Change in Oral Health-Related Quality of Life Following Minimally Invasive Aesthetic Treatment for Children with Molar Incisor Hypomineralisation: A Prospective Study

Abstract

Molar incisor hypomineralisation (MIH) is a common enamel condition, presenting with incisor opacities, which may be of psychosocial concern to children. This clinical study sought to determine whether minimally invasive treatment, aiming to improve incisor aesthetics, would also improve children’s oral health-related quality of life (OHRQoL). 111 MIH patients, aged 7–16 years, referred to a UK Dental Hospital, were invited to complete the Child Oral Health Impact Profile (C-OHIP-SF19) prior to any intervention (T0) and again at one-month following the intervention (T1) for MIH. Treatment regimens included one or more of the following: Microabrasion; resin infiltration; tooth whitening; resin composite restoration. Data were obtained for 93 children with a mean age of 11 years. Mean total C-OHIP-SF19 score at T0 was 47.00 (SD = 9.29; range = 0–76) and this increased significantly at T1 to 58.24 (SD = 9.42; range = 0–76; p < 0.001, paired t-test), indicating a marked improvement in self-reported OHRQoL. There were no statistically significant differences according to gender. This is the first study to show that simple, minimally invasive dental treatment, to reduce the visibility of enamel opacities, in MIH, can have a positive impact on children’s wellbeing.

Response to the Letter to the Editor by Drs Marina de Deus Moura de Lima, Renara Natália Cerqueira Silva and Lúcia de Fátima Almeida de Deus Moura. European Archives of Paediatric Dentistry (2019), 20: 63–63

“…There are, however, few recent studies showing reasonable results without side effects following either careful microabrasion alone (Sheoran et al 2014) or together with infiltration (Hasmun et al 2018) in elder children. In addition, further improvement may be achieved by the so-called 'abrasion effect' appearing later, as the ongoing hydration by saliva and the archived enamel alteration reflecting light differently, may camouflage the remaining subsurface enamel defect (Donly et al 1992).…”

“…Further, therefore, studies in elder children are indeed needed to establish the necessity or not of this technique that remains a conservative approach for the, sometimes, striking appearance of anterior enamel defects in MIH, leading to a negative impact on children's oral health-related quality of life (Hasmun et al 2018).…”

Molar Incisor Hypomineralisation—To Extract or to Restore beyond the Optimal Age?

“…This, in return, will negatively affect the restoration-support by the tooth surface [ 21 ]. There is also emerging and growing evidence of the influence of MIH on children’s oral health-related quality of life in terms of aesthetic concerns related to the maxillary incisors [ 28 , 29 , 30 ].…”

Molar incisor hypomineralisation and dental anomalies: A random or real association?

“…This is in contrast with clinical impressions held by the authors of the present paper. Our paediatric dentistry team sees ~10‐15 new MIH patients each week and has recently completed an intervention study involving 93 children with MIH . It is normal practice to take panoral radiographs to aid diagnosis and treatment planning for patients with severely compromised first permanent molars to determine the presence of all permanent successors, including third permanent molars, as well as the stage of dental development .…”