Influence of molar incisor hypomineralisation severity on dental hypersensitivity, anxiety/fear, and aesthetic self-perception

a cross-sectional study

Authors

DOI:

https://doi.org/10.1590/1678-7757-2024-0159

Keywords:

Molar incisor hypomineralisation, Dental hypersensitivity, Dental anxiet, Children

Abstract

Molar-incisor hypomineralisation (MIH) significantly impacts children's quality of life due to dental hypersensitivity, anxiety, and aesthetic concerns. Few studies have investigated these factors within the same sample, comparing varying levels of MIH severity to MIH-free controls. Objectives:  This study evaluated dental hypersensitivity, anxiety, and aesthetic self-perception in children with mild MIH, severe MIH, and controls, and explored correlations between the studied variables. Methodology:  A total of 605 students from a single school were evaluated: 110 children with MIH and 214 controls matched by age and sex. MIH severity was clinically assessed using the Ghanim criteria. Hypersensitivity was measured with the visual analogue scale (VAS) and the Schiff Cold Air Sensitivity Scale (SCASS). Anxiety and aesthetic concerns were assessed using the CFSS-DS and CQATA questionnaires, respectively. Results:  Overall, 78 children had mild MIH and 32 had severe MIH. Median for dental hypersensitivity (p<0.001) and aesthetic self-perception (p=0.002) were significantly higher in the severe MIH group compared to both the control and mild MIH groups. No differences were found for anxiety. Elevated VAS-measured dental hypersensitivity levels and impaired self-perceived aesthetics were significantly correlated with greater MIH severity (p<0.05). Spearman's correlation analysis further revealed significant positive correlations between anxiety/fear and VAS scores (p=0.023, r=0.239), between anxiety/fear and aesthetic self-perception scores (p=0.007, r=0.282), and between dental appearance classification and VAS hypersensitivity scores (p=0.035, r=0.222). In contrast, SCASS hypersensitivity scores did not significantly correlate with either anxiety/fear or dental appearance classification (p>0.05). Conclusions:  Children with severe MIH showed higher dental hypersensitivity and greater perceived aesthetic impairment than children with mild MIH or without MIH.

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References

Weerheijm KL, Jälevik B, Alaluusua S. Molar-incisor hypomineralisation. Caries Res. 2001;35(5):390-1. doi: 10.1159/000047479

» https://doi.org/10.1159/000047479

Lygidakis NA, Garot E, Somani C, Taylor GD, Rouas P, Wong FS. 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(1):3-21. doi: 10.1007/s40368-021-00668-5

» https://doi.org/10.1007/s40368-021-00668-5

Rodd HD, Boissonade FM, Day PF. Pulpal status of hypomineralized permanent molars. Pediatr Dent. 2007;29(6):514-20.

Fagrell TG, Lingström P, Olsson S, Steiniger F, Norén JG. Bacterial invasion of dentinal tubules beneath apparently intact but hypomineralized enamel in molar teeth with molar incisor hypomineralization. Int J Paediatr Dent. 2008;18(5):333-40. doi: 10.1111/j.1365-263X.2007.00908.x

» https://doi.org/10.1111/j.1365-263X.2007.00908.x

Raposo F, Rodrigues AC, Lia EN, Leal SC. Prevalence of hypersensitivity in teeth affected by Molar-Incisor Hypomineralization (MIH). Caries Res. 2019;53(4):424-30. doi: 10.1159/000495848

» https://doi.org/10.1159/000495848

Vicioni-Marques F, Carvalho MR, Raposo F, Paula-Silva FW, Queiroz AM, Leal SC, et al. Association of dental hypersensitivity and anxiety in children with molar-incisor hypomineralisation (MIH). Eur Arch Paediatr Dent. 2023;24(3):313-9. doi: 10.1007/s40368-023-00803-4

» https://doi.org/10.1007/s40368-023-00803-4

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(1):65-78. doi: 10.1007/s40368-021-00631-4

» https://doi.org/10.1007/s40368-021-00631-4

Jälevik B, Klingberg G. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralisation of their permanent first molars. Int J Paediatr Dent. 2002;12(1):24-32. doi: 10.1046/j.0960-7439.2001.00318.x

