European Academy Of Paediatric Dentistry Research Articles

A practical method for use in epidemiological studies on enamel hypomineralisation.

With the development of the European Academy of Paediatric Dentistry (EAPD) judgment criteria, there has been increasing interest worldwide in investigation of the prevalence of demarcated opacities in tooth enamel substance, known as molar–incisor hypomineralisation (MIH). However, the lack of a standardised system for the purpose of recording MIH data in epidemiological surveys has contributed greatly to the wide variations in the reported prevalence between studies. The present publication describes the rationale, development, and content of a scoring method for MIH diagnosis in epidemiological studies as well as clinic- and hospital-based studies. The proposed grading method allows separate classification of demarcated hypomineralisation lesions and other enamel defects identical to MIH. It yields an informative description of the severity of MIH-affected teeth in terms of the stage of visible enamel destruction and the area of tooth surface affected (i.e. lesion clinical status and extent, respectively). In order to preserve the maximum amount of information from a clinical examination consistent with the need to permit direct comparisons between prevalence studies, two forms of the charting are proposed, a short form for simple screening surveys and a long form desirable for prospective, longitudinal observational research where aetiological factors in demarcated lesions are to be investigated in tandem with lesions distribution. Validation of the grading method is required, and its reliability and usefulness need to be tested in different age groups and different populations.

Prevalence of Molar Incisor Hypomineralization and its Relation with Dental Caries in School Children of Udupi District, South India

ABSTRACTAimTo evaluate the prevalence of molar incisor hypomineralization (MIH) and its relationship with dental caries in school children of Udupi district.Materials and methodsA total of 352 school children were recruited for this study. The European Academy of Pediatric Dentistry (EAPD) 2003, criteria were followed for diagnosis of MIH. Dental caries was recorded using World Health Organization (WHO) guidelines (1997) under natural day light.ResultsThe prevalence of MIH was seen to be 27% (n = 95). A total of 323 teeth had hypomineralization (106 were incisors and 217 were molars). The lower molars (n = 127) were more frequently affected than the upper molars (n = 90). Overall the maxillary incisors (n = 68) were more affected than the mandibular incisors (n = 38). Amongst the children with MIH, the mean number of decayed teeth was significantly lower than mean number of hypomineralized teeth in first permanent molars and first permanent molars and incisors (p < 0.001 and < 0.001) respectively. The mean decayed teeth in first permanent molar and incisors were significantly higher in subjects with MIH than without MIH (p < 0.001). Poisson regression analysis showed a significant positive association between MIH and dental caries (B = 1.43; p < 0.001).ConclusionThe prevalence of MIH was relatively high and was associated with dental caries.How to cite this articleTadikonda AN, Acharya S, Pentapati KC. Prevalence of Molar Incisor Hypomineralization and its Relation with Dental Caries in School Children of Udupi District, South India. World J Dent 2015;6(3):143-146.

Molar incisor hypomineralization: Prevalence and defect characteristics in Indian schoolchildren

Objectives: To report the prevalence and clinical features of molar incisor hypomineralization (MIH) in 8-12-year-old Indian schoolchildren. Study Design: A cross-sectional survey including a random sample of 1,240 schoolchildren aged 8-12 years from Gautam Budh Nagar was conducted. The examination was performed by a single, well-trained calibrated examiner in wet conditions using an artificial light source. The diagnostic criteria were set as per the European Academy of Paediatric Dentistry (EAPD) 2003 criteria. Restorative treatment needs (RTN) owing to MIH were calculated as the number of affected subjects with post-eruptive breakdown (PEB), quantitative loss of tooth substance, or caries owing to MIH. The descriptive data were expressed as mean ± SD and/or n (%). For data analysis, the t -test and the Wilcoxon signed-rank test were used. Results: A prevalence of 10.48% (130/1240) was reported, with RTNs in 42.31% (55/130). Buccal surfaces were the most commonly affected surfaces ( P P P = 0.212), with mandibular first permanent molars (FPMs) being the most frequently affected type of teeth ( P = 0.001). Conclusion: The present study reported a prevalence of 10.48% with RTNs in 42.31% of the affected subjects. Further studies mapping the prevalence from various other geographical areas of India are required.

