year dental students at the Medical University of Vienna to assess their knowledge, perception and believes regarding MIH. One hundred dental students at the University Dental Clinic of Vienna were included in the study. At the time of the survey, they were in their 11th or 12th semester (final year). Information about the knowledge on diagnosis and prevalence, and attitudes and beliefs around etiology and management was collected.

Results

All students replied, 94 questionnaires could be included in the analysis (50% female). 98% of the students were familiar with MIH and 86% were aware with the clinical features of MIH. Only 13% reported clinical ability to identify MIH. Regarding the etiology of MIH, most of the students (69%) named "genetic factors" as the most frequent etiological factor.

Conclusion

Dental students showed great interest in the topic of MIH, as the majority of all respondents were in favor of deepening their knowledge regarding this topic. The students should be offered opportunities to do this both during and after their studies.

Oral health-related quality-of-life scores differ by socioeconomic status, mother's level of education, dental visits and severity of malocclusion in mixed dentition of eight-to-ten-year-old schoolchildren

Objective

To determinate the association among socioeconomic status subject’s mother’s level of educational attainment, dental visits, and malocclusion in mixed dentition with on the OHRQoL of eight-to-ten-year-old children.

Methods

A cross-sectional study conducted, in 2019, on Mexican children from households of different socioeconomic status (SES). The prevalence of malocclusion was evaluated using the Dental Aesthetic Index (DAI), while the SES of the participants’ households was evaluated using the three categories (corresponding to a high, middle, or low-income household) stipulated by the Consejo Nacional de Población (CONAPO or National Population Council). Oral Health-related Quality of Life (OHRQoL) was evaluated using the Child Perceptions Questionnaire (CPQ_8-10). Poisson regression models were performed for the analysis of the data obtained.

Results

A total of 79.4% of the subjects presented some type of malocclusion in mixed dentition, which was, by severity, as follows: definite (31.3%); severe (25.6%); and, very severe (22.5%). The Poisson regression model revealed a greater negative impact on the following four CPQ_8-10domains for children with severe/very severe malocclusion [RR]: oral symptoms [2.78]; functional limitations [2.72]; emotional well-being [2.59]; and, social well-being [3.99]. A greater impact on the four CPQ_8-10domains was found for children from a low-income household than for children from a high-income (p < 0.001) household. Furthermore, poor oral hygiene, lack of dental visits, and the mother’s level of educational attainment (<9 years) were found to have a negative impact on OHRQoL.

Conclusion

The findings of the present study demonstrated that the severity of malocclusion was associated with a greater negative impact on the OHRQoL of children, while those children who face greater health inequalities are likely to report a greater negative impact on their OHRQoL.

Influence of caries and molar incisor hypomineralization on oral health-related quality of life in children

OBJECTIVES

This study was aimed to compare the impact of caries and molar incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) in children.

MATERIAL AND METHODS

A total of 528 German children aged 7 to 10 years were recruited, half affected by caries and the other half affected by MIH. Both groups were matched according to age, sex, and social status and divided into 3 categories according to severity. The German version of the Child Perceptions Questionnaire for 8- to 10 years old (CPQ-G8-10) was used to analyze the impact on OHRQoL by applying ANOVA models.

RESULTS

Patients with MIH showed a mean CPQ score of 10.7 (± 9.3). This was significantly higher compared to the caries group with 8.1 (± 9.8). The score increased linearly from the low severity category to the high severity category in both groups (caries, 4.1 to 13.8; MIH, 5.2 to 17.7, respectively).

CONCLUSION

With increasing severity, both clinical conditions showed a greater negative impact on OHRQoL. MIH was associated with more impairments.

CLINICAL RELEVANCE

Currently, the focus in pediatric dentistry is placed on the prevention and treatment of caries. Both diseases may have a negative influence on OHRQoL. Since children perceive the impairments by MIH as worse and the prevalence is equal to that of caries, which focus might be shifted in the future.

Impact of molar incisor hypomineralization on oral health-related quality of life in 8-10-year-old children

Objectives

The aim of this study was to compare oral health–related quality of life (OHRQoL) in children with and without molar incisor hypomineralization (MIH) and to assess the impact of severity of MIH on OHRQoL in children between 8–10 years using the German version of the Child Perceptions Questionnaire (CPQ-G8-10).

Materials and methods

Children aged 8–10 years were recruited at a pediatric dental clinic in Hannover, Germany. Half of them were affected by MIH. Participants were evaluated for presence and severity of MIH (MIH-TNI), plaque and dental caries status. Children were asked to answer the CPQ-G8-10. Statistical analysis was performed using GraphPad Prism-software version 8.

