[2] This developmental condition is caused by the lack of mineralisation of enamel during its maturation phase, due to interruption to the function of ameloblasts.

[1] Peri- and post-natal factors including premature birth, certain medical conditions, fever and antibiotic use have been found to be associated with development of MIH.

It is important for the children who are suspected to suffer from MIH to visit their dentist at regular intervals to prevent any further complications affecting their oral health.

[10] Post-eruptive breakdown (PEB) is a clinical feature, often observed in the majority of severely affected cases and requires prompt dental treatment.

Progression of the carious lesion is also more rapid in teeth with MIH as patients may experience tooth sensitivity while carrying out oral hygiene, causing them to avoid doing so and consequentially accelerating the decay.

A study has suggested that a possible cause of hypersensitivity in MIH is the inflammatory reactions in the pulp due to oral bacteria penetrating through the hypomineralised enamel into the dentinal tubules.

Additionally, postnatal factors such as urinary tract infection, otitis media, measles, kidney disease, pneumonia, asthma, antibiotic use, and fever have all been associated with MIH.

During the perinatal stage, Pitiphat found that cesarean section and complications during vaginal delivery could contribute to an increased chance of MIH.

[10] Lastly, oxygen shortage combined with low birth weight is suspected to be a contributing factor [26] It is essential to exclude other causes of enamel opacities, differentiating MIH from them, to ensure an appropriate treatment plan is made.

Various systems commonly employed in studies include: Prevention is of prior importance at an early developmental age as the defective tooth is more likely to have caries and post-eruptive breakdown due to its increased porosity.

Factors may include condition severity, the patient's dental age, the child and parent's social background and expectations.

[38] Involves repeated cycles of etching with 37% phosphoric acid followed by applying 5% sodium hypochlorite until improvement of discolouration is achieved.

[42] However, careful consideration should be made of the risks including hypersensitivity, mucosal irritation and enamel surface alterations.

[46] Direct or indirect composite veneers can be effective in improving aesthetics with minimal tooth tissue removal.

[47] Ceramic veneers as a treatment option should be delayed due to the risks of resulting in a short clinical crown height, immature tooth pulp irritation and also the instability of the gingival margins during the eruption of teeth.

[48] For partially erupted molars with inadequate moisture control, glass ionomer cements (GIC) can be considered as an interim treatment option.

As the retention rate of GIC is often poor, replacement with a resin-based fissure sealant is recommended following tooth eruption.

[55][23] GIC materials have adhesive capabilities with both enamel and dentine, long-term fluoride release and hydrophilicity when there is inadequate moisture control intra-orally, during early post-eruptive stages.

[33] Studies with long-term follow-up times on the survival rates of GIC restorations of MIH-affected molars are lacking.

[56] The use of preformed metal crowns on MIH-affected molars can prevent further tooth loss, control hypersensitivity and aim to establish correct interproximal and occlusal contact.

Although the PMC has evidence to show that it is well accepted, a few of the children and their carers expressed their concerns about the metallic appearances of the restoration.

[59] A list of considerations can affect the final decision on whether extraction of the affected teeth should be carried out or should it be retained such as: severity of MIH; patient's aesthetic expectations; whether the patient is suitable to undergo orthodontic treatment; orthodontic concerns (e.g. crowding, facial profile, missing or supernumerary teeth, presence of third molars).

[52] A favourable occlusion may be acquired following a well-planned treatment and this eliminates the need for fixed orthodontic appliances therapy.

While MIH has a high prevalence across the globe, heavily populated countries such as those with low and middle incomes carry the highest burden.

However, a study by Kathmandu University reports that post eruptive breakdown occurs more frequently in boys than it does in girls.