Prevalence and Severity of Molar Incisor Hypomineralization in Students of Belém, Brazil

Objective: To measure the prevalence of Molar Incisor Hypomineralization (MIH), its severity and association with dental caries among public school children from Belem/PA, Brazil. Material and Methods: This is a cross-sectional study conducted with children enrolled in three public schools of Belem, which were selected by simple random sampling. MIH diagnosis was carried out according to criteria of the European Academy of Pediatric Dentistry. Results: Among the 260 students that met the inclusion criteria, 56.92% were male and 43.07% female. The average age was 10.22 years. Of these, 8.84% (n = 23) had MIH, but there was no statistically significant difference in this prevalence between sexes (p = 0.6244). The most affected teeth were the upper first permanent molars, followed by lower first permanent molars and upper permanent central incisors. About 43.48% of students had at least one tooth with severe defect in enamel and 30.43% of students with MIH presented dental caries in the affected teeth. Conclusion: Severe MIH was not the most prevalent among schoolchildren, but the relationship with dental caries found demonstrates the importance of knowledge about diagnosis and treatment of enamel defects, which should be part of promotion and prevention actions in oral health due to its epidemiological impact in the demographic change of dental caries.

Molar-incisor hypomineralisation (MIH) among Kurdish children in Sulaimani City, Iraq

Objectives: The aim of this study was to determine the prevalence and distribution of molar incisor hypomineralisation among Kurdish children in Sulaimani City, Iraq. Methods: A cross-sectional survey was carried out on primary school students in Sulaimani City. A total of 2346 Kurdish children aged 7 to 9 years old were examined; 1194 (50.9%) males and 1152 (49.1%) females, enrolled in 20 primary public schools. The index teeth were evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria for MIH. Results: The prevalence of MIH was found to be 18.2% where no statistically significant association was found with age or gender (P>0.05). Multiple teeth involvement (13.2%) was more common than a single molar involvement (5.1%). The mean number of the affected index teeth with MIH per affected child was (3.1). Mild defects were present in 64.1% of the affected teeth with demarcated creamy-white opacities were the most common finding (33.3%). Conclusion: It’s been found that MIH is a prevalent pathology among Kurdish children in Sulaimani City which could result in a large number of children continuously seeking professional dental treatment. Therefore, dental practitioners who deal with child patients could encounter such cases and should be aware of the treatment choices and management protocols for coping with this particular condition.

12th Congress of the European Academy of Paediatric Dentistry

12th Congress of the European Academy of Paediatric Dentistry

Background factors of molar-incisor hypomineralization in a group of Finnish children

Objective. Molar-Incisor Hypomineralization (MIH) is a common developmental enamel defect characterized by demarcated opacities in permanent molars and incisors. Its etiology still remains unclear. The aim of this retrospective cohort study was to assess if the socioeconomic environment of the child is associated with MIH. Materials and methods. The study was located in two rural towns and three urban cities in Finland. A total of 818 children, between 7–13 years old, were examined for MIH using the evaluation criteria in line with those of the European Academy of Paediatric Dentistry, but excluding opacities smaller than 2 mm in diameter. The mothers filled in a questionnaire which included questions related to the family’s way of living (e.g. area of residency, farming, day care attendance) and socioeconomic status (family income, number of mother’s school years, level of maternal education). Results. The prevalence of MIH in the study population was 17.1%. Family income, urban residency and day care attendance were associated with MIH in the univariate analysis. In the multivariate analysis using binary logistic regression, only urban residency during a child’s first 2 years of life remained associated with MIH. The prevalence of MIH in urban areas was 21.3% and in rural areas 11.5% (OR = 2.18, CI = 1.35–3.53, p = 0.001). Conclusions. The prevalence of MIH was related to urban residency and could not be explained by any other factor included in the study.

