Knowledge, perceptions, and clinical experiences on molar incisor hypomineralization among dental care providers in Hong Kong

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Abstract

Background

Molar incisor hypomineralization (MIH) is an alarming problem with considerable challenges in management. This study aimed to evaluate and compare the knowledge, perceptions, and clinical experiences of molar incisor hypomineralization (MIH) between general dental practitioners (GDPs) and paediatric dentists (PDs) in Hong Kong.

Methods

A cross-sectional survey of 557 randomly selected GDPs (approximately 25% of all registered dentists) and all registered PDs ( n = 31) were invited. They were asked to complete a 4-section questionnaire adapted and modified from a study by Gambetta-Tessini and co-workers on sociodemographic profiles, knowledge, experience, and perceptions regarding MIH. Data were analyzed with chi-square, Fisher’s exact, and multiple factor ANCOVA tests.

Results

The overall response rate was 43.37% (255/588). Majority (74.1%) of the respondents encountered MIH in their practices. A significantly higher mean knowledge score (46.33 ± 7.1) was observed among PDs than GDPs (43.09 ± 7.0) ( P < 0.01) and among PDs who are 40 years old or younger ( P < 0.001). Differences in treatment of MIH were also observed between PDs and GDPs ( P < 0.05). Paediatric dentists were more confident in diagnosing and treating MIH ( P < 0.001). Most respondents (87.8%) expressed a need for continuing education on MIH.

Conclusion

Continuing education on MIH is needed to assure that the highest quality of evidence-based care is given to patients with MIH. Dissemination of latest best evidence on MIH, especially to GDPs, will assure that the condition is accurately diagnosed and well managed.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0678-0) contains supplementary material, which is available to authorized users.

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Most cited references 22

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Etiology of molar incisor hypomineralization - A systematic review.

Mihiri J Silva, Katrina Scurrah, Jeffrey Craig … (2016)

Molar incisor hypomineralization (MIH) is a common developmental dental defect of permanent teeth, which can increase the risk of dental caries, infection and hospitalization. The etiology is currently unclear although prenatal or early childhood health factors are suspected. The aim of this systematic review was to assess the strength of evidence linking etiological factors with MIH.

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Molar-incisor-hypomineralisation (MIH). A retrospective clinical study in Greek children. II. Possible medical aetiological factors.

N Lygidakis, G Dimou, D Marinou (2008)

This was to examine the potential medical aetiological factors involved in the development of MIH. During the years 2003--2005, all MIH cases diagnosed according to set criteria were selected from the new patients clinic of a Community Dental Centre for Children (Athens). The age, gender and teeth involved were recorded. A control group of socio-demographically matched controls was also identified. The potential aetiological factors were retrieved through personal interview with the parents and from each child and mother's medical book. Only verified aetiological factors were recorded. Evaluation of the correlation of affected teeth and the timing of the insult was performed in a separate group of 225 affected children aged 8-12 with their entire 12 'index' teeth erupted. From the 3,518, 5.5 to 12 years old children examined, 360 (10.2%) had MIH. Aetiology of MIH: 44 children (12.2%), presented without any relevant medical history, the remaining 316 (87.8%) recorded various medical problems associated with MIH, compared with 18.9% for controls. Perinatal (163, 33.6%) and postnatal (162, 33.9%) problems were the most frequently found and prenatal the least (33, 8.6%). For 42 children (11.7%) problems occurred in more than one chronological period, mainly during both the perinatal and postnatal period (11.1%). The most common prenatal problem was repeated episodes of high fever (12/33), in the perinatal period birth by Caesarean section (92/163) and other birth complications (34/163). Various respiratory conditions (88/162), repeated episodes of high fever (31/162) and neonatal illness (28/162) were the commonly reported problems in the postnatal period. Many MIH cases presented with more than one medical problem during the peri-and postnatal period. Children with MIH recorded 68.9% more frequent medical problems than controls (p<0.0001). A positive correlation (p<0.001) between the total number and type of affected teeth with the timing of the insult was observed in the 225 MIH children with all their 'index' teeth erupted. Children with MIH present with more medical problems than controls during their prenatal, perinatal and postnatal period. The majority of these illnesses may produce hypocalcaemia, hypoxia and pyrexia to the child or the mother. The number of affected teeth was associated with the timing of the possible insult; children with prenatal, perinatal and postnatal problems present more affected teeth in increasing order.

