MIH is a common developmental condition affecting primarily one or more first permanent molars. The central incisors may be affected as well, but this usually occurs to a lesser extent. Hypomineralisation of the second deciduous molars (HSPM) or canines may also occur.

Clinical appearance

  • Demarcated opacities, ranging from creamy white to yellow, brown discolouration
  • Defective enamel has normal thickness (unless post eruptive breakdown has occurred)
  • Lesions may occur asymmetrically
  • When a first molar is severely affected, there is an increased chance that the contralateral molar is also affected
  • Lesions of central incisors are usually milder, but they can sometimes be unsightly


  • Hypersensitivity and decreased response to local anaesthesia
  • Rapid caries progression
  • Post eruptive breakdown
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Mild MIH – E. van Amerongen, The Netherlands

Moderate MIH – C. Baroni, Italy

Severe MIH – C. Baroni, Italy

Affected incisors as part of MIH – C. Baroni, Italy

Treatment plan

To provide the right answer to your patient is not always easy.
GC developed the below approach following Minimum Intervention philosophy to guide you in the treatment plan.

  • In-office application
  • Surface protection
  • Prevent sensitivity &
    enamel breakdown


Fuji Triage

Fluid Glass Ionomer for surface protection

  • Fluid, penetrates in fissure & create a protective coating on teeth that helps fight against sensitivity
  • Bonds chemically even in a moist environment
  • Protects teeth even before they are fully erupted
  • The setting of the pink shade of Fuji TRIAGE can be accelerated with the dental curing light, reducing treatment time
  • The pink version is easy to control & monitor in time

MI Varnish

Enhanced fluoride varnish treatment with bio-available calcium and phosphate

  • Desensitizes the teeth thanks to the Recaldent (CPP-ACP) and 22 400 ppm Fluoride content
  • Is easy to apply on clean teeth, even without full OHI procedures
  • Is available in 2 nice strawberry & mint flavours, improving the treatment acceptance by patients
  • The film will disappear in a few days, but the protective effect of CPP-ACP should remain
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  • At-home and in-office use
  • Strengthening with minerals
  • Desensitizing


Tooth Mousse

Protective cream with bio-available calcium and phosphate, without fluoride

  • Can be used below age of 6, as it does not contain fluoride
  • Strengthen teeth by providing constituting minerals (Calcium, Phosphate) present in Recaldent (CPP-ACP)
  • Desensitizes the teeth1,2
  • Gives extra protection, especially against acid attacks3,4
  • Is available in 5 delicious flavours for great patient’s acceptance

MI Paste Plus

Protective cream with bio-available calcium, phosphate and fluoride

  • Contains Recaldent (CPP-ACP) and 900 ppm Fluoride
  • Strengthens the teeth
  • Desensitizes the teeth1,2
  • Gives extra protection, especially against acid attacks3,4 & buffers the pH changes in plaque
  • Impairs the adhesion and growth of Streptococcus mutans and Streptococcus sobrinus to the tooth surface
  • Remineralises enamel lesions (remineralisation)
  • Optimises the way fluoride is transported to enamel and the fluoride intake by enamel
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  • Chemical bond
  • Fast bulk fill
  • Moisture tolerance



Bulk fill glass hybrid restorative system

  • Can be easily applied in bulk, even when moisture control & isolation is not possible
  • Bonds chemically which eliminates the need for a separate bonding
  • Is minimal invasive as only the infected dentin needs to be removed
  • Displays a very low risk of post-operative sensitivity
  • Is fast: a finished restoration is already obtained in 3.5 minutes
  • Uses a protective coating which brings wear resistance and eliminates need of finishing
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Molar Incisor Hypomineralisation – clinical problems, causes and therapeutic approaches by Jan Kühnish

Therapy of pain control & immediate treatment for MIH

An overview of the current diagnostic & therapy according to the Würzburg concept- from prophylaxis to restorations by Katrin Bekes and Norbert Krämer

MIH from clinical appearance to therapy – keep it simple- go easy. From practice to practice by M. Salim Doueiri

MIH: And now? – Practical conclusion on the evolution, frequency and treatment of MIH by Falk Schwendicke

Webinar “Hypomineralised enamel (MIH) – coming to a child near you” – Dr. David Manton

Webinar Minimum intervention multidisplinary dentistry by E. Ruiz de Castañeda

Webinar: “MI” restoration of the deeply cavitated caries lesion by Avi Banerjee

White spot lesions: Enamel defect of just caries? How to deal with them! Part 1 by Esther Ruiz de Castañeda

White spot lesions: Enamel defect of just caries? How to deal with them! Part 2 by Patricia Gatón

Caries – to remove or not? By Falk Schwendicke

Diagnosis tools and minimally invasive dentistry by Hervé Tassery

Minimum intervention oral healthcare (MIOC) – is there consensus? By Avijit Banerjee

The successful minimal invasive dentistry (MI) practice by Elmar Reich

Molar-Incisor-Hypermineralisation – from science to practice by Falk Schwendicke

MIH in 2019 by Patrick Rouas

The challenge of treating elderly by Gert Stel

A different challenge approach towards caries removal – different challenges? By Falk Schwendicke

MI restoration of the deeply cavitated caries lesions by Avijit Banerjee

Minimally invasive treatment and composite management

Minimum Intervention multidisciplinary dentistry by E. Ruiz de Castañeda

How do Tooth Mousse & MI Paste Plus help to remineralise and offer relief from sensitive teeth

How to apply MI Tooth Mousse/MI Paste Plus: remineralizin dental topical crème

How to apply MI Varnish–Topical fluoride varnish treatment with bio-available calcium and phosphate

1. Reynolds EC & Walsh L J: Additional Aids to the remineralisation of tooth structure in Preservation and Restoration of Tooth Structure”, editors: Graham J Mount & W.R. Hume (ISBN 192082474X) Chapter 8, 111-118
2. Clinical effectiveness of a CPP-ACP crème for tooth hypersensitivity treatment. A. Poitevin, M. Peumans, J. De Munck, K. Van Landuyt, E. Coutinho, M. Braem, B. Van Meerbeek. EADR Istanbul, 25-28 August 2004 – Abstract 0136
3. Iijima Y, et al. Acid resistance of enamel subsurface lesions remineralized by a sugar-free chewing gum containing casein phosphopeptides-amorphous calcium phosphate. Caries Res 2004;38:551-556 9.
4. Kariya S, Sato T, Sakaguchi Y, Yoshii E, Fluoride effect on acid resistance capacity of CPP-ACP containing material, IADR, 82nd General Session, Honolulu, 2004 Abstract 2045.