Citation Information :
Verma S, Dhinsa K, Tripathi AM, Saha S, Yadav G, Arora D. Molar Incisor Hypomineralization: Prevalence, Associated Risk Factors, Its Relation with Dental Caries and Various Enamel Surface Defects in 8–16-year-old Schoolchildren of Lucknow District. Int J Clin Pediatr Dent 2022; 15 (1):1-8.
Introduction: The decreased rate in dental caries cases across the world has created an enthusiasm in many clinicians to relate and study different developmental disorders. In past years, defects that are commonly associated with dentistry are hypomineralized areas commonly seen in central incisors and first molars. Molar incisor hypomineralization (MIH) is a defect of the enamel, which is qualitative in nature and systemic in origin characterized by advanced and concurrent hypomineralization of the enamel affecting the first permanent molars together with frequent association of the incisors.
Aim: To evaluate the prevalence of molar incisor hypomineralization (MIH), its possible risk factors and its association with dental caries and enamel surface defects (attrition and abrasion) in schoolchildren aged between 8 and 16 years in Lucknow district.
Methodology: Indexed teeth (first permanent molars and incisors) of 5,585 schoolchildren, selected by stratified random sampling technique between the age-group of 8 and 16 years, were examined by a trained and calibrated examiner. The data was recorded in a predesigned pro forma by examiner, which consisted of mainly two parts. The first part comprised of general information, while the second part comprised of questions related to risk factors related to MIH (prenatal, perinatal, and postnatal history). For the diagnosis of MIH, the Developmental Defects of Enamel (DDE) Index was used for diagnosis of MIH, while the decay-missing-filled teeth index (DMFT) criteria were used for assessing dental caries. Enamel surface defects were recorded using the Smith and Knight tooth wear index.
Results: A prevalence of 7.6% was reported wherein females were found to be more affected by MIH. A strong significant correlation was found between MIH prevalence and childhood infection.
Conclusion: Early diagnosis of MIH is necessary to prevent the rapid destruction of the tooth morphology resulting in complicated treatment. Further studies with greater samples are needed to investigate the different etiological factors and determine the biological molecular mechanism that they may cause.
Clinical significance: The data obtained from the current study does not portray a clear consideration of the infants’ medical history in the initial 4 years of life. Further studies may be performed to surpass these shortcomings by using more elaborate medical records of the child in addition to profound recollection of the parents. Due to paucity of literature on this issue in Lucknow District, our current study may provide some information at a baseline level for conducting an extensive research involving different regions pan-India.
Duric LM, Dolic O, Obradovic M, et al. Relationship between molar incisor hypomineralization and dental caries at eight-year-old children. DE GRUYTER 2017;64(2):81–87. DOI:10.1515/sdj-2017-0008
Goswami M, Bhushan U, Pandiyan R, et al. Molar incisor hypomineralization—an emerging burden: a short study on prevalence and clinical characteristics in Central Delhi, India. Int J Clin Pediatr Dent 2019;12(3):211–214. DOI: 10.5005/jp-journals-10005-1624
Yannam SD, Amarlal D, Rekha CV. Prevalence of molar incisor hypomineralization in school children aged 8-12 years in Chennai. J Indian Soc Pedod Prev Dent 2016;34(2):134–138. DOI: 10.4103/0970-4388.180438
Meligy OAESE, Alaki SM, Allazzam SM. Molar incisor hypomineralization in children: a review of literature. J Oral Hyg Health 2014;2(4):1–5. DOI: 10.1007/BF03262633
Bhaskar SA, Hegde S. Molar incisor hypomineralization: Prevalence, severity and clinical characteristics in 8 to 13-year-old children of Udaipur, India. J Indian Soc Pedod Prev Dent 2014;32(4):322–329. DOI: 10.4103/0970-4388.140960
Tadikonda 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. DOI:10.5005/jp-journals-10015-1330
Garg N, Jain AK, Saha S, et al. Essentiality of early diagnosis of molar incisor hypomineralization in children and review of its clinical presentation, etiology and management. Int J Clin Pediatr Dent 2012;5(3):190–196. DOI: 10.5005/jp-journals-10005-1164
Groselj M, Jan J. Molar incisor hypomineralisation and dental caries among children in Slovenia. Eur J Paediatr Dent 2013;14(3):241–245. PMID: 24295012.
