Tooth enamel is the body’s hardest substance, but in some children it is far from hard enough. And even after many years of research, one still does not understand what it comes from. The condition, or diagnosis, is called molar incisor hypomineralization (MIH). The weak enamel can appear as white and yellow-brown spots on molars and incisors. In others, the teeth may be partially brown with a rough surface. The children have pain when they eat food, when they brush their teeth and examinations at the dentist can be difficult. 14-year-old Jessica from Trøndelag is one of those struggling with this. And she is far from alone. Great pain Jessica’s mother says that they noticed the problems when it became increasingly difficult to be allowed to brush her daughter’s teeth. – She turned away and tightened her cheeks and lips. The pain meant that we, as parents, were not allowed to fully attend. It became a vicious circle, says Bente Amundsen to news. The pain and discomfort became a problem for Jessica. This led, among other things, to her being afraid to visit dentists. Just opening your mouth was a challenge. But with good help, the condition has improved much. Now the two hope to shed light on a topic that for many can be perceived as shameful. The white spot on the front teeth shows a mild degree of the disease. Jessica has struggled the most with the six-year-old molars. Photo: TkMidt Has received hundreds of children Runa Das is a dental specialist in pedodontics and accepts referred children and young people with a wide range of problems related to the mouth and teeth, including dental development disorders such as MIH. Over the past eight years, Das and his colleagues in Trondheim have taken in hundreds of children with MIH. Among them, Jessica. – It affects many people, and is the dental development disorder we see most in children. The Tromsø study shows an incidence of 13.9 per cent. This figure is the starting point, but there are many indications that the incidence is higher, says Das to news. She believes it is a problem that people do not know why this is happening. – That makes it difficult to prevent. The disease affects six-year molars and the permanent incisors. These teeth are formed between the ages of 0 and 4. During this time, many children experience various illnesses. These can be urinary tract infections, bronchitis, ear infections and asthma. It is thought that these may be associated with MIH, but is not sure. Runa Das works at the Competence Center Tannhelse Midt in Trondheim. Photo: Private – Not their parents’ fault For Jessica and Bente, it is important to talk about what they have experienced. They want to help other children and parents. – The hope is that someone can escape the pain our daughter has experienced. We also hope to be able to help remove the taboo and shame that parents may experience – those who wonder if this is their own fault, says Amundsen. Here she is supported by dentist Runa Das. – We experience that parents feel guilt and shame because they have not had the cleaning done well enough. This is not self-inflicted, but an enamel effect that occurs during the formation of the teeth. It’s not about parents not doing a good enough job, and it’s important to make a point, says Das. But a good piece of advice is to seek help as quickly as possible from the public dental health service, because then you have more choices when it comes to treatment. The most important thing is that the child gets help to reduce problems that arise in everyday life, the pedodontist reminds. Pregnant women and vitamin D Much research has been done on the topic, and recently researchers at NTNU tried to find answers. They investigated whether a lack of vitamin D during pregnancy could be a cause. The vitamin plays an important role in the absorption of calcium and phosphate in both teeth and bones. The study was carried out over seven years. 176 pregnant women were examined twice during pregnancy to check the level of vitamin D. After seven years, the children were called in to check their teeth. The study showed that 32 per cent of the children had at least one six-year-old molar with enamel defects. Some association was also found between mothers who had low levels of vitamin D and enamel defects in children. Nevertheless, they cannot conclude. These are two of the teeth that Jessica has had to pull due to MIH. Extraction of bad six-year molars is only one of several treatment options. Photo: Bente Amundsen Banging his head against the wall Because there are several people who have researched the same thing. A study from Denmark and another from the Netherlands show different results. In addition, some of the mothers in the Norwegian research are said to have withdrawn along the way. – We simply do not fully know the cause of this enamel failure. It is incredibly frustrating because we cannot go out with any preventive advice, says Torunn Børsting to Gemini.no. She is a doctoral student at NTNU and a project coordinator at the Competence Center Tannhelse Midt. Other researchers around the world are said to have looked at whether, among other things, lack of oxygen at birth could be the cause. Or whether stress and illness in the mother during pregnancy are decisive. Others have investigated whether low birth weight or genetics can have an effect. No one finds good answers. According to Torunn Børsting, there is only one thing to do: – The riddle continues. The conclusion can wait. You just have to go back to the beginning, apply for funding and do more research. The picture shows a six-year-old grinder where the enamel is crumbling away. Photo: TkMidt
ttn-69
Many children have teeth that almost fall apart – researchers cannot find an answer as to why – news Trøndelag
