MIH is an important clinical problem that often concerns both the general dental and specialist paediatric dentists; the present 'best clinical practice guidance' aims to further help clinicians dealing with the condition.
– 39 children were studied longitudinally at the age of 2, 3, and 4 yr for the colonization of S. mutans in plaque and saliva and for caries experience. S. mutans was found in 38% of the children, and the predominant serotype group was c/e/f. A total of 16 children got caries before the age of 4. Children who harbored S. mutans in their plaque at the age of 2, appeared to be the most caries‐active individuals. Their caries index values (number of decayed, missed and filled surfaces, dmfs = 10.6±5.3) at the age of 4 differed significantly from the values of children who harbored S. mutans later (dmfs = 3.4±1.8,P<0.005) or remained free from S. mutans infection (dmfs = 0.3±1.1, P<0.0003). It was thus concluded that the early establishment of S. mutans in the plaque of primary incisors indicated early and extensive caries attack in young primary dentition.
Despite increased knowledge on the aetiology of MIH insufficient evidence to verify the causative factors exists. Further studies, especially prospective ones, are needed to improve the level and strength of evidence of the role of the present putative factors and to reveal new factors that may be involved. Any combined effect of several factors should be taken into account. Experimental dose/response studies and research on the molecular mechanisms causing the abnormal function of the ameloblasts are also necessary to deepen our knowledge of MIH.
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