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Prevalence, Clinical Presentation, and Associated Sociodemographic Characteristics of Molar Hypomineralization in Indiana, USAAhmed, Azza Tagelsir Mohamed 05 1900 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / Molar Hypomineralization (MH) of the first permanent molars (FPMs) and the
second primary molars (SPMs) is a common developmental defect of enamel, with global
prevalence of 14% and 5% respectively. Children with MH represent a special pediatric
population because their affected molars have extreme susceptibility to enamel
breakdown, decay and tooth sensitivity. Although the problem of MH has been described
almost twenty years ago mainly through reports from Europe, there is very little
information about the problem from the USA. In this dissertation, MH was explored both
from the perspectives of pediatric dentists’ (PDs) and at population level. The majority of
the survey respondents perceived MH prevalence to be <10% in their clinical practice
(62%). The most cited clinical challenge in managing MH teeth was “long-term success
of restorations” (79%). When analyzed individually, responses differed significantly for
different demographics and educational characteristics of the respondents (p<0.05). At
population level, MH of the FPMs (Molar Incisor Hypomineralization (MIH) cohort: 337
schoolchildren, average age 9 years) and of the SPMs (Hypomineralized Second Primary
Molar (HSPM) cohort: 423 schoolchildren, average age 7 years) had prevalence estimates
of 13% and 6% respectively. In the MIH cohort, water fluoridation or non-Hispanic
Black race/ethnicity was significantly associated with higher collective prevalence of
enamel defect (EDs) (P<0.05), but not with the prevalence of MH of the FPMs. In the
HSPM cohort, race/ethnicity was significantly associated with higher overall prevalence of EDs of SPMs, but not with the HSPM prevalence. Older age group (>10 years), living
in central Indiana, and water fluoridation were significantly associated with higher
overall prevalence of EDs (P<0.01), but not with the HSPM prevalence. Caries
experience was significantly higher in children with MH of FPMs and/or SPMs than in
the group without MH. We concluded that USA pediatric dentists’ respondents were well
aware of the MH problem, but demonstrated discrepancies in different aspects of the MH
problem. At population level, MIH and HSPM were common presentation with
prevalence estimates similar to the global figures. Certain demographic characteristics
were significantly associated with the overall prevalence of the enamel defects of the
examined teeth.
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