Genome-wide association study (GWAS) for molar–incisor hypomineralization (MIH)

This genome-wide association study (GWAS) investigated the relationship between molar-incisor hypomineralization (MIH) and possible genetic loci. Clinical and genetic data from the 10-year follow-up of 668 children from the Munich GINI-plus and LISA-plus birth cohort studies were analyzed. The dental examinations included the diagnosis of MIH according to the criteria of the European Academy of Paediatric Dentistry (EAPD). Children with MIH were categorized as those with a minimum of one hypomineralized first permanent molar. A GWAS was implemented following a quality-control step and an additive genetic effect was assumed. A total of 2,013,491 single-nucleotide polymorphisms (SNPs) were available for analysis. Rs13058467, which is located near the SCUBE1 gene on chromosome 22 (p < 3.72E-7), was identified as a possible locus linked to MIH when using a threshold of p value <1E-6. After considering the limitations of the present study (e.g., limited sample size and lack of an independent replication sample), it can be concluded that (1) replication analyses in an independent cohort study are strongly recommended and (2) large-scale and well-powered studies are needed to investigate a possible genetic link to MIH.

Aetiology of molar-incisor hypomineralisation (MIH) in Brazilian children.

To determine the potential aetiological factors related to molar-incisor hypomineralisation (MIH) in Brazilian children. A total of 1,151 children aged 7-12years (mean 8.86±1.28), born and living in the urban area of Araraquara, Brazil, were examined by two examiners evaluating the presence of MIH according to criteria suggested by the European Academy of Paediatric Dentistry (2003). Their mothers completed a structured questionnaire about medical history, from pregnancy to the first 3years of the children's life. Descriptive analyses of data and odds ratios (OR) with 95% test-based confidence intervals (CI) were estimated. Chi-square test was used to evaluate the differences between groups. The prevalence of MIH in the children was 12.3%. The interviewing response rate was 90.4%. The prevalence of miscarriage history (25 vs. 15.4%; OR=1.21; 95% CI 0.30-4.92) and occurrence of anaemia (23 vs. 12.4%; OR=2.07; 95% CI 0.50-8.63) were higher in mothers from MIH group than those from non-MIH group. However, these associations were not statically significant. In the children's medical history, rhinitis, bronchitis (56.5 vs. 52.5%; OR=1.17; 95% CI 0.82-1.68), and high fever (20.4 vs. 18.2%; OR=1.14; 0.73-1.76) were more prevalent in MIH group, but there were no significant differences between the groups (p>0.05). No possible aetiological factor investigated was associated with MIH. Prospective studies are needed to define the aetiological factors involved with MIH.

Molar incisor hypomineralisation: prevalence and clinical presentation in school children of the northern region of India

There is rarity of prevalence data on molar incisor hypomineralisation (MIH) for the Indian population and the majority of data originated from European countries. To report on prevalence and defect characteristics of MIH for school children of the northern Indian region. A cross-sectional survey including 1,792, 6-9-year-old school children of Chandigarh, India was carried out using European Academy of Paediatric Dentistry (EAPD) 2003 criteria for diagnosis of MIH. In addition to descriptive analysis for distribution of various defects, comparative data analysis was carried out for inter-comparison of distribution and type of defect amongst two phenotypes, MH [first permanent molar (FPMs) involvement] and M + IH (simultaneous involvement of molars and incisors). Similar comparative analysis was performed for four subgroups on the basis of number of affected surfaces/subjects. A prevalence of 6.31% was reported. FPMs (2.83 ± 0.874/subject) were more commonly affected than permanent incisors (1.19 ± 1.614/subjects). White/creamy opacity without post-eruptive breakdown (PEB) was the most common lesion, seen in 85% of subjects. MH phenotype was seen in 44% of subjects and 56% exhibited M + IH phenotype. A trend toward greater severity was seen in M + IH phenotype when compared to MH phenotype. A greater number of surfaces presented with white/creamy opacities without PEB (p < 0.05). With an increase in the number of surfaces involved the severity of MIH also increased with more frequent presence of brown defects with PEB. With concomitant involvement of incisors, more severe presentation of MIH was seen. Also, with increase in number of affected surfaces a parallel increase in severity as well as extent of lesions was observed.

