Molar-Incisor Hypomineralisation (MIH)

Last updated: 26th June 2025

Written by Dr Zaeem Jafri

Causes | Signs | Prevention | Treatment | Speak to a dentist

If your child’s adult molars or front teeth appear patchy, discoloured, or extra sensitive, they may have a condition known as Molar Incisor Hypomineralisation (MIH). It’s more common than you might think and can sometimes be a little confusing — but don’t worry, we’re here to help explain it clearly.

What is Molar-Incisor Hypomineralisation?

MIH is a developmental condition that affects the enamel (the hard outer layer) of the first permanent molars and often the permanent incisors (front teeth). It occurs while the teeth are developing, typically during the first few years of a child’s life.

In MIH, the enamel forms with less mineral content than usual — meaning it’s weaker, softer, and more prone to damage. This can cause teeth to appear:

  • Creamy white, yellow, or brown

  • Uneven in texture

  • Prone to crumbling, chipping, or sensitivity

Picture taken from Dental Tribune

Causes of MIH

MIH is a developmental condition, which means it affects the teeth while they’re still forming under the gum — long before they appear in the mouth. The exact cause isn’t fully understood, but it’s thought to be linked to certain health or environmental factors during early childhood, a time when the adult molars and front teeth are still developing.

Possible contributing factors include:

  • High fevers or childhood illnesses

  • Premature birth or complications around birth

  • Use of certain medications in infancy

  • Environmental influences during early development

Because it happens so early — often in the first few years of life — MIH is not caused by poor brushing, diet, or anything you did later on. It’s something that develops behind the scenes, during the very early stages of tooth formation.

Signs of MIH

  • One or more adult molars or front teeth look chalky or discoloured

  • Your child complains of tooth sensitivity, especially to hot or cold

  • The enamel seems to wear down quickly or break

  • Brushing can be painful due to sensitive areas

Dentists usually diagnose MIH during routine check-ups when adult molars start coming in, typically around age 6–7.

Preventing MIH

Because MIH is a developmental condition that occurs while the teeth are still forming under the gum — often within the first few years of life — it’s not something that can be fully prevented. The exact causes are still being researched, and many of the potential factors (like early childhood illness or birth complications) are simply out of your control.

That said, there are a few general ways to support healthy tooth development in early life:

  • Good overall health during pregnancy and infancy can help set the stage for healthy tooth formation.

  • Where possible, minimising exposure to certain medications or environmental toxins during early childhood may be beneficial (always follow medical advice).

  • Regular dental check-ups from a young age mean that any signs of MIH can be spotted early and managed before they cause more serious problems.

While you may not be able to prevent MIH entirely, catching it early makes a big difference. The sooner it’s identified, the better your dentist can protect the affected teeth and reduce the risk of decay, discomfort, or further damage.

Treating MIH

Depending on how your teeth are affected, your dentist may recommend:

  • Fluoride treatments – to help strengthen weakened enamel and reduce sensitivity and risk of decay.

  • Fissure sealants – protective coatings applied to molars to shield vulnerable areas from decay.

  • Desensitising products, like special toothpaste or varnishes, to reduce discomfort.

  • Composite fillings or bonding – to repair chips, rebuild missing enamel, and improve appearance.

  • Crowns/veneers – used when the teeth are severely damaged and need long-term protection.

  • Tooth removal – In rare cases, very compromised molars might be extracted (usually considered in children when timing supports healthy tooth alignment later on).

Cosmetic Considerations

If front teeth are discoloured or patchy due to MIH, and you’re feeling self-conscious, cosmetic options like composite bonding, microabrasion, or veneers may help restore a more even, natural look. In some cases, teeth whitening may also be discussed, but only when appropriate and once the teeth are mature enough.

Long-Term Care

Because teeth with MIH are more prone to wear and decay, ongoing care is key:

  • Stick with regular dental check-ups

  • Maintain good oral hygiene using fluoride toothpaste

  • Let your dentist know if sensitivity worsens or you notice changes in the teeth

Still got questions?

While MIH can affect the strength and appearance of your teeth, modern dental treatments are highly effective at protecting, restoring, and improving comfort. With the right care plan, you can keep your teeth healthy and confident for the long term.

Need help managing MIH? Our team at Nova Smiles is here to guide you through every step, from diagnosis to tailored treatment options.