Molar Incisive Hypomineralization (MIH)

What is Molar Incisive Hypomineralization?

Molar-incisive-hypomineralization is a developmental disease of the first incisors and molars. The enamel is damaged with yellow-brownish or whitish-creamy stains when the teeth break through the gums at the age of about six. The molars are the first molars, which are affected far more frequently than the incisors. The enamel of these teeth is usually softer and more porous, which makes it much more susceptible to caries bacteria. In addition, the affected teeth are more sensitive to cold and heat.


Since MIH is a developmental disorder, it originates in the developmental phase of the affected teeth. This phase is between the 8th month of pregnancy and the fourth year of life. Usually several factors have to come together to trigger this serious illness.Important causes play here, for example, antibiotics and other medication intake of the child, chronic diseases (especially respiratory diseases) and environmental toxins. Environmental toxins are, for example, the smallest plastic particles.


The dentist makes the diagnosis by looking into the child's mouth. In order to avoid consequential damage, it is very important to regularly check your teeth in childhood. In this way, even a particularly severe form can be recognized and treated in good time. The best time to check is when you are eight years old, as this is when all permanent incisors and first molars have erupted. Timely treatment can prevent subsequent consequential damage.

Find out more about the topic: Change of teeth in the child

These symptoms may indicate molar incisor hypomineralization

In MIH, the teeth often have a typical color with yellowish-whitish enamel spots. These areas in the enamel are more porous and therefore more sensitive to external influences. Tooth enamel can flake off and affected teeth are sensitive to temperature or touch. This creates pain during everyday activities such as brushing your teeth or eating ice cream. The soft enamel is also much more susceptible to tooth decay than healthy teeth, which in turn quickly leads to holes in the tooth with pulling pain.

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With a mild form of MIH, a small filling or fissure seal of the affected tooth is often sufficient. In addition, regular fluoridation of the teeth at home and at the dentist's approximately every 3-6 months helps to strengthen healthy tooth enamel.

In the case of more pronounced defects in the tooth enamel, it is necessary to produce crowns or partial crowns that encompass the entire tooth. The affected tooth enamel is removed and an individually adapted cap, known as a crown, is made in the dental laboratory, which protects the tooth after it has been cemented / fixed.

Also read the article on the topic: Fluoridation of the teeth


Sealing the teeth means sealing the fissures. Here, small holes in the tooth fissures (areas / “valleys” between two tooth cusps) caused by caries are removed and then filled with a thin plastic. This prevents deep holes, often reaching as far as the nerve, from forming in the fissures. At MIH, affected areas can be strengthened by sealing them with fluoride varnishes. This varnish is regularly applied to the tooth (once a week at home) and stabilizes the tooth enamel, which makes it less sensitive to irritation and tooth decay.

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The duration of the illness is lifelong. Since the permanent teeth only grow once in humans, affected teeth are diseased as long as they are in the mouth. The disease cannot be reversed after the outbreak. Only prevention by taking less medication and avoiding plastic in everyday life is possible. If the affected teeth are removed due to excessive destruction, implants or dental bridges must be made to replace them.


Thanks to today's treatment methods, the prognosis for children with MIH is good. The disease only affects the teeth and cannot threaten life. The affected teeth can be preserved very well with regular control and treatment. In severe cases, the crowning of affected teeth is necessary and thus ensures preservation.
If the damage is too severe, lost teeth can be replaced in adulthood with implants or by bridging the gap. Even if this entails a lot of dental appointments, with good self-motivation and oral hygiene the affected teeth can stay healthy into old age.

Find out more about the topic: Dental crown

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