Influence of Environmental Factors on the Presence and Severity of Molar Incisor Hypomineralization


  • Fernanda Mafei Felix da Silva
  • Fernanda Gabriela de Fatima Vieira
  • Thais Rodrigues Campos Soares
  • Flavia Martinez de Carvalho
  • Alexandre Rezende Vieira
  • Marcelo de Castro Costa


Tooth Abnormalities, Dental Enamel Hypoplasia, Child, Tooth Demineralization


Objective: To assess the association between environmental factors during pregnancy and early childhood with the presence and severity of Molar Incisor Hipomineralization (MIH). Material and Methods: This cross-sectional study was conducted with 120 patients between 7 and 14 years of age. MIH was evaluated according to EAPD criteria. Data collected included the child’s medical history and the mother’s health. Chi-square and logistic regression were performed to determine any statistical evidence of the environmental factors, with the significance level set at 5%. Results: The participants were divided into groups with MIH (n=60) and without MIH (n=60), with average ages of 9.9 (±1.9) and 9.7 (±1.7) years, respectively. There was a statistically significant difference between intercurrences during pregnancy (OR=3.55; IC95%=1.35-10.57) and medication taken by the child (OR=3.01; IC95%=1.74-8.42) and the presence of MIH. In addition, other variables were also associated with the MIH (p≤0.05). However, there was no association with variables and degree of MIH severity (p>0.05). Conclusion: The use of medications in childhood and complications during pregnancy can be association to the presence of MIH. However, these factors do not interaction to MIH severity.


Chauhan D, Chauhan T. Prevalence of developmental defects of enamel in mixed and permanent dentition of 9 and 12 year old children of Himachal Pradesh, India: A cross sectional study. Int J Health Allied Sci 2013; 2(3):185-8.

Mejía JD, Restrepo M, González S, Álvarez LG, Santos-Pinto L, Escobar A. Molar incisor hypomineralization in Colombia: prevalence, severity, and associated risk factors. J Clin Pediatr Dent 2019; 43(3):185-9.

Jälevik B. Prevalence and diagnosis of molar-incisor hypomineralisation (MIH): a systematic review. Eur Arch Paediatr Dent 2010; 11(2):59-64.

Weerheijm KL, Duggal M, Majáre I, Papagiannoulis L, Koch G, Martens HC, et al. Judgement criteria for molar incisor hypomineralisation (MIH) in epidemiologic studies: a summary of the European meeting on MIH held in Athens, 2003. Eur J Paediatr Dent 2003; 4(3):110-3.

Schmalfuss A, Stenhagen KR, Tveit AB, Crossner CG, Espelid I. Canines are affected in 16-year-olds with molar-incisor hypomineralisation (MIH): an epidemiological study based on the Tromsø study: "Fit Futures". Eur Arch Paediatr Dent 2016; 17(2):107-13.

Elfrink ME, Ten Cate JM, Jaddoe VW, Hofman A, Moll HA, Veerkamp JS. Deciduous molar hypomineralization and molar incisor hypomineralization. J Dent Res 2012; 91(6):551-5.

Rodrigues FCN, Ribeiro PHB, Thomaz ÉBAF, Lima GQT, Neves PAM, Ribeiro CCC. Molar-Incisor hypomineralization in schoolchildren of Sao Luis, Brazil, Maranhao: Prevalence and associated factors. Pesqui Bras Odontopediatria Clín Integr 2015; 15(1):271-8.

Hernandez M, Boj JR, Espasa E. Do we really know the prevalence of MIH? J Clin Pediatr Dent 2016; 40(4):259-63.

Zhao D, Dong B, Yu D, Ren Q, Sun Y. The prevalence of molar incisor hypomineralization: evidence from 70 studies. Int J Paediatr Dent 2018; 28(2):170-179.

Da Costa Silva CM, Jeremias F, Souza JF, Cordeiro RCL, Santos Pinto L, Zuanon ACC. Molar incisor hypomineralization: prevalence severity and clinical consequences in Brazilian children. Int J Paediatr Dent 2010; 20(6):426-34.

Raposo F, de Carvalho Rodrigues AC, Lia EN, Leal SC. Prevalence of hypersensitivity in teeth affected by molar-incisor hypomineralization (MIH). Caries Res 2019; 53(4):424-430.

Leal SC, Oliveira TRM, Ribeiro APD. Do parents and children perceive molar-incisor hypomineralization as an oral health problem? Int J Paediatr Dent 2017; 27(5):372-37.

Da Silva FMF, Cruz CV, Leal L, de Castro Costa M. Aesthetic perception and psychological impact of molar-incisor hypomineralisation among patients and parents. Dentistry 3000 2019; 7(1):13-20.

Ozgül BM, Saat S, Sönmez H, Oz FT. Clinical evaluation of desensitizing treatment for incisor teeth affected by Molar-Incisor Hypomineralization. J Clin Pediatr Dent 2013; 38(2):101-5.

Vieira AR, Kup E. On the etiology of molar-incisor hypomineralization. Caries Res 2016; 50(2):166-169.

Jeremias F, Ricardo AG, Pierre JF, Souza CMB, Fragelli MRLS, Finoti DG, et al. Family-based genetic association for molar-incisor hypomineralization. Caries Res 2016; 50(3):310-8.

Laisi S, Ess A, Sahlberg C, Arvio P, Lukinmaa PL, Alauusua S. Amoxicillin may cause molar incisor hypomineralization. J Dent Res 2009; 88(2):132-6.

Alaluusua S. Aetiology of molar-incisor hypomineralisation: A systematic review. Eur Arch Paediatr Dent 2010; 11(2):53-8.

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 (MIH): An EAPD policy document. Eur Arch Paediatr Dent 2010; 11(2):75-81.

Jedeon K, Houari S, Loiodice S, Thuy TT, Le Normand M, Berdal A, Babajko S. Chronic exposure to bisphenol A exacerbates dental fluorosis in growing rats. J Bone Miner Res 2016; 31(11):1955-66.

Whatling R, Fearne JM. Molar incisor hypomineralization: a study of aetiological factors in a group of UK children. Int J Paediatr Dent 2008; 18(3):155-62.

Kuscu O, Caglar E, Sandalli N. The prevalence and aetiology of molar–incisor hypomineralisation in a group of children in Istanbul. Eur J Paediatr Dent 2008; 9(3):139-44.

Allazzam SM, Alaki SM, El Meligy OAS. Molar incisor hypomineralization, prevalence, and etiology. Int J Dent 2014; 2014:234508.

Rice F, Lewis A, Harold G, van den Bree M, Boivin J, Hay DF, et al. Agreement between maternal report and antenatal records for a range of pre and perinatal factors: the influence of maternal and child characteristics. Early Hum Dev 2007; 83(8):497-504.

Fagrell TG, Ludvigsson J, Ullbro C, Lundin S-A, Koch G. Aetiology of severe demarcated enamel opacities – an evaluation based on prospective medical and social data from 17,000 children. Swed Dent J 2010; 35(2):57-67.

Vieira AR, Manton DJ. On the variable clinical presentation of molar-incisor hypomineralization. Caries Res 2019; 53(4):482-488.




How to Cite

da Silva, F. M. F. ., Vieira, F. G. de F. ., Soares, T. R. C. ., de Carvalho, F. M. ., Vieira, A. R. ., & Costa, M. de C. . (2021). Influence of Environmental Factors on the Presence and Severity of Molar Incisor Hypomineralization. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 21, e0130. Retrieved from



Original Articles