Kirthiga M, Poornima P, Praveen R, et al. Prevalence and severity of molar incisor hypomineralization in children aged 11-16 years of a city in Karnataka, Davangere. J Indian Soc Pedod Prev Dent 2015;33(3):213–217. DOI: 10.4103/0970-4388.160366
Hanan SA, Filho AA, Medina PO, et al. Molar-incisor hypomineralization in schoolchildren of Manaus, Brazil. Pesqui Bras Odontopediatr Clin Integr 2015;15(1):309–317. DOI:10.4034/PBOCI.2015.151.33
Ravindran R, Saji AM. Prevalence of the developmental defects of the enamel in children aged 12–15 years in Kollam district. J Int Soc Prev Community Dent 2016;6(1):28–33. DOI: 10.4103/2231-0762.175407
Padavala S, Sukumaran G. Molar incisor hypomineralization and its prevalence. Contemp Clin Dent 2018;9(2):S246–S250. DOI:10.4103/ccd.ccd_161_18
Parikh DR, Ganesh M, Bhaskar V. Prevalence and characteristics of molar incisor hypomineralisation (MIH) in the child population residing in Gandhinagar, Gujarat, India. Eur Arch Paediatr Dent 2012;13(1):21–26. DOI: 10.1007/BF03262836
Rai A, Singh A, Menon I, et al. Molar incisor hypomineralization: prevalence and risk factors among 7-9 years old school children in Muradnagar, Ghaziabad. Open Dent J 2018;12:714–722. DOI: 10.2174/1745017901814010714
Ghanim A, Bagheri R, Golkari, et al. Molar-incisor hypomineralisation: A prevalence study amongst primary school children of Shiraz, Iran. Eur Arch Paediatr Dent 2014;5(2):75–82. DOI: 10.1007/s40368-013-0067-y
Mittal N, Sharma BB. Molar incisor hypomineralization: Prevalence and defect characteristics in Indian schoolchildren. J Craniomaxillofac Surg 2015;4(1):49–56. DOI: 10.1007/s40368-013-0045-4
Jasulaityte L, Veerkamp JS, Weerheijm KL. Molar incisor hypomineralization: review and prevalence data from the study of primary school children in Kaunas (Lithuania). Eur Arch Paediatr Dent 2007;89(2):87–94. DOI: 10.1007/BF03262575
Wogelius P, Haubek D, Poulsen S. Prevalence and distribution of demarcated opacities in permanent 1st molars and incisors in 6 to 8-years-old Danish children. Acta Odontol Scand 2008;66(1):58–64. DOI: 10.1080/00016350801926941
Krishnan R, Ramesh M, Chalakkal P. Prevalence and characteristics of MIH in school children residing in an endemic fluorosis area of India: an epidemiological study. Eur Arch Paediatr Dent 2015;16(6):45–60. DOI: 10.1007/s40368-015-0194-8
Mishra A, Pandey RK. Molar incisor hypomineralization: an epidemiological study with prevalence and etiological factors in Indian pediatric population. Int J Clin Pediatr Dent 2016;9(2):167–171. DOI: 10.5005/jp-journals-10005-1357
Leppaniemi A, Lukinmaa PL, Alaluusua S. Non-fluoride hypomineralizations in the first molars and their impact on the treatment need. Caries Res 2001;35(1):36–40. DOI: 10.1159/000047428
Makne SG, Kakade A, Takate V, et al. Prevalence of Molar Incisor hypomineralisation in municipal school going children in Mumbai. Int J Res Health Sci 2017;5(3):13–17.
Clarkson J. Review of terminology, classifications, and indices of developmental defects of enamel. Adv Dent Res 1989;3(2):104–109. DOI: 10.1177/08959374890030020601
Robles MJ, Ruiz M, Bravo-Perez M, et al. Prevalence of enamel defects in primary and permanent teeth in a group of schoolchildren from Granada (Spain). Med Oral Patol Oral Cir Bucal 2013;18(2):187–193. DOI: 10.4317/medoral.18580
Jindal C, Palaskar S, Kler S. The prevalence of the developmental defects of enamel in a group of 8–15 years old Indian children with developmental disturbances. J Clin Diagn Res 2011;5(3):669–674.
Tourino LFPG, Correa-Faria P, Ferreira RC, et al. Association between molar incisor hypomineralization in school children and both prenatal and postnatal factors: A population-based study. PLoS One 2016;11(6):1–12. DOI: 10.1371/journal.pone.0156332
Lygidakis NA, Dimou G, Marinou D. Molar-incisor-hypomineralisation (MIH). A retrospective clinical study in Greek children. II. Possible medical aetiological factors. Eur Arch Paediatr Dent 2008;9(4):207–217. DOI: 10.1007/BF03262637
Norwitz ER, Robinson JN, Challis JRG. The control of labor. N Engl J Med 1999;18:660–666. DOI: 10.1056/NEJM199908263410906
Nelson-Piercy C. Treatment of nausea and vomiting in pregnancy. When should it be treated and what can be safely taken? Drug Saf 1998;19(2):155–164. DOI: 10.2165/00002018-199819020-00006
Hansen AK, Wisborg K, Uldbjerg N, et al. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study. BMJ 2008;336((7635)):85–87. DOI: 10.1136/bmj.39405.539282
Shubha AB, Hegde S. Molar-incisor hypomineralization: review of its prevalence, etiology, clinical appearance and management. Int J Oral Maxillofac Pathol 2013;4(1):26–33.
