Molar Incisor Hypomineralisation Flashcards Preview

BDS2 Paediatric dentistry > Molar Incisor Hypomineralisation > Flashcards

Flashcards in Molar Incisor Hypomineralisation Deck (31)
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1

What % of child referrals are due to MIH?

25%

2

what teeth does MIH affect

1st permanent molars
permanent incisors

3

What does MIH look like

- distinctive from everything else
- very well demarked
- white, yellow, brown parts
- not symmetrical

4

What does "hypomineralised" mean

disturbance of enamel formation (secretory phase) resulting in a reduced mineral content

(shape is fine)

5

What does "hypoplastic" mean

reduced bulk or thickness of enamel

True= enamel never formed
Acquired = post-eruptive loss of enamel bulk

(shape is not fine)

6

why is it so difficult to determine aetiology

- unclear diagnostic criteria in classification
- most parents can't remember details from 8-10 years before
- variations in quality and completeness of case records
- study populations small

7

when is the critical period for formation of MIH

first year of life
(as enamel matrix of crown of first permanent molars is complete by 1 year)

8

what time period do you ask about to diagnose MIH?

Ask about the 3 different time periods:
- pre-natal
- natal
- post-natal

9

What prenatal questions do you ask mothers

- about their general health in 3rd trimester of pregnancy e.g. pre-eclampsia, gestational diabetes

10

What natal questions do you ask mothers

(time around birth)
- are they full term or premature?
- any emergency procedures?
- forceps?
- baby not getting enough oxygen etc?

11

What postnatal questions do you ask mothers?

- could they breathe properly when they came out?
- did they spend any time in a special baby unit?
- have they had chickenpox?
- any breathing problems?

12

How can you spot measles in children

- fever
- rash
- Koplik's spots (white spots in mouth)
- conjunctivitis
- cough
- coryza (runny nose)
- duration of illness =7-10days

13

How can you spot rubella in children

- mild fever
- maculopapular rash
- generalised lymphadenopathy
- malaise
- URTI
- duration of illness = 8-10days

14

How can you spot chicken pox in children

- low grade fever
- rash
- lots of spots
- duration of illness = 6-10 days

15

What did Fagrell et al find out about the possible aetiological factors of severe demarcated opacity (SDO)

Disturbances in nutrition in first 6 months might have an effect

16

What did Balmer et al find out about the relationship of MIH to socioeconomic status

association with first 4 deprivation quintiles

17

what is the histology like with MIH

- whole enamel layer yellow/brown (more porous)
- inner parts of enamel white/ cream
- chronologically dispersed hypomineralised demarcated opacities, higher carbon content, lower Ca,PO4

18

Is there underlying pulpal inflammation in MIH teeth

- more nerve innervation (senstivity, difficult to anaesthitise)
- lots more immune cell activity
- significant increase in vascularity (more inflamed)

19

What are the consequences for pain for MIH

- dentine hypersensitivity
- peripheral senstitisation
- central senstitisation

20

what is dentine hypersensitivity

porous enamel or exposed dentine facilitates fluid flow within dentine tubules to activate Adelta nerve fibres (hydrodynamic theory)

21

what is peripheral sensitisation

underlying pulpal inflammation leads to sensitisation of C-fibres

22

what is central sensitisation

from continued nociceptive input?

23

clinical problems for MIH

- loss of tooth substance (breakdown of enamel, tooth wear, secondary caries)
- sensitivity (don't like brushing)
- appearance (won't smile)
- very poorly caries resistant

24

treatment options for MIH

- composite/GIC restorations
- stainless steel crowns
- adhesively retained copings
- extraction (8.5-9.5yrs old)

25

If you're just trying to maintain the tooth until it's time to extract what could you use

GIC
- releases F
- deals with sensitivity
- makes tougher til time to remove

26

If it's extremely sensitive what could you use

stainless steel crown

27

When do you decide to remove the tooth

- radiographic calcification/bifurcation of the lower 7
- good to see developing 3rd molars too

28

what happens if you take out the tooth too early

they will also lose perfectly good premolars to try and make space

29

roughly what age would you look at taking out the tooth

8.5-9.5 years (but look at dental age)

30

what do you consider when considering extracting HFPM's

- age
- skeletal pattern
- future orthodontic needs
- quality of teeth e.g. caries