Impact of molar incisor hypomineralization on oral health-related quality of life, dental fear and anxiety in Swedish children
DOI:
https://doi.org/10.2340/aos.v84.43856Keywords:
Developmental defects of enamel, dental enamel hypomineralization, pediatric dentistry, IndexAbstract
Objectives: The aims this research were to analyze self-reported oral health-related quality of life (OHRQoL) and dental fear and anxiety (DFA) in 11-year-old patients after either restorative treatment or after extraction of first permanent molars (FPM) affected by severe molar incisor hypomineralization (MIH). The research question focused on whether these treatments lead to different outcomes of DFA and OHRQoL over time.
Materials and methods: GuREx-MIH, a multicenter trial, was conducted involving 83 children aged 6–9 years who were diagnosed with severe MIH in FPMs. Patients were randomly assigned to receive either restorative treatment with resin composite or extraction. Patient comfort was assessed through OHRQoL and DFA, using the Swedish version of the Child Perceptions Questionnaire (CPQ11-14) and the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), which were administered before treatment (T0) and at follow-up when patients were 11 years old (T1). Descriptive statistical analyses were conducted and comparisons between the restorative and extraction groups were performed using T-tests.
Results: A total of 79 patients completed the study, with 43 allocated to restorative treatment and 36 to extraction. At follow-up, the mean OHRQoL score was 8.9 (standard deviation [SD] 7.3) for patients in the restorative group and 9.6 (SD 6.7) for those in the extraction group (p: 0.337, T-test). The mean DFA score was 21.5 (SD 5.5) for the restorative group and 23.1 (SD 6.8) for the extraction group (p: 0.130, T-test).
Conclusions: Restorative treatment and extraction of FPMs affected by MIH lead to similar impact on DFA and OHRQoL at 11 years of age.
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Weerheijm KL, Jälevik B, Alaluusua S. Molar-incisor hypomineralisation. Caries Res. 2001;35:390–1. https://doi.org/10.1159/000047479 DOI: https://doi.org/10.1159/000047479
Zhao D, Dong B, Yu D, Ren Q, Sun Y. The prevalence of molar incisor hypomineralization: evidence from 70 studies. Int J Paediatr Dent. 2018;28:170–9. https://doi.org/10.1111/ipd.12323 DOI: https://doi.org/10.1111/ipd.12323
Jälevik B, Szigyarto-Matei A, Robertson A. The prevalence of developmental defects of enamel, a prospective cohort study of adolescents in Western Sweden: a Barn I TAnadvarden (BITA, children in dental care) study. Eur Arch Paediatr Dent. 2018;19:187–95. https://doi.org/10.1007/s40368-018-0347-7 DOI: https://doi.org/10.1007/s40368-018-0347-7
Raposo F, De Carvalho Rodrigues AC, Lia ÉN, Leal SC. Prevalence of Hypersensitivity in teeth affected by molar-incisor hypomineralization (MIH). Caries Res. 2019;53:424–30. https://doi.org/10.1159/000495848 DOI: https://doi.org/10.1159/000495848
Vanhé ET, Poncelet J, Cheikh-Ali S, Bottenberg P. Prevalence, caries, dental anxiety and quality of life in children with MIH in Brussels, Belgium. J Clin Med. 2022 May 29;11(11):3065. https://doi.org/10.3390/jcm11113065 DOI: https://doi.org/10.3390/jcm11113065
Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FSL. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation (MIH): an updated European Academy of Paediatric Dentistry policy document. Eur Arch Paediatr Dent. 2022;23:3–21. https://doi.org/10.1007/s40368-021-00668-5 DOI: https://doi.org/10.1007/s40368-021-00668-5
Hajdarević A, Čirgić E, Robertson A, Sabel N, Jälevik B. Treatment choice for first permanent molars affected with molar-incisor hypomineralization, in patients 7–8 years of age: a questionnaire study among Swedish general dentists, orthodontists, and pediatric dentists. Eur Archiv Paediatr Dent. Volume 25, pages 93–103, (2024) https://doi.org/10.1007/s40368-023-00860-9 DOI: https://doi.org/10.1007/s40368-023-00860-9
Skaare AB, Houlihan C, Nybø CJ, Brusevold IJ. Knowledge, experience and perception regarding molar incisor hypomineralisation (MIH) among dentists and dental hygienists in Oslo, Norway. Eur Arch Paediatr Dent. 2021;22:851–60. DOI: https://doi.org/10.1007/s40368-021-00649-8
Taylor GD, Bulmer V. Advances in knowledge and practice benefiting the health and management of first permanent molars in children. Br Dent J. 2025;238:92–8. https://doi.org/10.1038/s41415-024-8012-5 DOI: https://doi.org/10.1038/s41415-024-8012-5
Mejàre I, Bergman E, Grindefjord M. Hypomineralized molars and incisors of unknown origin: treatment outcome at age 18 years. Int J Paediatr Dent. 2005;15:20–8. https://doi.org/10.1111/j.1365-263X.2005.00599.x DOI: https://doi.org/10.1111/j.1365-263X.2005.00599.x
Crombie FA, Manton DJ, Weerheijm KL, Kilpatrick NM. Molar incisor hypomineralization: a survey of members of the Australian and New Zealand Society of Paediatric Dentistry. Aust Dent J. 2008;53:160–6. https://doi.org/10.1111/j.1834-7819.2008.00026.x DOI: https://doi.org/10.1111/j.1834-7819.2008.00026.x
Jälevik B, Klingberg GA. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their permanent first molars. Int J Paediatr Dent. 2002;12:24–32. https://doi.org/10.1046/j.0960-7439.2001.00318.x DOI: https://doi.org/10.1046/j.0960-7439.2001.00318.x
Cianetti S, Lombardo G, Lupatelli E, Pagano S, Abraha I, Montedori A, et al. Dental fear/anxiety among children and adolescents. A systematic review. Eur J Paediatr Dent. 2017;18:121–30.
