Molar-Incisor Hypomineralisation (MIH)

Affected teeth can show clearly different enamel colour or quality, sensitivity and difficulty tolerating routine dental care. The molars may break down after eruption, while incisors may show visible demarcated changes.

MIH is a developmental enamel condition. A child’s enamel appearance alone does not establish why the defect developed, so the visible change should be assessed rather than blamed on a particular event.

The condition may be recognised when affected permanent molars or incisors erupt. Enamel changes can range from visible demarcation to post-eruptive breakdown. The extent and sensitivity guide the clinical plan.

The relevant concern is the quality and integrity of affected enamel, especially on newly erupted molars. Sensitivity, breakdown and difficulty keeping a tooth clean influence the need for care.

A dentist diagnoses MIH by examining the enamel changes on the molars and incisors and considering sensitivity and breakdown. Other causes of enamel change may need to be distinguished clinically.

Management is tailored to the tooth’s sensitivity, enamel condition and ability to remain functional and clean. The AAPD guidance supports preventive and restorative planning according to the affected teeth.

The cost is shaped by the examination, preventive care, sensitivity management, and any restoration needed when affected enamel has broken down.

Affected enamel can be sensitive and may break down after eruption. That can make eating, brushing or dental treatment harder, so an early dental assessment is useful when a newly erupted tooth is painful or changing.

After MIH is identified, prevention focuses on protecting vulnerable enamel with preventive care, sensitivity management, and measures that reduce breakdown and caries.