Peer-reviewed article

Are childhood diseases associated with Molar-Incisor Hypomineralization? – Results from an observational study

Elena Pernegger, Nour Ammar, Karl-Ferdinand Fresen, Ramy Gaballah, Helen Irina Schill et al. · 7 Oct 2026

Summary

Written by AI, not yet AICS's view · claude-sonnet-5-5

This observational study looked at whether illnesses and medicines in early childhood are linked to molar incisor hypomineralization (MIH), a developmental defect of tooth enamel. In Bavaria, Germany, 5,418 children aged 8 to 10 had their teeth examined, and parents were asked to complete a questionnaire. 1,315 questionnaires were returned, and 20.0% of these children had MIH. Several childhood diseases and antibiotic use in the first two years of life were statistically linked to MIH. The authors conclude that these links involve small numbers of children and cannot explain the overall MIH prevalence, so the cause of MIH remains unclear.

Key points

263 of the 1,315 children with complete questionnaires (20.0%) had MIH, with an average of 3.3 affected teeth.
Bronchitis was associated with MIH (IRR 1.25, 95% CI 1.07–1.46).
Otitis media was associated with MIH (aOR 1.91, 95% CI 1.30–2.80).
Antibiotic use in the first year of life was associated with MIH (IRR 1.45; aOR 1.86), and use in the second year was also associated (IRR 1.35; aOR 1.36).
The associations mostly involved low case numbers and cannot explain the 20.0% prevalence, so the causes of MIH are still unclear.

Limitations

This is an observational study based on parent-reported illnesses and medication, and only 1,315 of 5,418 examined children had returned questionnaires. It cannot show that any disease or medicine causes MIH, and it covers Bavarian children only.

Abstract

Abstract Objective This observational study aimed to investigate the potential association between reported childhood diseases and medications during early infancy and the later appearance of molar incisor hypomineralization (MIH). Materials and methods As part of a prospectively designed epidemiological study, 5,418 Bavarian children aged 8 to 10 were examined for the presence of caries (WHO standard) and MIH (EAPD criteria). In addition, each child received a questionnaire to be completed by their parents. A total of 1,315 questionnaires were returned, containing complete information on childhood diseases, medication and socioeconomic status. Marginalized zero-inflated negative binomial regression models were constructed. Results A total of 263 children (20.0%) were diagnosed with MIH, with a mean of 3.3 (± 2.0) MIH-affected teeth. In cases of bronchitis (IRR 1.25 with 95% CI 1.07–1.46), otitis media (aOR 1.91 with 95% CI 1.30–2.80), eye diseases, allergies, speech disorders, worm infections and cardiac diseases, significant associations were found for the presence of MIH. In addition, a significant association between antibiotic use and MIH was confirmed (first year of life: IRR 1.45 with 95% CI 1.15–1.83; aOR 1.86 with 95% CI 1.13–3.05/second year of life: IRR 1.35 with 95% CI 1.05–1.77; aOR 1.36 with 95% CI 1.05–1.77). Conclusions The associations were mostly associated with low case numbers and accordingly cannot explain the documented MIH prevalence of 20.0%. Therefore, childhood diseases and antibiotic use probably do not solely contribute to MIH development. Clinical relevance MIH aetiology remains unclear, indicating a need for further research.