Abstract
(1) Background: Molar incisor hypomineralisation (MIH) is an enamel defect that affects an estimated 14.2% of children worldwide. Care takes place in primary and secondary care facilities. (2) Aim: To investigate how children with MIH are managed within a specialist centre in the north of England. (3) Method: A retrospective service evaluation within the paediatric dentistry department was registered with the clinical governance unit. Children who attended consultant-led new-patient clinics between 1 January and 31 December 2015 with a diagnosis of MIH were included. The data collected concerned the pre-referral treatment, the history and diagnoses and the treatments completed. (4) Results: Out of 397 records reviewed, 48 (12.1%) had MIH, where 81.3% and 18.8% of patients had severe and mild MIH, respectively. The majority of patients (n = 44 (91.7%)) were referred appropriately. Treatment was completed at the specialist centre for 44 (91.7%) patients. Twenty-five (52.1%) patients had an extraction of one or more first permanent molar teeth. Sixteen patients had the extractions at between 8 and 10 years old and 2 had the extractions later as part of an orthodontic plan. (5) Conclusion: Most children had severe MIH and were referred at an appropriate time to facilitate the consideration of loss of poor prognosis of first permanent molars (FPMs). Most children required specialist management of their MIH.
Highlights
Molar incisor hypomineralisation (MIH) is a developmental defect of enamel causing cream, yellow or brown opacities on the first permanent molars (FPMs) and sometimes the incisor teeth [1]
(5) Conclusion: Most children had severe MIH and were referred at an appropriate time to facilitate the consideration of loss of poor prognosis of first permanent molars (FPMs)
In Europe, a shared care approach between generalists and specialists is recommended [11,12], with mild cases being managed by general dental practitioners (GDPs) in primary care and the more complex cases being managed by specialists in paediatric dentistry [13] or in orthodontics, where FPMs are to be removed [14]
Summary
Molar incisor hypomineralisation (MIH) is a developmental defect of enamel causing cream, yellow or brown opacities on the first permanent molars (FPMs) and sometimes the incisor teeth [1]. It is a common defect, with the worldwide prevalence estimated to be approximately. Prevention should follow national guidelines for children at high risk of caries for both mild and severe cases [5,6], in addition to using desensitising treatments, such as casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) [7,8,9] and silver diamine fluoride [10]. In Europe, a shared care approach between generalists and specialists is recommended [11,12], with mild cases being managed by general dental practitioners (GDPs) in primary care and the more complex cases being managed by specialists in paediatric dentistry [13] or in orthodontics, where FPMs are to be removed [14]
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