» https://doi.org/10.1046/j.0960-7439.2001.00318.x

Hasmun N, Lawson J, Vettore MV, Elcock C, Zaitoun H, Rodd H. Change in oral health-related quality of life following minimally invasive aesthetic treatment for children with molar incisor hypomineralisation: a prospective study. Dent J. 2018;6(4):61. doi: 10.3390/dj6040061

» https://doi.org/10.3390/dj6040061

Athayde GD, Reis PP, Jorge RC, Americano GC, Fidalgo TK, Soviero VM. Impact of masking hypomineralization opacities in anterior teeth on the esthetic perception of children and parents: a randomized controlled clinical trial. J Dent. 2022;123:104168. doi: 10.1016/j.jdent.2022.104168

» https://doi.org/10.1016/j.jdent.2022.104168

Leal SC, Oliveira TR, Ribeiro AP. Do parents and children perceive molar-incisor hypomineralization as an oral health problem? Int J Paediatr Dent. 2017;27(5):372-9. doi: 10.1111/ipd.12271

» https://doi.org/10.1111/ipd.12271

Fragelli C, Barbosa TS, Bussaneli DG, Restrepo M, Cordeiro RC, Santos-Pinto L. Aesthetic perception in children with molar incisor hypomineralization. Eur Arch Paediatr Dent. 2021;22(2):227-34. doi: 10.1007/s40368-020-00541-x

» https://doi.org/10.1007/s40368-020-00541-x

Reissenberger T, Ebel M, Klode C, Hirsch C, Bekes K. Hypomineralized teeth and their impact on oral-health-related quality of life in primary school children. Int J Environ Res Public Health. 2022;19(16):10409. doi: 10.3390/ijerph191610409

» https://doi.org/10.3390/ijerph191610409

Instituto Brasileiro de Geografia e Estatística - IBGE. Ribeirão Preto [Internet]. Rio de Janeiro: IBGE; 2022 [cited 2025 May 27]. Available from: https://cidades.ibge.gov.br/brasil/sp/ribeirao-preto/panorama

» https://cidades.ibge.gov.br/brasil/sp/ribeirao-preto/panorama

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008 Apr;61(4):344-9. doi: 10.1016/j.jclinepi.2007.11.008

» https://doi.org/10.1016/j.jclinepi.2007.11.008

Ghanim A, Elfrink M, Weerheijm K, Mariño R, Manton D. A practical method for use in epidemiological studies on enamel hypomineralisation. Eur Arch Paediatr Dent. 2015;16(3):235-46. doi: 10.1007/s40368-015-0178-8

» https://doi.org/10.1007/s40368-015-0178-8

Vieira HA, Araujo LD, Carvalho FK, Queiroz AM, Paula-Silva FW. Use of images and clinical experience to calibrate dental surgeons for the diagnosis of molar incisor hypomineralization. Pesqui Bras Odontopediatria Clín Integr. 2023;23:e220040. doi: 10.1590/pboci.2023.026

» https://doi.org/10.1590/pboci.2023.026

Gift AG. Visual analogue scales: measurement of subjective phenomena. Nurs Res. 1989;38(5):286-8.

Fütterer J, Ebel M, Bekes K, Klode C, Hirsch C. Influence of customized therapy for molar incisor hypomineralization on children's oral hygiene and quality of life. Clin Exp Dent Res. 2020;6(1):33-43. doi: 10.1002/cre2.245

» https://doi.org/10.1002/cre2.245

Schiff T, Dotson M, Cohen S, De Vizio W, McCool J, Volpe A. Efficacy of a dentifrice containing potassium nitrate, soluble pyrophosphate, PVM/MA copolymer, and sodium fluoride on dentinal hypersensitivity: a twelve-week clinical study. J Clin Dent. 1994;5 Spec No:87-92.

Barberio GS. Confiabilidade e validade do questionário Children's Fear Survey Schedule-Dental Subscale para avaliação do medo e ansiedade ao tratamento odontológico em crianças [Reliability and validity of the Brazilian version of the Children's Fear Survey Schedule-Dental Subscale questionnaire for assessing fear and anxiety about dental treatment in children] [thesis]. Bauru: Faculdade de Odontologia de Bauru, Universidade de São Paulo; 2017. Portuguese. doi: 10.11606/T.25.2017.tde-28092017-183623

» https://doi.org/10.11606/T.25.2017.tde-28092017-183623

Martinez-Mier EA, Maupome G, Soto-Rojas AE, Urena-Cirett JL, Katz BP, Stookey GK. Development of a questionnaire to measure perceptions of, and concerns derived from, dental fluorosis. Community Dent Health. 2004;21(4):299-305.

