Molar incisor hypomineralization incidence among 6-11-year-old schoolchildren of two rural community of Jaipur, India

Abstract

Background: External conditions affecting the growing enamel, combined with a genetic susceptibility, cause molar incisor hypomineralization (MIH). It happens when the activity of ameloblasts is disrupted during the later stages of amelogenesis, leading onto deficient enamel. Clinically, the damaged enamel shows as white to brown defined opacities. Aim: The aim of the study is to find out MIH incidence among 6-11-year-old schoolchildren of two rural community of Jaipur, India. Settings and Design: Among two rural areas of Jaipur, a cross-sectional epidemiological study was undertaken in school kids aged 6-11 years. Materials and Methods: The 1 st permanent molar and incisors were tested for MIH using the diagnostic criteria established by the European Academy of Paediatric Dentistry in 2003. Results: A total of 490 children aged 6-11 years were evaluated, with MIH being discovered in 30 of them. There were 20 girls and 10 boys among the children that were impacted. Conclusion: MIH was found in the permanent dentition of 6.12% of schoolchildren in the two villages. Only a small percentage of MIH-affected youngsters have sought dental therapy. To minimize the problem, sufficient awareness and organized preventive and restorative initiatives are essential.

Full text

Journal of Advanced Clinical & Research Insights (2021), 8, 73–75
Journal of Advanced Clinical & Research Insights ● Vol. 8:4 ● Jul-Aug 2021 73
ORIGINAL ARTICLE
Molar incisor hypomineralization incidence among
6–11-year-old schoolchildren of two rural community of
Jaipur, India
Bibin Jacob Emmanuel1, Jacob Raja2, Diksha Shikhawat1, Bathel Yeptho1, Mukesh Kumar3
1Department of Pediatric and Preventive Dentistry, Jaipur Dental College, Jaipur, Rajasthan, India, 2Department of Periodontics, Rajas Dental College, Tirunelveli,
Tamil Nadu, India, 3Department of Oral Diagnosis and Radiology, Jaipur Dental College, Jaipur, Rajasthan, India
Abstract
Background: External conditions aecting the growing enamel, combined with a
genetic susceptibility, cause molar incisor hypomineralization (MIH). It happens when
the activity of ameloblasts is disrupted during the later stages of amelogenesis, leading
onto decient enamel. Clinically, the damaged enamel shows as white to brown dened
opacities.
Aim: The aim of the study is to nd out MIH incidence among 6–11-year-old
schoolchildren of two rural community of Jaipur, India.
Seings and Design: Among two rural areas of Jaipur, a cross-sectional epidemiological
study was undertaken in school kids aged 6–11 years.
Materials and Methods: The 1st permanent molar and incisors were tested for MIH
using the diagnostic criteria established by the European Academy of Paediatric
Dentistry in 2003.
Results: Atotal of 490 children aged 6–11 years were evaluated, with MIH being
discovered in 30 of them. There were 20 girls and 10 boys among the children that were
impacted.
Conclusion: MIH was found in the permanent dentition of 6.12% of schoolchildren in
the two villages. Only a small percentage of MIH-aected youngsters have sought dental
therapy. To minimize the problem, sucient awareness and organized preventive and
restorative initiatives are essential.
Keywords:
Hypomineralized second primary molars,
molar incisor hypomineralization prevalence
in India, molar incisor mineralization
Correspondence:
Dr.Bibin Jacob Emmanuel, Department of
Pediatric and Preventive Dentistry, Jaipur
Dental College, Jaipur, Rajasthan, India.
E-mail:boscobibin@gmail.com
Received: 01 June 2021;
Accepted: 03 July 2021
doi: 10.15713/ins.jcri.334
Introduction
External conditions aecting the growing enamel, combined with
a genetic susceptibility, cause molar incisor hypomineralization
(MIH). It occurs when the activity of ameloblasts is disrupted
during the later stages of amelogenesis, leading onto decient
enamel. Clinically, the damaged enamel shows as white to brown
dened opacities. In 2001, Weerheijm et al. coined the term MIH.
Even though the enamel is rm, students reported discomfort
and sensitivity on the teeth that have been aected when
brushing. MIH is linked to the sudden emergence of cavities in
emerging permanent 1st molars.[1] MIH thought to be produced
by disruption of rst maturation phases of amelogenesis,
resulting in dened opacication. These opacication are higher
in carbon and lower in Ca and PO in MIH. Hypomineralized
enamel has a higher density than normal enamel portion. Enamel
of MIH-aected molars is lesser than in unaected sound areas.
Enamel deciencies are most likely caused by a change in the Ca-
phosphate balance or a lack of oxygen availability to ameloblasts
as a result of these causes. The present study is to nd out the
MIH incidence among 6–11-year-old schoolchildren of two
rural community (Basna and Toda Meena) of Jaipur, India.
Aim
The aim of the study is to nd out MIH incidence among 6–11-year-
old schoolchildren of two rural community of Jaipur, India.
Materials and Methods
Between January 2020 and February 2020, a cross-sectional
epidemiological study was undertaken on a random sample
of normal healthy elementary pupils aged 6–11 years in two