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Mechanical properties and microstructure of hypomineralised enamel of permanent teeth.

Erin K Mahoney, R Rohanizadeh, F.S.M. Ismail … (2004)

Isolated enamel defects are commonly seen in first permanent molar teeth but there has been little work on the physical and morphological composition of affected molars. The aim of this study was to determine the mechanical and morphological properties of hypomineralised first permanent molar teeth, utilising the Ultra-Micro-Indentation System (UMIS) and scanning electron microscope, respectively. Further investigations using Energy Dispersive X-ray Spectrometery (EDS), Back Scatter Electron (BSE) Imaging, and X-ray diffraction were employed to attempt to determine the chemical composition, mineral content and crystalline structure of the hypomineralised tissue, respectively, of eight first permanent molars with severe enamel hypomineralisation. The hardness and modulus of elasticity were found to be statistically significantly lower (0.53+/-0.31 and 14.49+/-7.56 GPa, respectively) than normal enamel (3.66+/-0.75 and 75.57+/-9.98 GPa, respectively). Although the fractured surface of the hypomineralised enamel was significantly more disorganised and the relative mineral content was reduced by approximately 5% in comparison to sound enamel, the mineral phase and Ca/P ratio was similar in hypomineralised and sound enamel. The dramatic reduction in the mechanical properties of first permanent molar teeth has ramifications when clinicians are choosing restorative materials to restore the defects. The reason for the dramatic reduction in mechanical properties of hypomineralised first permanent molar teeth is at present unknown.

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Author and article information

Contributors

Gianina Camille Sicangco Gamboa: gianinacamille@gmail.com

Gillian Hiu Man Lee:

ORCID: http://orcid.org/0000-0002-6192-4923

(852) 28590255 , lee.gillian@gmail.com

Manikandan Ekambaram: mani.ekambaram@otago.ac.nz

Cynthia Kar Yung Yiu: ckyyiu@hku.hk

Journal

Journal ID (nlm-ta): BMC Oral Health

Journal ID (iso-abbrev): BMC Oral Health

Title: BMC Oral Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6831

Publication date (Electronic): 13 December 2018

Publication date PMC-release: 13 December 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 217

Affiliations

[1 ]ISNI 0000000121742757, GRID grid.194645.b, Paediatric Dentistry, Faculty of Dentistry, , The University of Hong Kong, Prince Philip Dental Hospital, ; 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR China

[2 ]ISNI 0000 0004 1936 7830, GRID grid.29980.3a, Paediatric Dentistry, Faculty of Dentistry, , University of Otago, ; Dunedin, New Zealand

Author information

Gillian Hiu Man Lee http://orcid.org/0000-0002-6192-4923

Article

Publisher ID: 678

DOI: 10.1186/s12903-018-0678-0

PMC ID: 6293514

PubMed ID: 30545337

SO-VID: bbf1a15c-a4b8-455d-baa2-c84b9d3b165c

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 27 October 2017

Date accepted : 27 November 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100003802, University Research Committee, University of Hong Kong;

Award ID: 201611159294

Award Recipient : Gillian Hiu Man Lee

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ScienceOpen disciplines: Dentistry

Keywords: molar incisor hypomineralization,disturbances in dental development,oral health care,dental practitioners,children

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ScienceOpen disciplines: Dentistry

Keywords: molar incisor hypomineralization, disturbances in dental development, oral health care, dental practitioners, children

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Knowledge, perceptions, and clinical experiences on molar incisor hypomineralization among dental care providers in Hong Kong

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Most cited references 22

Etiology of molar incisor hypomineralization - A systematic review.

Molar-incisor-hypomineralisation (MIH). A retrospective clinical study in Greek children. II. Possible medical aetiological factors.

Mechanical properties and microstructure of hypomineralised enamel of permanent teeth.

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