Skip to main content

Treatment of Children with MIH: A Challenge in Pain Control and Behaviour Management

  • Chapter
  • First Online:
Molar Incisor Hypomineralization

Abstract

MIH (molar incisor hypomineralization) describes the clinical picture of more or less strongly hypomineralized first permanent molars and permanent anterior teeth. Some of these teeth are highly hypersensitive and can only be treated when complete pain control is ensured. Taking into consideration the possible causes of this hypersensitivity and the help of a correct behaviour control with correct anaesthesia technique, sometimes with the help of sufficient premedication and compassion for our patients, it should be possible to treat most of the teeth affected by MIH. With the therapy-appropriate formulations of the adequate anodyne, it is also possible to control the symptoms of chronically inflammatory MIH molars (pain protocol; pain algorithms). Sedation with nitrous oxide/oxygen allows an intensive application of behaviour management techniques. As a last treatment option, the patient could be brought to rehabilitation under general anaesthesia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. European Academy of Paediatric Dentistry. 6th EAPD Interim Seminar Helsinki (14–16. Mai 2009); Programme and Abstracts, Supplement for the Seminar. Eur Archs Paediatr Dent. 2009:1–25.

    Google Scholar 

  2. Weerheiijm KL, Duggal MS, Mejàre I, Papagiannoulis L, Koch G, Martens LC, Hallonsten AL. Judgement criteria for molar incisor Hypomineralisation (MIH) in epidemiologic studies: a summary of the European meeting in MIH held in Athens, 2003. Eur Arch Paediatr Dent. 2003;4(4):110–3.

    Google Scholar 

  3. Chawla N, Messer LB, Silva M. Clinical studies on molar-incisor-hypomineralisation: part 2: development of a severity index. Eur Arch Paediatr Dent. 2008;9(4):191–9.

    Article  Google Scholar 

  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):45–51.

    Article  Google Scholar 

  5. Kelllerhoff NM, Lussi A. Die molaren inzisiven hypomineralisation. Schweiz Monatsschr Zahnmed. 2004;114:243–9.

    Google Scholar 

  6. Weerheijm KL, Jalevik B, Alaluusua S. Molar-incisor hypomineralization. Caries Res. 2001;35:390–1.

    Article  Google Scholar 

  7. Lygidakis NA, Wong F, Jalevik B, Vierrou AM, Alaluusua S, Espelid I. Best clinical practice guidance for clinicians dealing with children presenting with molar-incisor-hypomineralisation. An EAPD policy document. Eur Arch Paediatr Dent. 2010;11(2):75–81.

    Article  Google Scholar 

  8. Willmott NS, Bryan RAE, Duggal MS. Molar-incisor-hypomineralisation: a literature review. Eur Arch Paediatr Dent. 2008;9(4):172–9.

    Article  Google Scholar 

  9. William V, Suarez-Clua MC, Messer LB, Burrow MF. Molar incisor hypomineralization: review and recommendations for clinical management. Pediatr Dent. 2006;28:224–32.

    PubMed  Google Scholar 

  10. Fayle SA. Molar incisor hypomineralization: restorative management. Eur J Paediat Dent. 2003;4:121–6.

    Google Scholar 

  11. Jalevik B, Klingberg GA. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their first permanent molars. Int J Paediat Dent. 2002;12:24–32.

    Google Scholar 

  12. Kopperud SE, Pedersen CG, Espelid I. Treatment decisions on molar-incisor hypomineralization (MIH) by Norwegian dentists–a questionnaire study. BMC Oral Health. 2017;17

    Google Scholar 

  13. Huang D, Wun E, Stern A. Current treatments and advances in pain and anxiety management. Dent Clin N Am. 2011;55:609–18.

    Article  Google Scholar 

  14. Herzka HS. Kinderpsychopathologie. Ein Lehrgang. Basel: Schwabe; 2001.

    Google Scholar 

  15. Oelkers-Ax R. Aua, das tut weh- über Schmerzen bei Kindern und Jugendlichen. Vortrag und Manual SVK Kongress “Schmerz”. 2010, Bern.

    Google Scholar 

  16. Carlson CR. Psychological factors associated with orofacial pain. Dent Clin N Am. 2007;51:145–58.

    Article  Google Scholar 

  17. Rodd HD, Boissonade FM, Day PF, Boissonade FM. Pulpal status of hypomineralised permanent molars. Paediat Dent. 2007;29:514–20.

    Google Scholar 

  18. Steffen R, Kraemer N, Van Waes H. Molaren-Inzisiven-Hypomineralisation: Grundlagen, Ursachen, Präventionsansätze und Therapie. Thieme Up2Date. 2015;4:313–24.

    Google Scholar 

  19. Lygidakis NA, Chaliasou A, Siounas G. Evaluation of composite restorations in hypomineralised permanent molar. Eur Arch Paediatr Dent. 2003;3:143–8.

    Google Scholar 

  20. Steffen R, Diener V. Behaviour Management in der Kinderzahnmedizin: Mehr als Tell–Show–Do! Quintessenz. 2018;69(4):396–404.

    Google Scholar 

  21. Roberts JF, Curzon MEJ, Koch G, Martens LC. Review: behaviour management techniques in paediatric dentistry. Eur Arch Paediatr Dent. 2010;11(4):166–74.

    Article  Google Scholar 

  22. Remschmidt H, Mattejat F, Warnke A. Therapie psychischer Störungen bei Kindern und Jugendlichen; Ein integratives Lehrbuch für die Praxis. Stuttgart: Thieme; 2010.

    Google Scholar 

  23. Daubländer M, Kämmerer P. Aktueller Stand der zahnärztlichen Lokalanästhesie. Quintessenz. 2010;61(8):899–908.

    Google Scholar 

  24. Gallacchi G. Algorithmen für Diagnose und Therapie des Schmerzes: Ein interdisziplinäres Konzept gegen Schmerzen. Praxis (Bern 1994). 2003;92(12):1955–60.

    Article  Google Scholar 

  25. Hargreaves K, Abbott PV. Drugs for pain management in dentistry. Aust Dent J. 2005;50(Suppl 2):14–22.

    Article  Google Scholar 

  26. Esch J. Anxiolyse und Sedierung mit Lachgas in der Kinderzahnheilkunde. Quintessenz. 2009;60(10):1215–23.

    Google Scholar 

  27. Steffen R, Langerweger C. Die Lachgassedation: ein klinischer Leitfaden. Version 4.5, SVK Weiterbildungsmanual für den SVK Fähigkeitsausweis. Zürich: SVK Druck; 2018.

    Google Scholar 

  28. Steffen R. Einsatz von Lachgas in der Kinderzahnmedizin: Der aktuelle Stand bei der Lachgassedierung Bayerisches Zahnärzte Blatt. BZB. 2018;5:66–9.

    Google Scholar 

  29. Hosey MT. UK national clinical guidelines in paediatric dentistry. Managing anxious children: the use of conscious sedation in paediatric dentistry. Int J Paediatr. 2002;12:359–72.

    Google Scholar 

  30. American Dental Association. Guidelines for the use of sedation and general anaesthesia by dentists. www.ada.org/prof/resources/positions/statements/anesthesia_guidelines.pdf. Stand: Oktober 2016; Zugriff: Januar 2019.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Richard Steffen .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Steffen, R. (2020). Treatment of Children with MIH: A Challenge in Pain Control and Behaviour Management. In: Bekes, K. (eds) Molar Incisor Hypomineralization. Springer, Cham. https://doi.org/10.1007/978-3-030-31601-3_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-31601-3_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-31600-6

  • Online ISBN: 978-3-030-31601-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics