Fissure Sealants for Managing Hypersensitivity and Posteruptive Breakdown in MIH-Affected Molars

Abstract

Molar incisor hypomineralisation (MIH) is defined as hypomineralisation of systemic origin of one to four first permanent molars with or without the involvement of the permanent incisors. In addition to opacities and posteruptive breakdown, hypersensitivity may be a common problem, especially in the molars. Children then often report that hot and cold drinks and meals, toothbrushing, and even air flow cause pain. Therapy approaches to reduce and stop the hypersensitivity include the sealing of affected teeth. Fissure sealants can be placed in mildly affected molars that show no breakdowns in the occlusal surfaces. Thereby, resin-based sealants can be considered for fully erupted teeth, whereas glass ionomers are the treatment of choice in difficult clinical conditions as an interim treatment where isolation is inadequate and the molar has not fully erupted. The aim of this chapter is to describe the phenomenon of hypersensitivity in MIH-affected teeth, to discuss treatment approaches including the placement of sealants as well as the management of posteruptive breakdowns, and to present data on oral health-related quality of life in children suffering from hypersensitivity.