HEALTH RISKS OF MOLAR HYPOMINERALISATION

Soft and porous enamel is the hallmark of Molar Hypomineralisation. Unsurprisingly then, a most serious aspect of Molar Hypomineralisation is the lifelong risk it brings for tooth decay (dental caries) – in absence of dental intervention, caries is an almost inevitable consequence in moderate/severe cases. Dental caries may in turn lead to major disruption or even loss of affected molars, often necessitating input from Dental Specialists where available (e.g. Paediatric Dentist, Orthodontist, Prosthodontist, Endodontist). On its own, Molar Hypomineralisation often causes sufficient dental pain (toothache) to interfere with eating, drinking and oral hygiene. Cosmetic issues can also arise, particularly when the front teeth are affected too (MIH). As with caries, these lifelong issues
can lead to quality-of-life problems including dental anxiety, behavioural
lapses and absences from school or work.

The specific risks and liabilities associated with Molar Hypomineralisation
have been addressed in several studies including the following: 

TOOTH DECAY (DENTAL CARIES)

Caries

  • In Western Australia, children with hypomineralised 6-year molars were found to be at 14-fold increased risk of dental caries (i.e. DMFT) when compared to those lacking this developmental defect (read more)
  • In Wainuiomata (near Wellington, NZ), children exhibited over 11-fold increased risk of dental caries if their 6-year molars were severely hypomineralised whereas mild/moderate cases had 3-fold higher risk when compared to those without Molar Hypomin
    (read more).
  • In a Dutch study of children with a low overall level of decay, those
    with hypomineralised 2-year molars exhibited a 3-fold higher
    experience of dental caries than those without Molar Hypomin
    (read more)
  • A study in Thailand found that children with hypomineralised 6-year
    molars had 10-fold higher risk for caries on average, with even higher
    risk (18 fold) for those in the upper jaw (read more)
  • In a forthcoming report by members of The D3 Group, a modelling
    analysis predicts that well over half of the caries in 7-year-olds
    from Western Australia can be accounted for by hypomineralised
    6-year molars
    (MJ Hubbard et al., manuscript in preparation)

TOOTHACHE (DENTAL PAIN)

Boy In Chair - Dental treatment

  • In Melbourne Australia, about 20% of children with hypomineralised 6-year molars reported having significant dental pain associated with this condition (read more)
  • A Brazilian study found that, amongst children with hypomineralised 6-year molars, about 35% were sensitive to a blast of air or scratching with a dental probe (read more)

DENTAL TREATMENT NEEDS

  • In a Greek study, children with Molar Hypomineralisation had 11 times the chance of requiring dental restorations when compared to a control group (read more)
  • A Swedish study found that, by the age of 9, children with Molar Hypomineralisation had undergone nearly 10 times the treatment on their 6-year molars when compared to healthy controls. Moreover, on average, every defective tooth had been treated twice, prompting dental anxiety in many children. A follow-up study
    showed the need for extra dentistry persisted 9 years later but dental
    anxiety had returned to normal levels (read more here and here)
  • Another Swedish study of 18-year-olds with hypomineralised 6-year
    molars found dental restorations had lasted only 5 years on average,
    thereby necessitating ongoing treatment. However most cases treated
    by extractions had satisfactory outcomes (read more)

ORTHODONTIC NEEDS

  • An English study found that, by the age of 12, hypomineralised 6-year molars had led to a 10-fold higher rate of extraction for these orthodontically important teeth (read more)
  • In Sweden, a study investigating spontaneous closure of the gap created by extraction of 6-year molars found that nearly half of the children required future orthodontic treatment. Nearly half of this group (20% of total sample) required orthodontic treatment specifically related to their molar extractions (read more)
  • The timing of extraction of 6-year molars affects the future need for orthodontics, with one study finding that extractions at the age of 8 to 10 years of age provided the best orthodontic results (read more)

PSYCHOSOCIAL ISSUES

  • An English study found that children with pyschosocial issues surrounding their hypomineralised front teeth experienced much-improved quality of life after appearance was improved by cosmetic dental treatment (read more)
  • It was found that many Columbian children with Molar Hypomineralisation experienced negative impacts on their quality of life (read more)
  • In Nigeria, children with Molar Hypomineralisation often had concerns about their appearance which, together with other related issues, could impact their quality of life negatively (read more)