Paediatric or pediatric dentistry?

Paediatrics (or pediatrics) is the branch of medicine that deals with the medical care of children. A medical practitioner who specialises in this branch of medicine is known as a paediatrician (or pediatrician), and similarly in dentistry a dental practitioner who specialises in the dental treatment of children is known as a paediatric (or pediatric) dentist or alternatively as a paedodontist (or pedodontist). However, there is much confusion as to which of the two spellings is correct and many are unaware of the etymology (origin) of the word. Many students, general practitioners and indeed specialists have frequently asked “is it paediatric or pediatric dentistry that is the correct spelling?” Further confusion is caused by some podiatry words beginning with “pedo” (relating to feet). In ancient times physicians like Hippocrates understood the differences in growing and developing children and that this necessitated different treatment and management. Byzantine physicians made significant contributions to child care and built baby shelters (children’s hospitals). Later, a Persian physician (Al-Razi, 865–925 CE) published a short treatise on diseases among children and the first printed book on paediatrics (or pediatrics) was in Italian (Bagellardo 1472). Paediatrics (or pediatrics) as a specialised field of medicine developed in the mid-19th century, with the German Abraham Jacobi (1830–1919), who later worked in New York, USA, regarded as the father of paediatrics (or pediatrics). The first paediatric (or pediatric) hospital was the Hopital des Enfants Malades (Hospital for Sick Children), which opened in Paris in 1802 and accepted patients up to the age of 15 years. Following this a separate Paediatric (or Pediatric) Pavillion was created at the Charite Hospital in Berlin in 1830 and later in St. Petersburg (1834), Vienna (1837) and Wroclaw (1837). Great Ormond Street Hospital for Sick Children in London was formed in 1852 and in the USA the first children’s hospitals were the Children’s Hospital of Philadelphia (1855) and then Boston Children’s Hospital (1869). Academically the first University Chair of Paediatrics (or Pediatrics) in the UK was founded in Scotland in 1924 with the appointment of Professor Leonard Findlay. The first Chair of Paediatrics (or Pediatrics) in the USA was established earlier, in 1888, with the appointment of Professor Thomas Morgan Rotch at Harvard. In dentistry the first European Professor of Paediatric (or Pediatric) Dentistry was Gottorm Toverud at the University of Oslo, Norway. Scholarly journals for paediatrics (or pediatrics) were founded from 1884 (Archives of Pediatrics) and the first for paediatric (or pediatric) dentistry was in 1933 (Journal of Dentistry for Children). The American Academy of Pediatric Dentistry was founded in 1947, with its journal Pediatric Dentistry first published in 1978. By comparison, the European Academy of Paediatric Dentistry was founded in 1990 and our own journal was first published in 2000, originally as the European Journal of Paediatric Dentistry and since 2006 as the European Archives of Paediatric Dentistry. The question still remains: “is paediatric or pediatric the correct spelling?” The word paediatric (or pediatric) originates from two Greek words: παiς (pais or paedion = child) and ατρός (iatros = doctor or healer). The Ancient Greek diphthongs\αι[ and\οι[ were transliterated into Latin as \ae[ and \oe[. Therefore, the original spelling in English was “paediatric”. Noah Webster (1758–1843), an American lexicographer and English spelling reformer, K. J. Toumba (&) Department of Paediatric Dentistry, Leeds Dental Institute, Clarendon Way, Leeds LS2 9LU, UK e-mail: k.j.toumba@leeds.ac.uk

Epidemiologic study of molar‐incisor hypomineralization in 8‐year‐old Spanish children