Jalevik B, Klingberg G, Barregard L, et al. The prevalence of demarcated opacities in permanent first molars in a group of Swedish children. Acta Odontol Scand 2001;59(5):255–260. DOI: 10.1080/000163501750541093
Muratbegovic A, Markovic N, Selimovic MG. Molar incisor hypomineralisation in Bosnia and Herzegovina: prevalence, aetiology and clinical consequences in medium caries activity population. Eur Arch Paediatr Dent 2007;8(4):189–194. DOI: 10.1007/BF03262595
Allazzam SM, Alaki SM, Meligy OASE. Molar incisor hypomineralization, prevalence, and etiology. Int J Dent 2014;2014:1–8. DOI: 10.1155/2014/234508
Beentjes VEVM, Weerheijm KL, Groen HJ. Factors involved in the aetiology of molar-incisor hypomineralisation (MIH). Eur J Paediatr Dent 2002;3(1):9–13. PMID: 12871011.
Koruyucu M, Ozel S, Tuna EB. Prevalence and etiology of molar-incisor hypomineralization (MIH) in the city of Istanbul. J Dent Sci 2018;13(4):318–328. DOI: 10.1016/j.jds.2018.05.002
Whitford GM, Angmar-Mansson B. Fluorosis-like effects of acidosis, but not NH+4, on rat incisor enamel. Caries Res 1995;29(1):20–25. DOI: 10.1159/000262035
Sui W, Boyd C, Wright JT. Altered pH regulation during enamel development in the cystic fibrosis mouse incisor. J Dent Res 2003;82(5):388–392. DOI: 10.1177/154405910308200512
Jalevik B, Noren JG. Enamel hypomineralization of permanent first molars: a morphological study and survey of possible aetiological factors. Int J Paediatr Dent 2000;10(4):278–289. DOI: 10.1046/j.1365-263x.2000.00210.x
Hong L, Levy SM, Warren JJ, et al. Association of amoxicillin use during early childhood with developmental tooth enamel defects. Arch Pediatr Adolesc Med 2005;159(10):943–948. DOI: 10.1001/archpedi.159.10.943
Gottberg B, Berne J, Quinonez B, et al. Prenatal effects by exposing to amoxicillin on dental enamel in Wistar rats. Med Oral Patol Oral Cir Bucal 2014;19(1):38–43. DOI: 10.4317/medoral.18807
de Souza JF, Gramasco M, Jeremias F, et al. Amoxicillin diminishes the thickness of the enamel matrix that is deposited during the secretory stage in rats. Int J Paediatr Dent 2016;26(3):199–210. DOI: 10.1111/ipd.12184
Wuollet E, Laisi S, Salmela E, et al. Molar-incisor hypomineralization and the association with childhood illnesses and antibiotics in a group of Finnish children. Acta Odontol Scand 2016;74(5):416–422. DOI: 10.3109/00016357.2016.1172342
Laisi S, Ess A, Sahlberg C, et al. Amoxicillin may cause molar incisor hypomineralization. J Dent Res 2009;88(2):132–136. DOI: 10.1177/0022034508328334
Preusser SE, Ferring V, Wleklinski C, et al. Prevalence and severity of molar incisor hypomineralization in a region of Germany - a brief communication. J Public Health Dent 2007;67(3):148–150. DOI: 10.1111/j.1752-7325.2007.00040.x
Cho SY, Ki Y, Chu V. Molar incisor hypomineralization in Hong Kong Chinese children. Int J Paediatr Dent 2008;18(5):348–352. DOI: 10.1111/j.1365-263X.2008.00927.x
da Costa-Silva CM, Jeremias F, De Souza JF, et al. Molar incisor hypomineralization: prevalence, severity and clinical consequences in Brazilian children. Int J Paediatr Dent 2010;20(6):426–434. DOI: 10.1111/j.1365-263X.2010.01097.x
Garcia-Margarit M, Catala-Pizarro M, Montiel-Company JM, et al. Epidemiologic study of molar-incisor hypomineralization in 8-year-old Spanish children. Int J Paediatr Dent 2014;24(1):14–22. DOI: 10.1111/ipd.12020
Kazoullis S, Seow WK, Holcombe T, et al. Common dental conditions associated with dental erosion in schoolchildren in Australia. Pediatr Dent 2007;29(1):33–39. PMID: 18041510.