Factors Associated with Hypersensitivity, Management, and Treatment Options for Teeth with Molar Incisor Hypomineralisation.

Abstract

Tooth hypersensitivity is a common symptom in molar incisor hypomineralisation (MIH) patients and can affect children's quality of life. During daily routine, children with MIH often report sensitivity to various thermal and mechanical stimuli, and difficulty in achieving effective analgesia is a common issue becoming a challenge for dentists. Research has focused on the possible pathophysiological mechanisms behind this phenomenon, which, in turn, have not been determined. Even with the apparently intact enamel of MIH-teeth, the porosity of the hypomineralised enamel acts as an open door for the invasion of oral microorganisms, which reach the dentinal tubules, and stimulate subclinical inflammatory reactions in the pulp. Tissue inflammation may, in turn, lead to morphological and cytochemical changes within sensory neurons, resulting in sensitization of these nerve fibers. This phenomenon is complex, and the treatment modalities focus on inflammation management followed by tubule obliteration by using different materials and technologies. In conclusion, this chapter reviews the concept and etiology of hypersensitivity in teeth with MIH and summarizes the clinical management according to the best evidence available.