Emmanuel, et al. MIH among schoolchildren in Jaipur
74 Journal of Advanced Clinical & Research Insights ● Vol. 8:4 ● Jul-Aug 2021
villages in Jaipur city, Rajasthan, India: Toda Meena (120
boys and 280 girls) and Basna (46 boys and 44 girls). Data
needed for the research were carried out during the Jaipur
Dental College’s school dental camp program. The school’s
director granted permission for oral exam of the students. Each
participating child’s parents signed a written consent form.
The oral examination was performed using a sterile mouth
mirror and a blunt probe in natural light. Criteria for scoring
MIH were according to the European Academy of Paediatric
Dentistry. All the surfaces of incisors and permanent rst
molars were used. SPSS version 20 was used to analyze the
data. Fisher’s exact test was used to compare the groups as the
sample size was smaller.
Inclusion criteria
• Kids 6–11 years old
• Kids whose parents/guardians consented to take part in the
study for various treatment procedures
• One of the permanent 1st molars which are aected could be
taken for the study.
Exclusion criteria
•Kids with uorosis and other white spot lesions apart from
MIH were excluded from the study
• Kids wearing orthodontic appliances and xed space
maintainers.
Discussion
According to this study, the prevalence of MIH among
schoolchildren in two villages of Jaipur city was 6.12%.
The differences in prevalence rates between studies in
different locations could be due to differences in race, age
demographic, and criteria of diagnosis used. The age range of
6–11 years was chosen because at this age, as the first molars
might have been erupted. According to the findings of this
study, MIH has no gender preference, which is consistent
with the findings of other authors. The varied degrees of
MIH in incisors and 1st molars suggest that every one of these
teeth is sensitive to developmental disruptions in different
ways.
In the current investigation, delineated opacities were the
most common kind of MIH, with yellow/brown opacication
[Figure 1] being more prevalent than white/creamy
opacication [Figure 2]. The yellow/brown opacities are said
to have more hypomineralized tissue porous structure and
poorer enamel, putting them at a higher risk of post-eruptive
collapse.[2] Mandibular 1st molars were shown to be substantially
more aected than maxillary molars with hypomineralized aws
in the current investigation.
Results
MIH was detected in 30 of the 490 children tested. Out
of the kids 10 were boys, while the remaining 20 children
were girls. MIH was found to be prevalent in 6.12% of
the sample. Table 1 summarizes the patterns of MIH
distribution and prevalence. Girls were more likely to
have solely incisor involvement, while males were more
likely to have both molar and incisor involvements. The
Table 1: Distribution and prevalence of MIH by gender
Distribution Boys Girls To tal
Only incisor 2 9 11
Only molars 5 6 11
Molars and incisors 3 5 8
Total MIH 10 20 30
Total non-MIH 156 304 460
The Fisher’s exact test statistic value is 1. The result is not significant at
P<0.05. MIH: Molar incisor hypomineralization
Figure2: white/creamy opacication.
Figure1: yellow/brown opacication.

MIH among schoolchildren in Jaipur Emmanuel, et al.
Journal of Advanced Clinical & Research Insights ● Vol. 8:4 ● Jul-Aug 2021 75
Fisher’s exact test statistic value is 1. The result is not
significant at P < 0.05.
Conclusion
MIH was reported to be present in 6.12% of elementary
schoolchildren in two villages in Jaipur city. Mandibular
tooth is the most affected. There was no gender predilection
for the faulty enamel, which was more prone to collapse
and cavities as it grew older. To find out the incidence and
cause of MIH in different regions of Jaipur, more research
is needed.
References
1. Joshi M, Emmanuel BJ, Manzoor R, Manzoor M, Kumar M,
Raja J, et al. Hypomineralized second primary molar. Int J Dent
Med Sci Res 2021;3:895-7.
2. Weerheijm KL, Jälevik B, Alalususua S. Molar incisor
hypomineralization. Caries Res 2001;35:390-1.
How to cite this article: Emmanuel BJ, Raja J, Shikhawat D,
Yeptho B, Kumar M. Molar incisor hypomineralization incidence
among 6–11-year-old schoolchildren of two rural community of
Jaipur, India. J Adv Clin Res Insights 2021;8(4): 73-75.
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