Skip to main content

A comparison of the presentation of molar incisor hypomineralisation in two communities with different fluoride exposure

European Archives of Paediatric Dentistry volume 16, pages 257–264 (2015)Cite this article

Abstract

Aim

To compare the clinical presentation of two cohorts of children diagnosed with molar incisor hypomineralisation (MIH) and living in areas of low and high background fluoridation.

Methods

The study population comprised 12-year-old children participating in the 2008–2009 National Dental Epidemiological Programme in five regions in Northern England. Participating dentists were trained and calibrated in the use of the modified Developmental Defects of Enamel Index. Children were examined at school under direct vision with the aid of a dental mirror. First permanent molars and incisors were recorded for the presence and type of enamel defects greater than 2 mm. A diagnosis of MIH was ascribed to any child with a demarcated defect in any first permanent molar. Risk ratios for the occurrence of demarcated, diffuse and hypoplastic defects were generated for MIH children in the fluoridated and non-fluoridated area.

Results

3,233 children were examined. The prevalence of MIH in the fluoridated community was 11 % and in the non-fluoridated community was 17.5 %. Incisors in children with MIH were at greater risk of having demarcated defects (risk ratio 4.0, 3.6–4.5) and diffuse defects (risk ratio 2.2, 2.0–2.5). Molars in children with MIH were at greater risk of diffuse defects (risk ratio 4.4, 3.8–5.0). The teeth of children with MIH living in the fluoridated area were at greater risk of demarcated defects for both incisors (risk ratio 1.6, 1.3–2.0) and molars (risk ratio 1.3, 1.2–1.5) relative to the teeth of MIH children living in the non-fluoridated area.

Conclusions

Children with MIH were at increased risk of both diffuse and demarcated defects in their incisors. Children with MIH living in the fluoridated area were at increased risk of diffuse and demarcated defects relative to MIH children living in the non-fluoridated area.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  • Arrow P. Risk factors in the occurrence of enamel defects of the first permanent molars among schoolchildren in Western Australia. Commun Dent Oral Epidemiol. 2009;37:405–15.

    Article  Google Scholar 

  • Balmer R, Toumba J, Godson J, Duggal M. The prevalence of molar incisor hypomineralisation in Northern England and its relationship to socioeconomic status and water fluoridation. Int J Pediatr Dent. 2012;22:250–7.

    Article  Google Scholar 

  • Calderara PC, Gerthoux PM, Mocarelli P, et al. The prevalence of molar incisor hypomineralisation (MIH) in a group of Italian school children. Eur J Paediatr Dent. 2005;6:79–83.

    PubMed  Google Scholar 

  • Cho S-Y, Ki Y, Chu V. Molar incisor hypomineralization in Hong Kong Chinese children. Int J Pediatr Dent. 2008;18:348–52.

    Article  Google Scholar 

  • Clarkson J, O’mullane D. A modified DDE Index for use in epidemiological studies of enamel defects. J Dent Res. 1989;68:445–50.

    PubMed  Article  Google Scholar 

  • Commission on Oral Health Research and Epidemiology. A review of the developmental defects of enamel index (DDE Index). Report of an FDI working group. Int Dent J. 1992;42:411–26.

    Google Scholar 

  • Cutress TW, Suckling GW, Pearce EI, Ball ME. Defects of tooth enamel in children in fluoridated and non-fluoridated water areas of the Auckland region. NZ Dent J. 1985;81:12–9.

    Google Scholar 

  • Da Costa-Silva CM, Jeremias F, De Souza JF, et al. Molar incisor hypomineralization: prevalence, severity and clinical consequences in Brazilian children. Int J Pediatr Dent. 2010;20:426–34.

    Article  Google Scholar 

  • Fteita D, Ali A, Alaluusua S. Molar-incisor hypomineralization (MIH) in a group of school-aged children in Benghazi, Libya. Eur Arch Paediatr Dent Off J Eur Acad Paediatr Dent. 2006;7:92–5.

    Article  Google Scholar 

  • Holtta P, Kiviranta H, Leppaniemi A, et al. Developmental dental defects in children who reside by a river polluted by dioxins and furans. Arch Environ Health. 2001;56:522–8.

    PubMed  Article  Google Scholar 

  • 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;159:943–8.

    PubMed  Article  Google Scholar 

  • Jalevik B, Noren JG. Enamel hypomineralization of permanent first molars: a morphological study and survey of possible aetiological factors. Int J Pediatr Dent. 2000;10:278–89.

    Article  Google Scholar 

  • Jalevik B, Klingberg G, Barregard L, Noren JG. The prevalence of demarcated opacities in permanent first molars in a group of Swedish children. Acta Odontol Scand. 2001;59:255–60.