To find the prevalence of molar-incisor hypomineralization (MIH) in a random sample of Spanish children, and to investigate the gender influence, distribution of defects, the treatment need associated and the relation between this disorder and dental caries. A cross-sectional study was carried out to determine MIH and caries prevalence in a randomly selected sample of 840 children from the 8-year-old population of the Valencia region of Spain. The examinations were carried out in the children's schools by one examiner who had previously been calibrated with the MIH diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD). The percentage of children with MIH was 21.8% (95% CI 19.1-24.7), with a mean 3.5 teeth affected (2.4 molars and 1.1 incisors) been the maxillary molars the most affected. No gender differences were found. Of those with MIH, 56.8% presented lesions in both molars and incisors Children with MIH needed significantly more urgent and non-urgent treatment than those without MIH (chi-squared test P-value<0.005). Both caries indices were significantly higher (Student's t-test P-value <0.05) in the children with MIH than in the healthy children: the DMFT scores were 0.513 and 0.237 and the DMFS scores 1.20 and 0.79, respectively. Molar-incisor hypomineralization prevalence is high in the child population of this region and equally affects boys and girls. The condition increases significantly the need of treatment of affected children. A significant association with dental caries was observed.

Dental caries experience and Molar-Incisor Hypomineralization

Objective. This cross-sectional study assessed the prevalence and severity of the enamel defects, known as Molar-Incisor Hypomineralization (MIH) and its relationship to dental caries. Materials and methods. A sample of 1157 schoolchildren (population based), aged 6–12 years, of the Araraquara city-Brazil, was evaluated according to the European Academy of Paediatric Dentistry (EAPD) criteria by two trained examiners. The dental impact caused by MIH was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index (WHO). Data were analyzed using ANOVA and Chi-square tests (p < 0.05). The socioeconomic status was collected using a questionnaire answered by parents. Results. The prevalence of MIH was 12.3%. Mild impairment was the most frequent diagnosis. DMFT of children with MIH was 0.89 (±1.18), which are higher than those of the unaffected group (0.43 ± 1.01). An association was found between dental caries only in the permanent dentition of children with MIH (p = 0.0001). Family income was considered low in 85% of the families of children with MIH in the public system, while in private school it was 18% (p < 0.05). Conclusion. The prevalence of MIH in Araraquara was associated with greater caries experience in the permanent dentition.

Proportion and extent of manifestation of molar‐incisor‐hypomineralizations according to different phenotypes

This epidemiological study aimed to assess the proportion and extent of manifestation of enamel hypomineralization, including molar-incisor-hypomineralization (MIH), in the permanent and primary dentition. A total of 693 children enrolled in an ongoing birth cohort study (GINIplus-10) were examined at their 10-year follow-up. Enamel hypomineralization was scored in the primary and permanent dentition on a tooth- and surface-related level based on the criteria of the European Academy of Paediatric Dentistry (EAPD). Children were grouped according to their distribution pattern of enamel hypomineralization: children with a minimum of one hypomineralized tooth in the primary dentition (ht ≥ 1) and permanent dentition (HT ≥ 1); with a minimum of one hypomineralization on at least one first permanent molar (MIH); and with hypomineralization on at least one first permanent molar and permanent incisor (M + IH). For each group, the mean values of hypomineralized primary teeth (ht), permanent teeth (HT), and permanent surfaces (HS) were calculated. The proportion of affected children was 36.5 percent (HT ≥ 1), 14.7 percent (MIH), and 9.4 percent (M + IH); 6.9 percent of the subjects had a minimum of one affected primary tooth (ht ≥ 1). The mean number of hypomineralized permanent teeth and surfaces were 2.3HT/2.9HS (HT ≥ 1), 3.4HT/4.8HS (MIH), and 4.2HT/5.9HS (M + IH). The mean number of hypomineralized primary teeth amounted to 0.1ht in the entire study population. Enamel hypomineralization can be detected frequently in this study sample. Children with M + IH showed the highest number of affected teeth and surfaces followed by those with MIH.

