Microabrasion
The aesthetics of a child’s anterior teeth is a concern for both children and their parents alike. Yellow or brownish-yellow defects are of full thickness, and therefore may respond to bleaching with carbamide peroxide. However, careful consideration should be made of the risks including hypersensitivity, mucosal irritation and enamel surface alterations.Creamy-yellow or whitish-creamy defects are less porous and variable in depth, and may respond to microabrasion with 18% hydrochloric acid or 37.5% phosphoric acid and abrasive paste. Again, this should be undertaken cautiously as microabrasion may result in loss of enamel. Veneers
Direct or indirect composite veneers can be effective in improving aesthetics with minimal tooth tissue removal. Ceramic veneers as a treatment option should be delayed due to the risks of resulting in a short clinical crown height, immature tooth pulp irritation and also the instability of the gingival margins during the eruption of teeth. Posterior teeth
Fissure sealants
The placement of fissure sealants on permanent molars without post-eruptive breakdown should be undertaken. Use of a 5th generation bonding adhesive prior to fissure sealant application may improve retention rates of fissure sealants.For partially erupted molars with inadequate moisture control, glass ionomer cements (GIC) can be considered as an interim treatment option. As the retention rate of GIC is often poor, replacement with a resin-based fissure sealant is recommended following tooth eruption.Resin-based fissure sealants can be beneficial to patients affected with mild MIH where the first permanent molars have fully erupted, although the degree of hypomineralization affects the bond strength of said sealants.
Lastly oxygen shortage combined with low birth weight is suspected to be a contributing factor

Diagnosis
Differential diagnosis
It is essential to exclude other causes of enamel opacities, differentiating MIH from them, to ensure an appropriate treatment plan is made. These conditions include:

Dental caries, which is the most common cause of destruction of dental hard tissues. This is more unlikely in a patient with a previously intact primary dentition. White spot lesions are also uncommon on incisors, hence ruling out dental caries. Fluorosis, which can result from an intake of a high fluoride concentration while the tooth is still undergoing mineralisation. Fluorosis presents as irregular, diffuse enamel opacities which affect more than 1 tooth, in contrast to the well-demarcated borders of hypomineralised enamel seen in MIH. Amelogenesis imperfecta, a genetic condition, and thus there may be a history of similar defects in other family members. This condition affects both the primary and permanent dentition, and all surfaces tend to be equally affected, differentiating it from MIH. Trauma to primary incisors resulting in discolouration of permanent incisors. Administration of tetracycline during pregnancy and to children under 6 resulting in tooth staining (grey or yellow). Enamel hypoplasia, caused by defective enamel matrix formation, is a quantitative defect which presents as a localised reduction in enamel thickness. This differs from hypomineralisation, which is a qualitative defect affecting the translucency of enamel. Classification
MIH examination should be carried out on clean, wet teeth.