MIH Diagnosis — NDEB AFK MCQ

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ModeratePaediatric DentistryMIH DiagnosisNDEB AFK

A child presents with multiple brown spots on newly erupted permanent first molars with soft enamel that chips easily. The incisors also show demarcated opacities. Which condition is most likely?

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Correct answer: B — Molar-incisor hypomineralisation (MIH)

MIH specifically affects permanent first molars and incisors with demarcated opacities (white, yellow, or brown), soft porous enamel prone to post-eruptive breakdown (PEB), and hypersensitivity. The asymmetric distribution (some affected molars may be more severely involved than others) and the specific pattern (first molars + incisors) distinguish it from generalised conditions (fluorosis — diffuse opacities; AI — all teeth affected; tetracycline — chronological pattern). Aetiology is multifactorial and not fully understood. Management ranges from desensitisation and remineralisation to SSCs or extraction in severe cases.

Reference: Weerheijm KL – Eur J Paediatr Dent, 2003; Neville – Oral and Maxillofacial Pathology, 4th ed., 2016