This can be especially challenging in paediatric dentistry thus more specialised methods may be needed to increase the efficiency of anaesthetising teeth.Opacities due to MIH can be quite visible especially on anterior teeth which could present as a problem aesthetically. Patients frequently claim aesthetic discomfort when anterior teeth are involved. The discoloured appearance of the anterior teeth could also have negative effects on a child’s psychological development and self-esteem. Tooth breakdown and restoration problems
MIH-affected teeth are more prone to breakdown as they are hypomineralised which weakens the enamel structure. Restorations placed on MIH-affected teeth were found to be more prone to failure due to both loss of tooth structure and material loss. The enamel can also fracture more easily due to chewing forces. Causes
The exact cause of MIH is unknown but thought to be multifactorial.Pre-natally: risks, such as infection, maternal psychological stress and frequent exposure to ultrasonic scans were all correlated with increased risks of MIH. During the perinatal stage, Pitiphat found that cesarean section and complications during vaginal delivery could contribute to an increased chance of MIH. Children born preterm and those with poor general health or systemic conditions in their first 3 years of development also run a higher risk of developing MIH. It has also been proposed that developmental dental defects were associated with long-term breastfeeding due to exposure to dioxin. More recent evidence has suggested a relationship between respiratory diseases and oxygen shortage of the ameloblasts and MIH.
Schilders disease may refer to two different diseases described by Paul Schilder:

Adrenoleukodystrophy
Diffuse myelinoclastic sclerosis