Molar Incisor Hypomineralisation (MIH)

Patient Information Leaflet

What is MIH?

• Molar-incisor hypomineralisation (MIH) is a dental condition that affects enamel, the hard outer layer of a tooth.
• In MIH, the enamel is softer than usual.
• This means the teeth can be more sensitive and more likely to get tooth decay.
• The adult molars (back teeth) and incisors (front teeth) are most often affected.

Signs and symptoms of MIH

• White, cream, yellow or brown marks on the teeth.
• Pain or sensitivity, including when brushing.
• The tooth may look rough or crumbly and may chip more easily.
• If MIH is severe, the tooth can break down quickly and may need to be removed.

What causes MIH?

• The exact cause of MIH is not fully understood.
• There may be links with illness during pregnancy, around the time of birth or in early childhood.
• These illnesses may affect how the teeth develop.
• Around 1 in 8 children in the UK are affected by MIH.

How is MIH diagnosed?

• MIH is often noticed when the adult back teeth and front teeth start to come through, usually at about 6 to 7 years old.
• Your dentist may ask about your child's health and may take X-rays if needed.
• They may refer your child to community dental services or a dental hospital for specialist children's dental care.

How is MIH treated?

• Your dentist will discuss the best treatment for your child.
• This depends on their age, how well they can manage dental treatment and how badly the tooth is affected.
• Treatment aims to reduce sensitivity and stop the tooth from breaking down further.

Fluoride varnish

• Fluoride painted onto the teeth at least twice a year.

Fissure sealant

• A plastic coating put on the chewing surface of a back tooth.

White filling

• A filling material used to repair or cover the tooth.
• A numbing injection may be needed if drilling is needed.

Preformed metal crown

• A silver-coloured cap that covers the tooth.

Tooth removal

• Badly affected teeth may need to be removed.
• An orthodontist may be asked to help choose the best time so other adult teeth can move into the space.

What treatment can be used for front teeth?

Microabrasion

• A polishing paste is used to remove a very thin outer layer of enamel.

White filling

• Filling material can be used to cover discolouration.

Tooth whitening

• This is only used in specific circumstances for people under 18.

What else can I do?

• Reduce how often your child has sugary food and drinks.
• Your dentist may prescribe a higher-fluoride toothpaste for children aged 10 years or older.
• A fluoride mouthwash may be advised for children aged 7 years or older.
• Take your child for regular dental checks.

Get more information

British Society of Paediatric Dentistry: https://www.bspd.co.uk/