    PubMed  Article  Google Scholar 

  • Jalevik B. Prevalence and diagnosis of molar-incisor-hypomineralisation (MIH): a systematic review. EurArch Paediatr Dent Off J Eur Acad Paediatr Dent. 2010;11:59–64.

    Article  Google Scholar 

  • Kanagaratnam S, Schluter P, Durward C, Mahood R, Mackay T. Enamel defects and dental caries in 9-year-old children living in fluoridated and nonfluoridated areas of Auckland, New Zealand. Commun Dent Oral Epidemiol. 2009;37:250–9.

    Article  Google Scholar 

  • Koch G. Prevalence of enamel mineralisation disturbances in an area with 1–1.2 ppm F in drinking water. Review and summary of a report published in Sweden in 1981. Eur J Paediatr Dent. 2003;4:127–8.

    PubMed  Google Scholar 

  • Milsom K, Mitropoulos CM. Enamel defects in 8-year-old children in fluoridated and non-fluoridated parts of Cheshire. Caries Res. 1990;24:286–9.

    PubMed  Article  Google Scholar 

  • NHS Dental Epidemiological Oral Health Survey of 12 year old children in England 2008/2009 National Protocol. 2008. Available http://www.nwph.net/dentalhealth/survey-results-12.aspx. Accessed June 2013.

  • NHS North East—Dentistry. The Strategic Health Authority for the North East (Online). 2011. Available http://www.northeast.nhs.uk/news-centre/news-packs/38187E9CB86249E483B739F0EB731E56.aspx. Accessed June 2013.

  • Pendrys DG. The fluorosis risk index: a method for investigating risk factors. J Public Health Dent. 1990;50:291–8.

    PubMed  Article  Google Scholar 

  • Sharma R, Tsuchiya M, Skobe Z, Tannous BA, Bartlett JD. The acid test of fluoride: how pH modulates toxicity. PLoS One. 2010;5:e10895 (electronic resource).

    PubMed Central  PubMed  Article  Google Scholar 

  • Sierant ML, Bartlett JD. Stress Response pathways in ameloblasts: implications for amelogenesis and dental fluorosis. Cells. 2012;1:631–45.

    PubMed Central  PubMed  Article  Google Scholar 

  • Suckling GW, Herbison GP, Brown RH. Etiological factors influencing the prevalence of developmental defects of dental enamel in 9-year-old New Zealand children participating in a health and development study. J Dent Res. 1987;66:1466–9.

    PubMed  Article  Google Scholar 

  • Suga S. Enamel hypomineralization viewed from the pattern of progressive mineralization of human and monkey developing enamel. Adv Dent Res. 1989;3:188–98.

    PubMed  Google Scholar 

  • Weerheijm KL, Jalevik B, Alaluusua S. Molar-incisor hypomineralisation. Caries Res. 2001;35(5):390–1.

    PubMed  Article  Google Scholar 

  • Weerheijm KL, Duggal M, Mejare I, et al. Judgement criteria for molar incisor hypomineralisation (MIH) in epidemiologic studies: a summary of the European meeting on MIH held in Athens, 2003. Eur J Paediatr Dent. 2003;4:110–3.

    PubMed  Google Scholar 

  • Weerheijm KL. Molar incisor hypomineralisation (MIH). Eur J Paediatr Dent. 2003;4:114–20.

    PubMed  Google Scholar 

  • Whitford GM, Angmar-Mansson B. Fluorosis-like effects of acidosis, but not NH4+, on rat incisor enamel. Caries Res. 1995;29:20–5.

    PubMed  Article  Google Scholar 

  • Wong FSL, Winter GB. Effectiveness of microabrasion technique for improvement of dental aesthetics. Br Dent J. 2002;193:155–8.

    PubMed  Article  Google Scholar 

  • Wright JT. The etch-bleach-seal technique for managing stained enamel defects in young permanent incisors. Pediatr Dent. 2002;24:249–52.

    PubMed  Google Scholar 

  • Zagdwon AM, Toumba KJ, Curzon ME. The prevalence of developmental enamel defects in permanent molars in a group of English school children. Eur J Paediatr Dent. 2002;3(2):91–6.

    PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Affiliations

  1. Department of Child Dental Health, Leeds Dental Institute, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK

    R. Balmer, K. J. Toumba, T. Munyombwe & M. S. Duggal

Authors
  1. R. Balmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. J. Toumba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Munyombwe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. S. Duggal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Balmer.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Balmer, R., Toumba, K.J., Munyombwe, T. et al. A comparison of the presentation of molar incisor hypomineralisation in two communities with different fluoride exposure. Eur Arch Paediatr Dent 16, 257–264 (2015). https://doi.org/10.1007/s40368-014-0170-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40368-014-0170-8

Keywords

  • Molar incisor hypomineralisation
  • Enamel defects
  • Fluoride