Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their permanent first molars.

TLDR: It is reasonable to assume that experiences of pain and discomfort on repeated occasions were related to the occurrence of BMP in patients with MIH, and an early treatment planning and prognostication based on increased knowledge of hypomineralized first molars is desirable.

Abstract: Summary. Objectives. To assess the demand for restorative treatment, dental anxiety and dental behaviour management problems among children with severe hypomineralization of their first molars (MIH). Design. Case control study. Sample and methods. Data were compiled from the dental records of 32 9-year-old children with severe enamel hypomineralization of their first molars and from 41 controls of the same age group concerning dental health, a number of restorative treatments, use of local anaesthesia and clinical behaviour management problems (BMP). A questionnaire containing specific questions on children’s experiences of dental care and the Children’s Fear Survey Schedule – Dental Subscale (CFSS-DS), was answered by the parents. Results. The children in the study group had undergone dental treatment of their first molars nearly 10 times as often as the children in the control group. Repeated treatments of these teeth at brief intervals were common. The dental treatment was often undertaken without the use of local anaesthesia, and BMP, and dental fear and anxiety (DFA) were more common than in the controls. Conclusions. Children with severe enamel hypomineralization of their first molars had had to undergo a considerable amount of dental treatment. It is reasonable to assume that experiences of pain and discomfort on repeated occasions were related to the occurrence of BMP in patients with MIH. An early treatment planning and prognostication based on increased knowledge of hypomineralized first molars is desirable. Local anaesthesia and other pain-reducing techniques, e.g. sedation, should be used when treating these teeth. Extraction should be considered in cases of extensive disintegration of the crown, in cases of frequently repeated treatments or when pulpal symptoms are hard to cure.