Child dental: hypomineralisation

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Hello. My 8 year old daughter has hypomineralisation of the upper teeth which apparently means her teeth are weak and chalky. A rear upper molar needs a filling (really looking forward to taking her to that ).

At the previous appointment a few mints ago I tried asking the dentist a bit more about it and she basically was very cagey and we were out of the surgery in about 4 minutes, no kidding.

Yesterday I went in determined to ask my damned questions! Again she looked as though we were taking up her precious time. I persisted as much as I could and just sat there asking away. We were still out of there in only 7 1/2 minutes (I know this because I recorded it). Pretty rubbish basically and my DD needs a filling.

i asked her if she was going to clean my daughter’s teeth and she said no she doesn’t need it. Ahem… I though she has a condition that exposes her to decay!

I don’t really know what to do. Shall I take her to a private pediatric orthodontist? I want to give her the best start in life and teeth are important. Is this normal practice from our dentist? At the end of the day I don’t feel in the greatest of hands there.

I’d be very grateful if you could advise or share your experience.

Cleaning by a dentist does nothing to stop decay. Diet is what is important.

What she eats and drinks at mealtimes doesn't matter it's what they eat and drink in-between times. So anything sugary/starchy should be kept to meal times. Does she graze or sip on stuff between meals? Not just sweets etc but fruit juice, smoothies, raisins,yoghurt, flapjacks etc will all decay teeth.

Hypomineralised teeth will not necessarily need filling if you are careful about diet and what they eat and drink between meals. More than three sugar attacks a day will cause problems , particularly if they eat or drink anything just before bed, even if they brush teeth afterwards.

An orthodontist is someone who specialises in braces so will do no good. Really it's up to what your child eats and drinks, even with hypomineralised teeth , which only affects ,typically, a couple of teeth and for most people is a mainly cosmetic problem. However regular application by the dentist of fluoride varnish, along with dietary changes , may help.

Hi there. This sounds like what my daughter has been diagnosed with - Molar Incisor Hypomineralization. We are not in the Uk. I believe there are different severities. She has some discolouration on the front two upper teeth but that’s mainly cosmetic. The real issue is with the molars. Basically the enamel is a lot weaker than on normal teeth. We attend a specialist paediatric dentist. We’ve had to have some interventions (steel caps to protect a couple of the teeth and a couple of extractions). They need to monitor it reasonably closely so we attend about 2-3 times a year. It’s not cheap (consultations c€200 a time).

My dd had this, she saw a pediatric dentist every 3 months to keep an eye on it and they would put the fluoride coating on her teeth. They also went on a lot about what she was eating and drinking! They use a Hall crown instead of a filling as it’s easier to do on a child and doesn’t involve any drilling.

Get a better dentist. We got absolutely fucked over with this with bad dentists as they all gave up during Covid, and they basically left my son’s teeth, claiming it was “just discolouration” until the teeth were so bad that when we finally found one who took us seriously, we ended up needing four grand’s worth of remedial work to fix them (the NHS’s alternative, which we were fast tracked for, was to remove 14 baby teeth). Get a more engaged dentist, even if you have to pay, and also look up GC Tooth Mousse or GC MI Paste (available on Amazon or from a good dentist) to use on her teeth every night to help them. Do not let tooth brushing slip for even a day. This condition is a total bastard.

This is the weird thing. She’s really good re sweets etc and seems to hate chocolate. She won’t drink any fruit juice and asks for water when she’s thirsty.

Thank you for the tips. Really useful.

It's not just sweets ,fizzy , it's yoghurt, raisins , dried fruit , starchy foods etc all can cause decay.

What does she snack or graze on in-between meals? Every bite or sip attacks the teeth for an hour afterwards , so it doesn't need to be much but any food or drink in-between meals needs to be sugar/starch free. Starchy foods are converted to sugar in the mouth so crisps , rice cakes etc are also a problem.

Thank you for this. In view of the fact that most people don’t brush teeth after lunch wjat difference does it make whether sugar is eaten outside of mealtimes. Surely lunch is not a get-out for eating snacks?

Regardless of whether you brush teeth afterwards every time you eat or drink something sugary or starchy the acid produced attacks the teeth for an hour afterwards. The exception is at bedtime, because the saliva that neutralises the acid is much less at , anything eaten or drunk just before bed , even if teeth are brushed , is more damaging.

In general more than 3 to 4 acid attacks a day and you will get decay . So if you limit acid attacks to breakfast , lunch and dine there will not be a problem with decay . What causes tooth damage is grazing or sipping on sugary or starchy foods inbetween meals because then teeth are bathed in acid for hours during the day .

Brushing teeth does not neutralise the acid any quicker (although chewing cheese may do ) but the fluoride deposited on the teeth helps in repairing early enamel damage , however it cannot compensate for a diet where teeth are exposed multiple times a day to sugar/starch.

@Lollygagglecan I ask you a question while you’re here?
dental pain in a filled tooth, dentist has drilled through, removed filling and found nerve isn’t dead. Filled with biodentine. Unsure if it is that tooth but the others have no fillings and no visible cracks or decay
pain on the right when eating on the left, not affected by brushing or heat, throbbing pain
sound like a decent plan?

Biodentine is a brilliant material when decay has gone very close to the nerve and can quite often avoid root treatment .
However any filling where the decay goes close to the nerve can have the potential to help the nerve to die off.

I would expect a filling that is deep enough to need biodentine to take a while to settle down .

unfortunately dentistry is not an exact science and sometimes diagnosing and treating pain is extremely difficult . It makes sense to tackle obvious things first hence treating the tooth that has a filling. A tooth can be in the process of dying and appear ok when first investigating then dying off later. In a multi rooted tooth (a molar or premolar) things can be more complicated in as much as part of the nerve can be dead and part still alive.

Yep it’s a molar
he said the original filling wasn’t that close to the nerve so he had to drill further in which bloody hurt as nerve still alive!
he’s puzzled basically as brushing and hot cold all fine but it’s just throbbing and eating on the other side is excruciating
X-rays show nothing

Very interesting. Thanks

Do study said that this affects 20% of children. I was shocked to hear this because no one in seems to be talking about this.

No because for most people it is a minor discolouration , that may not be noticeable , particularly as the child gets older .

For most of the rest there is cosmetic discolouration which some people may choose to do something about when they are older .

For a small minority they may have to be very careful about diet and getting fluoride or sealants onto molars .

For a tiny minority , in addition to being careful about diet there may be a necessity for dental treatment for the affected teeth, including removal of severely affected .

https://www.leedsth.nhs.uk/patients/resources/molar-incisor-hypomineralisation-mih/

DD 8 has this on one of her front teeth. The dentist keeps a close eye on it & on the rest of her teeth. On her most recent appointment, the dentist suggested that we could use a product called Tooth Mousse (do not use if your child has a milk allergy), which apparently helps to remineralise teeth. I'm going to buy some next week to try it out.