Molar Incisor Hypomineralisation: Possible aetiological factors in children from urban and rural areas

To analyse factors potentially associated with molar incisor hypomineralisation (MIH) development. METH¬ODS: A population-based study was carried out with 903 children aged from 6-12 years old, born and residing in rural and urban areas of the town of Botelhos, State of Minas Gerais, Brazil. Their mothers completed a structured medical history questionnaire, from pregnancy to the child's 3rd year of life. Two examiners evaluated children for MIH according to criteria suggested by the European Academy of Paediatric Dentistry. Descriptive analyses of the data and odds ratios (OR) with 95% test-based confidence intervals (CI) were estimated. Chi-square test was used to evaluate the differences between groups. The prevalence of MIH in children from rural area (RA) was significantly higher than those from the urban area (UA) (24.9% versus 17.8%, p= 0.01). In urban children, neither significant associations with MIH nor medical problems were found. In rural children, however, MIH was significantly more common among those whose mothers had experienced medical problems during pregnancy (OR=2.11; 1.01-4.37 CI 95%; p=0.04), who had throat infections (OR=2.93; 1.47-5.87 CI 95%; p=0.01), who had high fever (OR=1.91; 1.07-3.39 CI 95%; p=0.02), and who had used amoxicillin associated with other antibiotics (OR=1.92; 1.02-3.62 CI 95%; p=0.04) during the first 3 years of life. This study suggests a link between MIH and health problems during pregnancy, as well as environmental factors.

Is there a positive relationship between molar incisor hypomineralisations and the presence of dental caries?

This epidemiological study aimed to compare the caries experience in 10-year-olds with and without molar incisor hypomineralisation (MIH). About 693 children from an ongoing birth cohort study (GINIplus10) were examined for caries lesions to determine the DMF index. Furthermore, enamel hypomineralisation (EH) was scored on all permanent teeth/surfaces, according to the criteria of the European Academy of Paediatric Dentistry. Children with EH were categorised into those with a minimum of one EH in the permanent dentition (MIH/1), with EH on at least one-first permanent molar (MIH/1A), on at least one-first permanent molar and permanent incisor (MIH/1B), and on other permanent teeth (MIH/1C). The mean caries experience was 0.4 (SD 0.9) DMFT. Existence of MIH/1, MIH/1A, MIH/1B, and MIH/1C was determined in 36.5%, 14.7%, 9.4%, and 21.8% of all children. The corresponding DMFT values were the following: no MIH: 0.3 (SD 0.8); MIH/1: 0.5 (SD 0.9); MIH/1A: 0.5 (SD 0.9); MIH/1B: 0.4 (SD 0.9); and MIH/1C: 0.4 (SD 0.9) DMFT. No significant differences were found between all groups. There was no relationship between the presence of EH/MIH and caries in 10-year-olds. A ratio of one EH-associated defect to two caries lesions indicates that both conditions are prevalent and influence the oral health status of 10-year-old children from Munich, Germany.

Prevalence of demarcated hypomineralisation defects in second primary molars in Iraqi children

Demarcated hypomineralization lesions are not uncommon in second primary molars. Data on the prevalence of hypomineralized second primary molars (HSPM) are scarce. To investigate the prevalence of HSPM, assess the relationship between HSPM and first permanent molars previously diagnosed with demarcated lesions and to determine the severity of HSPM in relation to dental caries severity. A cluster sample of 809, 7- to 9-year-old children was examined. The scoring criteria proposed by the European Academy of Paediatric Dentistry for hypomineralization in permanent dentition were adapted to score HSPMs. The International Caries Detection and Assessment System was used to assess caries status in the second primary molar of the children diagnosed with demarcated defects. The examination was carried out in schools by a calibrated dentist. Of the children examined, 53 (6.6%) had hypomineralization defects in at least one second primary molar. Combinations of affected first permanent and second primary molars were reported in 21 (39.6%) of cases. Severe carious lesions were found mostly in teeth with enamel breakdown. The prevalence of HSPM was 6.6%. Over one-third of affected second primary molars were associated with demarcated lesions in the first permanent molars. The chance of severe caries increased with the increase in the demarcated lesion severity.

