One of the recently identified conditions in the field of dentistry is Molar-Incisor Hypomineralization (MIH). This disorder was officially recognized in 2001 by Professor Henrik Weerheijm and his research team at the Academic Centre for Dentistry Amsterdam (ACTA) in the Netherlands, through their groundbreaking study that described the condition for the first time. This marked the beginning of growing awareness around the issue of enamel hypomineralization in children.
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Understanding the Possible Causes
Since then, MIH has become a major subject of interest in medical and scientific circles. Researchers are striving to uncover its potential causes—ranging from environmental to genetic factors—while also working on effective treatment strategies for its associated symptoms, such as severe tooth sensitivity and increased risk of cavities. This ongoing research is helping to shed light on the mechanisms of the condition and how to prevent it.
Is Vitamin D the Main Culprit?
Recent studies suggest that vitamin D deficiency during childhood is a key risk factor for developing MIH. Vitamin D plays a crucial role in regulating the absorption of calcium and phosphorus—two minerals that make up more than 90% of tooth enamel.
Evidence from Labs Around the World: Saudi Arabia, Japan, Switzerland
Switzerland: A 2024 study from the University of Zurich, led by Professor Benjamin Sluska and published in BMC Oral Health, found that vitamin D deficiency increases the risk of MIH by up to 43%.
Saudi Arabia: A 2023 systematic review published in Children – MDPI, led by Dr. Ahmed Al-Ali from King Abdulaziz University, confirmed that low vitamin D levels at birth are associated with a higher risk of developing MIH.
Australia: In a 2025 study published in Clinical Oral Investigations, Dr. Sophie Hammond showed that sun exposure during a child's first two years reduces the risk of MIH by 38%.
Japan: A 2024 study from Osaka University, led by Dr. Yamamoto and published in the Paediatric Dental Journal, warned against the early use of antibiotics, which can negatively affect vitamin D levels and increase the incidence of MIH.
USA: A 2023 study by Columbia University, published in BMC Oral Health, found that children with vitamin D deficiency are 22% more likely to suffer from dental caries, especially in primary teeth.
A Global Epidemic: Alarming Numbers
A global study led by Dr. Wenjundong Zhao from Anhui Medical University in China (2017), published in the International Journal of Paediatric Dentistry, revealed that 12.9% of the world’s children are affected by MIH, with rates as high as 20% in parts of South America.
The author of this article suspects even higher prevalence in the Arab world, pending a major upcoming study by King Saud University’s College of Dentistry on MIH epidemiology in Gulf Cooperation Council countries.
The devastating effects of this condition are not just cosmetic—it can affect nutrition, mental health, and cause dental fear from an early age due to the need for intensive dental treatments at a very young age.
The Rescue Plan: Protecting Children’s Teeth Starts Today
In its 2025 annual report for World Oral Health Day (March), the World Health Organization recommended the following steps to protect children from MIH:
Early diagnosis: Visit the dentist before age 6 and before the eruption of permanent teeth.
Sun exposure: 15 minutes of daily sunlight (under medical advice).
Vitamin D screening: Test and supplement if deficient—particularly important in Arab countries, where despite abundant sunlight, up to 90% of people are deficient due to sun avoidance.
Preventive care: Regular fluoride use and periodic dental checkups.
Advanced treatments: Use of resistant fillings or crowns (ceramic or metal) for advanced MIH cases.
Final Word
Molar-Incisor Hypomineralization is not merely about white spots—it may be an early indicator of a serious vitamin D deficiency that threatens bone development and overall health. Prevention starts from day one of a child’s life, through proper nutrition and consistent exposure to sunlight.
