Molar incisor hypomineralisation associated with caries

shutterstock_34500700 - caries sign

Yesterday we considered a review of the aetiological factors associated with molar incisor hypomineralisation (MIH). There are concerns that the prevalence of MIH may be increasing and a number of studies have suggested that children with MIH are more likely to have dental caries.

The aim of this review is to assess the association between MIH and dental caries in the permanent dentition.


A search was conducted in Medline for studies conducted in children that reported on MIH and caries in permanent teeth. Studies in English published after 2003 were considered. Study selection was carried out in 3 stages independent reviewers. Study quality was assessed using the Newcastle-Ottawa Scale (NOS)


  • 17 studies (2 cohorts, 15 cross-sectional) were included
  • None of the included studies was considered to be of high quality.
  • The studies were conducted in a number of countries, Bosnia and Herzegovina, Brazil, China, Germany, Greece, India, Iran, Iraq, New Zealand, Slovenia, Spain, Sweden and Thailand.
  • Prevalence of MIH in the included studies ranged for 2.8%- 36.5%.
  • Most publications reported that children with MIH have higher caries experience.
  • One study did not observe a difference in DMF values among children affected or not by MIH.
  • Three studies reported that children with MIH were 2.1 to 4.6 times more likely to have caries in the permanent dentition than children without MIH.


The authors concluded

The findings show a significant association between MIH and dental caries. Both DMF index and caries prevalence were higher in children with MIH than in children without MIH. As none of the studies included in the present review was, however, classified as high-quality studies, the results should be interpreted cautiously.


This review is restricted to a single database and English language studies so it is possible that relevant studies have not been included. The possibility for observer bias exists in the majority of the included studies as caries and DMF was assessed by the same observer, only in 3 studies were separate observers used. As the authors note the DMF index is insensitive which may result in an overestimation of caries levels in those affected by MIH.


Primary paper

Americano GC, Jacobsen PE, Soviero VM, Haubek D. A systematic review on the association between molar incisor hypomineralization and dental caries. Int J Paediatr Dent. 2016 Apr 21. doi: 10.1111/ipd.12233. [Epub ahead of print] Review. PubMed PMID: 27098755.

Other references

Molar incisor hypomineralisation- review suggests link with childhood illnesses

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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