Afzal SH, Skaare AB, Wigen TI, Brusevold IJ. Molar-Incisor Hypomineralisation: Severity, caries and hypersensitivity. J Dent. 2024;142:104881. doi: 10.1016/j.jdent.2024.104881

» https://doi.org/10.1016/j.jdent.2024.104881

Muniz RS, Carvalho CN, Aranha AC, Dias FM, Ferreira MC. Efficacy of low-level laser therapy associated with fluoride therapy for the desensitisation of molar-incisor hypomineralisation: randomised clinical trial. Int J Paediatr Dent. 2020;30(3):323-33. doi: 10.1111/ipd.12602

» https://doi.org/10.1111/ipd.12602

Laureano IC, Farias L, Fernandes LH, Alencar CR, Forte FD, Honorio DR, et al. Dental fear in children: association with dental caries and molar incisor hypomineralization. Braz Dent J. 2020;31(6):673-9. doi: 10.1590/0103-6440202003880

» https://doi.org/10.1590/0103-6440202003880

Vanhée T, 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;11(11):3065. doi: 10.3390/jcm11113065

» https://doi.org/10.3390/jcm11113065

Jälevik B, Klingberg G. Treatment outcomes and dental anxiety in 18-year-olds with MIH, comparisons with healthy controls: a longitudinal study. Int J Paediatr Dent. 2012;22(2):85-91. doi: 10.1111/j.1365-263X.2011.01161.x

» https://doi.org/10.1111/j.1365-263X.2011.01161.x

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(2):123-9. doi: 10.1007/s40368-016-0221-4

» https://doi.org/10.1007/s40368-016-0221-4

Menoncin BL, Portella PD, Ramos BL, Assunção LR, Souza JF, Menezes JV. Dental anxiety in schoolchildren with molar incisor hypomineralization-A population-based cross-sectional study. Int J Paediatr Dent. 2019;29(5):615-23. doi: 10.1111/ipd.12503

» https://doi.org/10.1111/ipd.12503

Carlsson V, Hakeberg M, Blomkvist K, Wide Boman U. Orofacial esthetics and dental anxiety: associations with oral and psychological health. Acta Odontol Scand. 2014;72(8):707-13. doi: 10.3109/00016357.2014.898786

» https://doi.org/10.3109/00016357.2014.898786

Grecu AG, Balazsi R, Dudea D, Mesaroş AŞ, Strîmbu M, Dumitraşcu DL. Oral health related quality of life and self-esteem in a general population. Med Pharm Rep. 2019;92(Suppl No 3):S65-S72. doi: 10.15386/mpr-1520

» https://doi.org/10.15386/mpr-1520

Tondolo J Junior, Ortiz FR, Ramadan YH, Maroneze MC, Agostini BA, Ardenghi TM. Direct relations between sense of coherence and oral health-related quality of life in adolescents. Oral Dis. 2023;29(3):1367-75. doi: 10.1111/odi.14111

» https://doi.org/10.1111/odi.14111

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Published

2025-07-07

Issue

Vol. 33 (2025)

Section

Original Articles

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Copyright (c) 2025 Bianca Caroline Gomes, Lana Cardoso-Silva, Beatriz Kelly Barros Lopes, Roberta Paula de Faria Melo, Isabella Silva Catananti, Alexandra Mussolino de Queiroz, Francisco Wanderley Garcia Paula-Silva, David John Manton, Fabrício Kitazono de Carvalho

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How to Cite

Gomes, B. C., Cardoso-Silva, L., Lopes, B. K. B., Melo, R. P. de F., Catananti, I. S., Queiroz, A. M. de, Paula-Silva, F. W. G., Manton, D. J., & Carvalho, F. K. de. (2025). Influence of molar incisor hypomineralisation severity on dental hypersensitivity, anxiety/fear, and aesthetic self-perception: a cross-sectional study. Journal of Applied Oral Science, 33, e20240159. https://doi.org/10.1590/1678-7757-2024-0159