title: Trends of oral health care and dental treatment needs in relation to molar incisor hypomineralisation defects: a study amongst a group of Iraqi schoolchildren.
abstract: BACKGROUND
  The dynamic properties of molar-incisor-hypomineralisation lesions (MIH) may impact negatively on personal daily oral care resulting in increased treatment needs.
  
  
  OBJECTIVE
  To describe and compare individual oral health care practices between MIH-affected and non-affected children, to evaluate and compare dental treatment needs between hypomineralised and non-hypomineralised first permanent molars, and to explore the role of reported fluoride exposure in the development of MIH.
  
  
  METHODS
  A cluster sample of 7-9 year-old Iraqi schoolchildren (823 of 1000 eligible, response rate 82.3%) had their first permanent molars and incisors evaluated using the European Academy of Paediatric Dentistry evaluation criteria for MIH. Of these 153 were diagnosed with the defect and were referred to as MIH-affected children.
  
  
  METHODS
  Mothers of the participating children were asked to complete an oral health-questionnaire administered at schools. This included questions regarding child's history of dental visits, fluoride intake and the pattern of oral hygiene practices. Assessment of the dental treatment requirements for the first permanent molars was performed in a sample subset drawn from a larger data set of affected children (n=100) having their teeth assessed previously for dental caries status following the International Caries Detection and Assessment System. The sample subset consisted of 130 hypomineralised molars and 270 non-hypomineralised molars.
  
  
  RESULTS
  Of the total sample, approximately 71% of parents had taken their children to the dentist at some stage. For the total sample, tooth restoration or extraction was the most likely causes for seeking dental care at the first dental appointment (57.9%). Tap water was the main source of water consumed at home by the majority of children (77.8%). The prevalence of dental caries and tooth restorations was higher in hypomineralised affected molars (78.5%) than in the defect-free molars (33.7%).
  
  
  METHODS
  MIH-affected children reported significantly higher frequency of seeking dental care than their non-affected counterparts (82.4%, 68.2%; respectively). They were over three times (OR = 3.18) more likely to visit the dentist complaining of pain and were over six times (OR = 6.37) more likely to seek dental care due to tooth sensitivity than their non-affected peers. No significant differences were found between the study groups in terms of tooth brushing and toothpaste history with brushing frequency "once-a-day" was commonly reported in both groups (75.5%). Early exposure to fluoridated water appeared to have a protective effect for MIH (OR=0.38). Affected molars required more than twice the amount of restorative care than unaffected molars.
  
  
  CONCLUSIONS
  MIH did not seem to have an impact on the personal daily oral hygiene practices; however, MIH patients were commonly seeking dental consultation and needed care more often to improve their oral health.
authors.affiliation: The University of Melbourne, Victoria, Australia. dentagh@gmail.com
authors.forename: A M
authors.initials: AM
authors.lastname: Ghanim
authors.forename: D J
authors.initials: DJ
authors.lastname: Manton
authors.forename: M V
authors.initials: MV
authors.lastname: Morgan
authors.forename: R J
authors.initials: RJ
authors.lastname: Mariño
authors.forename: D L
authors.initials: DL
authors.lastname: Bailey
mesh_terms: D000367:Age Factors; D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003729:Dental Care / Q000706:statistics & numerical data / Q000639:trends*; D003744:Dental Enamel Hypoplasia / Q000473:pathology / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data; D005459:Fluorides / Q000627:therapeutic use; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007223:Infant; D007493:Iraq; D009910:Oral Hygiene / Q000706:statistics & numerical data / Q000639:trends*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D013997:Time Factors; D014081:Tooth Extraction / Q000706:statistics & numerical data; D014098:Toothache / Q000628:therapy; D014099:Toothbrushing / Q000706:statistics & numerical data; D014100:Toothpastes / Q000627:therapeutic use
chemical_list: D002327:Cariostatic Agents; D014100:Toothpastes; D005459:Fluorides