Dental health estimation for children age twelve and fifteen

Introduction. The problem of chronic diseases such as caries is very complex because it appears very early in life, often during childhood. The number of involved people is growing as well as the number of affected teeth and surfaces that eventually lead to teeth loss. The aim of this study was to determine the dental status of adolescents age 12 and 15 in three municipalities in Bosnia, Foca, Cajnice and Kalinovik. Material and methods. The study included 506 school children both genders of six schools in three municipalities (Foca, Cajnice and Kalinovik). Teeth examination and criteria for diagnosis and coding were estimated based of criteria of the European Academy of Paediatric Dentistry (EAPD). To estimate dental health DMFT index [number of carious teeth (D), missing (M) and filled teeth (F)] and related indices (Person Caries Index, Teeth Caries Index, Average Caries Index and DMFT structure) were used. Results. Dental health status and caries prevalence were presented through the values of the Average Caries Index. The value of Average Caries Index for examined children was 6.17. Of all examined children 96.05% of them had at least one carious tooth. The average value of Teeth Caries Index was 23.04%. Conclusion. Dental health of the children in the examined region was characterized by high values of untreated carious teeth as well as the other components of DMFT index. Therefore, preventive measures and primary dental care must be implemented better among school children.

Molar-incisor hypomineralisation: prevalence and defect characteristics in Iraqi children

BACKGROUND. Little prevalence data relating to molar incisor hypomineralisation (MIH) exist for Middle East populations. AIM. To evaluate the prevalence and the clinical features of MIH in school-aged children residing in Mosul City, Iraq. DESIGN. A cluster sample of 823 7- to 9-year-old children had their first permanent molars and incisors (index teeth) evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria for MIH. The examinations were conducted at schools by a calibrated examiner. RESULTS. Of the children examined, 177 (21.5%) had hypomineralisation defects in at least one index tooth, 153 (18.6%) had at least one affected first molar or first molars and incisors and were considered as having MIH. The most commonly affected teeth were maxillary molars. Demarcated creamy white opacities were the most frequent lesion type. Dental restorations and tooth extraction because of MIH were uncommon. Children with three or more affected teeth were 3.7 times more likely to have enamel breakdown when compared with those children having only one or two affected teeth. CONCLUSIONS. Molar incisor hypomineralisation was common amongst Iraqi children. Demarcated opacities were more prevalent than breakdown. The severity of the lesions increased with the number of affected teeth. The more severe the defect, the greater the involved tooth surface area.

Survey on sedation in paediatric dentistry: a global perspective

Paediatric dentists receive training in sedation during their advanced education training, but evidence suggests that this training varies widely. The purpose of this study was to survey members of the International Association of Paediatric Dentistry (IAPD) and the European Academy of Paediatric Dentistry (EAPD) on their opinion on pharmacological and other behavioural management techniques and their training related to provision of oral health care of paediatric patients in the dental setting. A request was made for access to the IAPD and EAPD membership email addresses. The responses were recorded anonymously and data uploaded into spss (version 9) and analysed using descriptive analysis and chi-square with and without tabulation processes. A total of 311 respondents of 1973 targeted individuals answered the survey. The response rate was 16%. The majority of the respondents came from the continent of Europe, Asia, and the Americas. The most frequent type of sedation was general anaesthesia (52% of the respondents), followed by nitrous oxide (46%) and then oral sedation (44%). At least 91% of the respondents indicated that they were interested in the development of continuing education on the topic of sedation. Paediatric dentists around the world use relatively few behaviour management techniques, including pharmacological management. There is a definite interest in continuing education in the area of sedation.