Krekmanova L, Sotirianou M, Sabel N. Young patients’ self-reported fear compared to professionals’ assessments during invasive and non-invasive dental visits: a prospective, longitudinal study. Eur Arch Paediatr Dent. 2022;23:309–15. https://doi.org/10.1007/s40368-021-00685-4 DOI: https://doi.org/10.1007/s40368-021-00685-4
Klingberg G. Dental fear and behavior management problems in children. A study of measurement, prevalence, concomitant factors, and clinical effects. Swed Dent J Suppl. 1995;103:1–78.
Milgrom P, Weinstein P, Golletz D, Leroux B, Domoto P. Pain management in school-aged children by private and public clinic practice dentists. Pediatr Dent. 1994;16:294–300.
Jälevik B, Sabel N, Robertson A. Can molar incisor hypomineralization cause dental fear and anxiety or influence the oral health-related quality of life in children and adolescents? A systematic review. Eur Arch Paediatr Dent. 2022;23:65–78. https://doi.org/10.1007/s40368-021-00631-4 DOI: https://doi.org/10.1007/s40368-021-00631-4
Bekes K, Hirsch C. What is known about the influence of dentine hypersensitivity on oral health-related quality of life? Clin Oral Investig. 2013;17 Suppl 1:S45–51. DOI: https://doi.org/10.1007/s00784-012-0888-9
Scheffel DLS, Jeremias F, Fragelli CMB, Dos Santos-Pinto LAM, Hebling J, De Oliveira Jr OB. Esthetic dental anomalies as motive for bullying in schoolchildren. Eur J Dent. 2014;8:124–8. https://doi.org/10.4103/1305-7456.126266 DOI: https://doi.org/10.4103/1305-7456.126266
Scapini A, Feldens CA, Ardenghi TM, Kramer PF. Malocclusion impacts adolescents’ oral health-related quality of life. Angle Orthod. 2013;83:512–8. https://doi.org/10.2319/062012-509.1 DOI: https://doi.org/10.2319/062012-509.1
Jokovic A, Locker D, Guyatt G. Short forms of the Child Perceptions Questionnaire for 11–14-year-old children (CPQ11-14): development and initial evaluation. Health Qual Life Outcomes. 2006;4:4. https://doi.org/10.1186/1477-7525-4-4 DOI: https://doi.org/10.1186/1477-7525-4-4
Nicholas Dean. The Random Number Generator (Version 5.3). 2013. Available from: https://apps.apple.com/se/app/the-random-number-generator/id611762447 (cited January 12 2025)
Gruebbel AO. A measurement of dental caries prevalence and treatment service for deciduous teeth. J Dent Res. 1944;23:163–8. https://doi.org/10.1177/00220345440230030201 DOI: https://doi.org/10.1177/00220345440230030201
Cuthbert MI, Melamed BG. A screening device: children at risk for dental fears and management problems. ASDC J Dent Child. 1982;49:432–6.
Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent. 2007;17:391–406. https://doi.org/10.1111/j.1365-263X.2007.00872.x DOI: https://doi.org/10.1111/j.1365-263X.2007.00872.x
Bekes K, Amend S, Priller J, Zamek C, Stamm T, Krämer N. Changes in oral health-related quality of life after treatment of hypersensitive molar incisor hypomineralization-affected molars with a sealing. Clin Oral Investig. 2021;25:6449–54. https://doi.org/10.1007/s00784-021-03947-z DOI: https://doi.org/10.1007/s00784-021-03947-z
Tugcu N, Sezer B, Caliskan C, Durmus B, Kargul B. Changes in oral health-related quality of life after treatment of molar incisor hypomineralisation using Glass Hybrid Restorations. J Pak Med Assoc. 2022;72:1977–82. https://doi.org/10.47391/JPMA.3848 DOI: https://doi.org/10.47391/JPMA.3848
Gutiérrez TV, Ortega CCB, Pérez NP, Pérez AG. Impact of molar incisor hypomineralization on oral health-related quality of life in Mexican schoolchildren. J Clin Pediatr Dent. 2019;43:324–30. DOI: https://doi.org/10.17796/1053-4625-43.5.4
Mc Grath C, Bedi R. Gender variations in the social impact of oral health. J Ir Dent Assoc. 2000;46:87–91.
Elhennawy K, Rajjoub O, Reissmann DR, Doueiri MS, Hamad R, Sierwald I, et al. The association between molar incisor hypomineralization and oral health-related quality of life: a cross-sectional study. Clin Oral Investig. 2022;26:4071–7. https://doi.org/10.1007/s00784-022-04375-3 DOI: https://doi.org/10.1007/s00784-022-04375-3
Kosma I, Kevrekidou A, Boka V, Arapostathis K, Kotsanos N. Molar incisor hypomineralisation (MIH): correlation with dental caries and dental fear. Eur Arch Paediatr Dent. 2016;17:123–9. https://doi.org/10.1007/s40368-016-0221-4 DOI: https://doi.org/10.1007/s40368-016-0221-4
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