Integrated Management of Molar-Incisor Hypomineralisation in a Paediatric Patient: A Case-Based Perspective

Molar-incisor hypomineralisation (MIH) is a prevalent dental condition that poses significant management challenges. This case report details the multidisciplinary management of an 11-year-old female patient diagnosed with MIH, presenting with severe pain associated with the lower right first molar. Clinical examination revealed extensive enamel defects, characterised by demarcated yellowish and whitish hypomineralised areas on her incisors and molars, alongside significant dental caries. A comprehensive treatment plan was developed, involving preventive measures such as oral hygiene education and dietary counseling, alongside restorative interventions. Initial management focused on alleviating pain and restoring function, which included the extraction of nonrestorable teeth and the placement of resin restorations in affected molars. Additionally, the application of fluoride varnishes, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) was implemented to enhance enamel remineralisation. Behavioural management strategies were introduced to address the patient's dental anxiety, stemming from previous negative experiences with anaesthesia. Follow-up appointments were scheduled to monitor the effectiveness of treatments and to reinforce oral hygiene practices. The patient's symptoms improved, root canal and restorative procedures were successfully completed and orthodontic treatment was initiated. She remains under regular follow-up, demonstrating good cooperation and stable progress. This case emphasises the importance of early diagnosis and a collaborative approach in the management of MIH. By integrating restorative dentistry, preventive care and psychological support, the management plan is aimed not only at addressing the immediate dental concerns but also at improving the patient's overall quality of life and long-term dental health.