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Molar Incisor Hypomineralisation (MIH) – Definition and Treatment

From time to time a new disease develops. That happens. For example, that was the cause with AIDS at the beginning of the 1980s or the Spanish flu from 1918 onwards. The causes for this can be manifold, for example it is assumed that even new drugs against new diseases can trigger other diseases in the first place.

Of course, nature is also in constant development and transformation, so that it may be possible for new parasites and viruses to develop overnight, so to speak, and people will consume them in the form of food without knowing the risk. It is assumed that the virus responsible for the flu outbreak first settled on a cucumber which was eaten accidentally.

And so, according to this pattern, there are still diseases today that seem to come out of nowhere and spread rapidly. It does not necessarily have to be said that infected patients themselves are responsible for the transmission to others. Of course, it is also possible that, for example, many people ingest a certain virus through food or similar means and the disease spreads accordingly.

A press release issued in May 2018 by the German Society of Dentistry, Oral Medicine and Maxillofacial Surgery calls such a "new widespread disease" the so-called molar incisive hypomineralisation, or MIH for short. (Generally, it is also called chalk teeth.) Today we want to give some information about this.

What is MIH?

The press release defines MIH as "a systemic structural anomaly primarily of the enamel". It manifests itself in white-yellow to yellow-brown areas on the enamel. These areas do not necessarily attack the enamel, but rather are mineralization disorders. This means that the enamel no longer receives enough minerals from the inside to make it stable.

The causes of the development of chalk teeth are still largely unknown. It is known that teeth suffer from lack of mineralization. Only where this comes from is still unclear. There are only theories; most assume that this is a "multifactorial event", in other words influenced by many different factors.

Particularly with small children, this includes, among other things, that the mother might have been ill in the last two months of pregnancy or there might have been complications at birth. It is also suspected that frequent diseases of children in their first years of life can be responsible for chalk teeth. These include, above all, high fever. In addition, discussions are currently underway and tests are being carried out to see whether a lack of vitamin D as well as an early intake of amoxicillin can cause chalk teeth.

Treatment of chalk teeth

Since it is mainly the lack of minerals that damages the teeth most severely, it is important to provide the teeth with such from the outside. This is best done by taking fluoride. Particularly in early childhood, it is recommended to use these fluoridation measures intensively in order to protect the teeth against tooth decay. As concrete measures, the use of fluoride-containing toothpaste, fluoride-containing table salt and highly concentrated fluoride jelly can be used. In addition, a visit to the dentist should be scheduled every three to six months.

If the chalk teeth are already damaged in the milk teeth status, it is possible that this also applies to the permanent teeth as soon as they break through. In this case, longer treatments should be carried out by the dentist so that he can gradually rebuild the teeth using various techniques and reduce the risk of tooth decay accordingly.


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