Perception, knowledge and attitudes of Ecuadorian dentists towards patients with molar incisor hypomineralization

Molar Incisor Hypomineralization (MIH) is one of the most prevalent enamel development defects in contemporary dental practice. Understanding perceptions, knowledge, and attitudes of professionals towards this condition is key to optimizing clinical protocols and improving therapeutic results.

To evaluate the perception, knowledge and attitudes of Ecuadorian dentists about diagnosis and management of patients with MIH.

A cross-sectional observational study was carried out using a self-administered survey of registered dentists in Ecuador. A validated 19-question questionnaire was applied that explored demographic characteristics, knowledge of etiology and prevalence, attitudes towards clinical management, and therapeutic choices. In addition, two clinical cases with photographic support were included to evaluate treatment decisions. The statistical analysis incorporated descriptive statistics, chi-square or Fisher's exact tests, and multivariate logistic regression models.

A total of 352 dentists participated, predominantly working in private practice (71.9%), particularly in general dentistry (61.1%). Most practitioners reported observing MIH monthly (45.7%) and perceived an increase in its occurrence (67.0%). Demarcated opacities were the most frequent clinical manifestation (93.2%), with antibiotics being the main reported etiological factor (31.8%). The frequency of observation varied significantly between specialties (p < 0.05). Management was considered difficult, with durability of restorations being the main concern. Glass ionomer (37.5-71.4%) was the primary therapeutic choice, followed by fluoride varnish (22.6-37.5%). In the multivariate logistic regression model, professionals with 6-10 years of experience showed significantly higher odds of adequate knowledge (adjusted OR = 2.23, 95% CI: 1.14-4.37, p = 0.019). No independent predictors of favorable attitude towards MIH management reached statistical significance after multivariate adjustment.

MIH is recognized as a growing and complex problem. It is frequently observed with demarcated opacities as the predominant sign and antibiotics as the main etiological factor. Its management is challenging, and professional experience appears to influence clinical knowledge. Continuing education and the development of standardized clinical protocols are needed to strengthen professional competence in MIH management.