I was blamed for my son’s crumbling teeth – but a common condition was to blame

I was blamed for my son’s crumbling teeth – but a common condition was to blame

One in eight children are affected by MIH, a condition causing sensitive and discoloured teeth. When my son was diagnosed, my mum guilt went into overdrive

‘Did you have any complications in your pregnancy? How was your labour? Did you take any medications or have any illnesses before or after your baby was born?’ These are questions that the dentist fired at me as she peered into my seven-year-old son’s mouth. My pregnancy? What on earth did that have to do with his toothache? I wondered.

I started racking my brain to think of anything, but my pregnancy had been really straightforward – he was a healthy baby, and now a healthy child. But her suggestion that I could have unknowingly done something to his teeth when he was still in the womb broke my heart. I burst into tears right there in the examination room.

Ollie has a condition called molar incisor hypomineralisation (MIH) on two of his adult back teeth. I realised it was a problem when he was around seven and complained of pain when he ate foods like ice cream. When I asked him to open his mouth, I was horrified to see that a new molar on the bottom right of his mouth was brown. I was shocked. I’m so careful with sugary foods and drinks – I couldn’t understand what had gone wrong.

MIH causes teeth to develop with poor quality enamel, making them extra sensitive and discoloured – it most commonly affects the first adult molars (back teeth) and incisors (front teeth). While it was easy for the dentist to diagnose, the cause is still unclear. Factors such as difficulties during pregnancy or labour and frequent childhood illnesses up to the age of three years can be a factor, though no one really knows. Sadly, our dentist didn’t explain that to me when she diagnosed it at our first appointment, so my mum guilt went into overdrive.

MIH appears to be something of a mystery

I went home and immediately started trying to find out as much as I could about MIH. I learned it has nothing to do with brushing or dental care and the causes could vary from being genetic, developmental or environmental. MIH appears to be something of a mystery.

One in eight children in the UK is affected by MIH, which equates to around one million kids according to the British Society of Paediatric Dentistry. As well as causing tooth sensitivity, it can also lead to more cavities in teeth and tooth decay because the enamel is softer than normal. The teeth may also appear chalky and be more crumbly.

Dental practitioner and founder of Icy Bear Dental Dr Hanna Kinsella says it’s a condition she’s seeing more frequently than she used to: “Research shows that about 10-20 per cent of children may be affected by MIH, but because it often doesn’t show symptoms right away, it can easily go unnoticed. As a mother, I’m particularly concerned about how many families are unaware of this condition until it’s too late,” she says.

Kat Storr (right) believes the 5:1 ratio trick has improved her relationship with her husband Matt (left)
Kat, pictured with her husband, doesn’t yet know if her two younger sons are affected by MIH

Dr Kinsella, who specialises in prosthodontics (the restoration and replacement of teeth), says it’s frustrating that experts can’t pinpoint a cause of MIH. “There are a number of potential factors, including genetic predisposition, environmental influences, and even health issues or antibiotics taken during childhood,” she explains. “It’s a tricky condition because it doesn’t have a single cause that we can point to, and that makes it hard to prevent.”

Some research has shown that premature birth, low birth weight or maternal illness such as gestational diabetes can increase risk. This means enamel cells and their function can be damaged even before a tooth has erupted through the gum. 

While I now feel reassured that I wasn’t to blame for the issue, I still feel upset for my son. He’s had numerous X-rays and appointments to try to work out what’s best for the affected teeth. He’s been so brave so far but the dentist has had to use local anaesthetic injections and gas and air when trying to fill or cap the worst-affected molar. We’re waiting to find out what the next option is but at the last appointment the dentist (the fourth one we’ve seen) said she thinks extraction under general anaesthetic might be the best option.

Elin, a mother of two, says her eight-year-old daughter was diagnosed with MIH in her front two teeth and four of her adult molars. “We first realised that there was something not right with her teeth when she was six or seven,”she says. “Her front two teeth are very discoloured and uneven.”

The family saw a number of dentists before they were told “it was worst case scenario and that one molar was effectively crumbling already, another was in bad shape and the top two were also affected”.

They were told their options were “single tooth extractions under local anaesthetic during different appointments on the NHS – something the dentist explained would be pretty awful for our daughter – or that we went private and got them all extracted under general anaesthetic”.

The family opted to have all four of the back teeth removed and were reassured that the gaps will be filled with other teeth as they realign themselves. However, Elin, who lives in South Wales, says her daughter’s discoloured front teeth will need different treatment when she’s slightly older. But it’s had a big impact on her daughter: “She gets asked often by classmates why her teeth are yellow and has been losing her confidence. She doesn’t smile showing her teeth anymore and cries before bed each time someone says something.”

Elin, like me, has been frustrated with the lack of information about MIH and the parental shame that surrounds it. “I’ve seen three dentists in total and have been told it could be trauma during pregnancy, a virus during pregnancy or a virus during my baby’s early life,” she says. “The only ‘trauma’ I can think of was my c-section (planned, so it was actually really smooth and fine). I didn’t have any illness during pregnancy and she had bronchitis at two months old.”

Neither of us will ever know what’s caused these issues in our children but we both feel like we have to emphasise to friends and family that it’s not our children’s diet or neglect on our part. “I’m forever explaining to people what the condition is so they don’t judge me. And I’m really paranoid about her having sweet stuff which is probably OTT but I just want to protect her teeth as much as I can,” Elin explains.

While it’s not known how to prevent MIH, there are a number of ways it can be treated, and extraction is usually only a last resort.

Jessica Large, a specialty registrar in paediatric dentistry and doctoral researcher at Loughborough University, says teeth which are only mildly affected can be protected with fissure sealants (protective coatings on back teeth). A filling or crown might be needed to repair any damage to the tooth.

There are also treatments available to help mask or cover yellow patches on front teeth. “Treatment planning for MIH can be complex and referral to a specialist in paediatric dentistry is recommended in these cases,” she says.

The BSPD recommends a dental check when your child’s first milk teeth start to come through. The organisation says this also “ensures that children with MIH or any other dental condition can be diagnosed early and, with their parents, can receive preventive advice at the optimum time”.

We’re still waiting for a decision on what’s best for Ollie but I’m hopeful that this will be a small hurdle and that no more of his adult teeth will be affected. We’re yet to know if his six-year-old twin brothers will be affected too.

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