Results

One hundred eighty-eight children (mean age 8.80 [± 0.84]; 43.10% female) were included in the study with 94 children having MIH. CPQ-G8-10 mean scores in MIH-affected children were significantly higher than in children showing no MIH (13.87 [± 8.91] vs. 4.20 [± 3.74]; p < 0.0001) showing that MIH has negative impact OHRQoL. Similar trends were seen in all four subdomains. Regarding severity, CPQ-G8-10 mean scores increased from mild to severe forms of MIH.

Conclusion

Children affected by MIH show an impaired OHRQoL compared to children without MIH; with increasing severity, OHRQoL gets more impaired.

Clinical relevance

To understand the patient’s perception and the individual oral health needs will help to prioritize MIH and recognize its impact.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00784-021-04150-w.

Molar Incisor Hypomineralisation: Current Knowledge and Practice

BACKGROUND

Molar incisor hypomineralisation (MIH) is a common developmental dental condition that presents in childhood. Areas of poorly formed enamel affect one or more first permanent molars and can cause opacities on the anterior teeth. MIH presents a variety of challenges for the dental team as well as functional and social impacts for affected children.

OBJECTIVES

Here, we provide an up-to-date review of the epidemiology, aetiology, diagnosis and clinical management of MIH.

MATERIALS AND METHODS

A review of the contemporary basic science and clinical literature, relating to MIH, was undertaken using information obtained (up to 10 April 2020) from the electronic databases PubMed, Scopus, Web of Science and the Cochrane Library.

RESULTS

There is a growing body of evidence relating to the aetiology, presentation and clinical management of MIH. Current knowledge appears to be focused on potential genetic aspects, as well as the development and validation of indices for the diagnosis and management of MIH. There has also been increasing recognition of the global and individual burden of this common condition.

CONCLUSIONS

Dental health professionals should regularly appraise the basic science and clinical MIH literature to ensure that they provide the best possible short- and long-term care for their young patients.

Knowledge, attitudes, and beliefs regarding molar incisor hypomineralization (MIH) amongst German dental students

BACKGROUND

Knowledge of molar incisor hypomineralization (MIH) has relevance for paediatric dentists.

AIM

To assess final-year German dental students' knowledge, attitudes, and beliefs regarding MIH.

MATERIALS AND METHODS

A previously validated questionnaire was posted to the 31 German dental schools. Demographic covariates as well as knowledge regarding diagnosis and prevalence, and attitudes and beliefs around aetiology and management were collected.

RESULTS

Twenty-two (71%) dental schools responded and a total of 877 students participated. Most (97%) were familiar with MIH and 88% were aware of the diagnostic criteria for MIH; however, only 42% knew how to implement them. One-third were able to identify MIH and 16% reported diagnostic confidence when doing so; 90% assumed the MIH prevalence to be <10%. Two-thirds of the respondents implicated genetic components as the main aetiological factor of MIH. Resin composite (60%) and preformed metal crowns (46%) were the dental materials most often suggested for restorative management. Almost all (98%) respondents were interested in receiving more clinical training.

CONCLUSION

German students were familiar with MIH; however, they reported low levels of knowledge and confidence regarding its prevalence and diagnosis. Standardized nationwide, up-to-date curricula should be implemented to educate future dentists in Germany.

Association between sociodemographic factors and noncavitated and cavitated caries lesions in 8- to 12-year-old Mexican schoolchildren

The aim of this study was to evaluate the association between sociodemographic factors and noncavitated and cavitated caries lesions in Mexican schoolchildren.This cross-sectional study was conducted in 2020 on 8-to-12-year-old schoolchildren of different socioeconomic status (SES). The caries was evaluated using ICDAS II, SES was evaluated using three categories---a high, middle, or low-income level---of the CONAPO. Multinomial logistic regression analyses were performed in order to ascertain the associations between socioeconomic factors and noncavitated and cavitated caries lesions.The prevalence of noncavitated lesions was 38.0% and cavitated lesions was 43.4% in permanent dentition. In all the samples, 50.6% of schoolchildren had poor oral hygiene. About 52.5% of the mothers and 64.7% of the fathers had less than 9 years of education. Schoolchildren with a low-income level have more cavitated lesions (ICDAS II 4-6) than schoolchildren with high-income level (56.3% vs 15.8%, P = .009). The multinomial logistic regression models showed that mother's level of education <9 years and low-income level were significantly associated with cavitated caries lesions (ICDAS II 4-6), [odds ratio = 1.79 (1.17 - 2.75); P = .007], [OR = 2.21 (1.23 - 3.97); P = .008], respectively. The socioeconomic level was not associated with noncavitated caries lesions (ICDAS II 1-3).An association was found between the presence of cavitated caries lesions and the subject's mother's level of education and a low-income level. Socioeconomic factors were found to be associated with inequalities in caries distribution in the age group studied.

Changes in oral health-related quality of life after treatment of hypersensitive molar incisor hypomineralization-affected molars with a sealing

Objectives

The aim of this study was to investigate the changes in oral health-related quality of life (OHRQoL) before and after treatment of hypersensitive molars affected by molar incisor hypomineralization (MIH) with a sealing.

Methods

Thirty-eight children with two MIH-affected molars showing hypersensitivity and non-occlusal breakdowns were included. Hypersensitivity was assessed with an evaporative (air) stimulus. Two affected teeth were sealed by two calibrated operators using a split-mouth design: Clinpro Sealant in combination with Scotchbond Universal, and Ketac Universal (3M), respectively. OHRQoL was measured using the German version of the CPQ8–10 (CPQ-G8–10) at baseline, and after 1, 4, 8, and 12 weeks, respectively.

Results

The CPQ total score decreased significantly from a mean of 14.7 (±5.9) to 6.4 (±4.7) (p < 0.001) 1 week after treatment revealing improved OHRQoL. After 12 weeks, OHRQoL improved again proven by a decreased mean score of 2.7 (±3.2).

Conclusions

Sealing of hypersensitive MIH-affected molars revealed a significant improvement of OHRQoL immediately and throughout the 12-week follow-up.

Clinical relevance

Hypersensitivity can be a major complaint in patients with MIH. This is the first study evaluating the effect of sealing on OHRQoL in affected patients.

Incisor Molar Hypomineralization and Quality of Life: A Population-Based Study with Brazilian Schoolchildren

AIM

To assess the impact of incisor molar hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perception of students and their parents/caregivers.

MATERIALS AND METHODS

This is a cross-sectional population-based study with 463 Brazilian students aged 11-14 years. OHRQoL was measured using the Child Perceptions Questionnaire (B-CPQ11-14ISF: 16) applied to students and the short version of the Parental-Caregiver Perceptions Questionnaire (B-P-CPQ) applied to parents/caregivers. The diagnosis of MIH followed the European Academy of Paediatric Dentistry criteria modified in 2019. Caries experience (ICDAS II), malocclusion (DAI), and socioeconomic and demographic factors were assessed as confounding factors for impact on OHRQoL. Cluster analysis was carried out to dichotomize the negative impact into greater and lesser impact. The chi-square test and Poisson regression were performed (p < 0.05) to verify associations between quality of life and MIH, adjusted for confounding variables.

RESULTS

The prevalence of MIH was 10.8%. Multivariate regression demonstrated that caries experience was the only oral disease that impacted OHRQoL according to students' self-perception in the functional limitation domain (PR = 1.82; 95% CI = 1.20-2.77) and in the total questionnaire score (PR = 1.59; 95% CI = 1.00-2.51). However, according to the perception of parents/caregivers, in addition to caries experience, which affected OHRQoL in the oral symptoms (PR = 3.57; 95% CI = 1.71-7.414) and emotional well-being domains (PR = 1.71; 95% CI = 1.08-2.69), as well as in the total B-P-CPQ score (PR = 1.67; 95% CI = 1.01-2.76), malocclusion also affected OHRQoL in the social well-being domain (PR = 1.50; 95% CI = 1.07-2.10) and in the total questionnaire score (PR = 1.54; 95% CI = 1.11-2.15).

CONCLUSION

According to students and their parents/caregivers' perception, incisor molar hypomineralization did not influence OHRQoL of the studied sample.

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).

Molar-incisor hypomineralization: parent's and children's impact perceptions on the oral health-related quality of life

PURPOSE

To evaluate the perception of parents and children and the impact of molar and incisor hypomineralization (MIH) on the oral health-related quality of life (OHRQoL).

METHODS

A cross-sectional study was conducted with a group of 253 children aged 6-12 years presenting MIH and their parents or guardians who initially answered an interview containing socioeconomic and demographic questions as well as the Parental-Caregiver's Perceptions Questionnaire (P-CPQ). The children answered the Child Perceptions Questionnaire (CPQ8-10) and Child Perceptions Questionnaire (CPQ11-14) and the clinical evaluation of MIH was performed. Poisson regression with robust variance was used in the data analysis.

RESULTS

The parent's perception showed that the impact felt by the children regarding caries leads to a higher oral symptom impact, functional limitation, emotional well-being and total PCPQ score domains, as well. For children with severe MIH, a higher prevalence of impact was felt regarding the functional limitation and emotional well-being. For CPQ8-10, the oral symptoms domain presented the highest mean score, while CPQ11-14 showed the functional limitations domain and P-CPQ the emotional well-being domain.

CONCLUSION

Considering the perception of parents or guardians, it was concluded that MIH promotes a negative impact on the OHRQoL. MIH had no significant impact on OHRQoL according to children's perceptions.