Dental Students’ Knowledge, Attitudes and Beliefs Regarding Molar Incisor Hypomineralization (MIH): A Survey in Vienna, Austria

Figures & data

Table 1 Students’ Responses on Knowledge, Attitudes and Believes Toward MIH Diagnosis and Prevalence

Question	Total Response Rate	Percentage Distribution of Positive Answers
		All Students (N=94)	11th Semester (N=20)	12th Semester (N=74)
Are you familiar with MIH?
	98%	92 (98%)	2 (10%)	28 (38%)*
How did you hear about it?
Dental journals		13 (14%)	6 (32%)	7 (10%)
Lectures		81 (88%)	15 (79%)	66 (90%)
Lecture notes		35 (38%)	8 (42%)	27 (37%)
Brochures or pamphlets		6 (7%)	0 (0%)	6 (8%)
Internet		23 (25%)	9 (47%)	14 (19%)*
Books		17 (18%)	5 (26%)	12 (16%)
Dental clinic		67 (73%)	13 (68%)	54 (74%)
Other students		8 (9%)	1 (5%)	7 (10%)
Do you know the clinical features of MIH?
	86%	81 (86%)	15 (79%)	66 (90%)
Do you know if there are clinical criteria to diagnose MIH?
Yes, and I know how to implement them	23%	18 (82%)	1 (50%)	17 (85%)
Yes, but I do not know how to implement them	23%	4 (18%)	1 (50%)	3 (15%)
In clinic, do you know if you can identify a patient with MIH?
Yes	23%	12 (13%)	2 (10%)	10 (27%)
Not sure	57%	54 (57%)	12 (60%)	42 (57%)
How confident do you feel when diagnosing MIH?
Very confident		–	–	–
Confident	23%	1 (5%)	–	1 (5%)
Slightly confident		19 (86%)	2 (100%)	17 (85%)
Not confident at all		2 (9%)	–	2 (10%)
Do you have difficulty distinguishing MIH as a developmental defect of enamel that differs from other tooth conditions?
	77%	72 (77%)	12 (80%)	60 (81%)
Which ones?
Dental fluorosis	77%	18 (25%)	3 (20%)	15 (26%)
Enamel hypoplasia		49 (68%)	8 (53%)	41 (72%)
Amelogenesis imperfecta		52 (72%)	12 (80%)	40 (70%)
Dentinogenesis imperfecta		11 (15%)	3 (20%)	8 (14%)
Are you aware of the prevalence of MIH in Austria?
	32%	30 (32%)	2 (10%)	28 (38%)*
Do you think it would be worthwhile investigating the prevalence in Austria?
	94%	88 (94%)	18 (90%)	70 (95%)
How often do you notice these teeth in clinic?
Monthly basis	23%	3 (14%)	–	3 (15%)
Yearly basis		19 (86)	2 (100%)	17 (85%)
In what proportion of patients do you observe MIH teeth?
<10%	23%	18 (82%)	2 (100%)	16 (80%)
10–25%		4 (18%)	–	4 (20%)
Which of the following features do you most frequently notice regarding severity of the defect?
White demarcation	23%	2 (9%)	–	2 (10%)
Yellow/brown demarcation		11 (50%)	2 (100%)	9 (45%)
Post-eruptive enamel breakdown		9 (41%)	–	9 (45%)
In clinic, have you encountered demarcated hypomineralized defects in permanent teeth other than the first permanent molars and incisors?
	6%	6 (27%)	–	6 (30%)
Name the tooth/teeth
Canines	3%	3 (14%)		3 (15%)
Premolars		3 (14%)		3 (15%)
How frequently do you notice demarcated hypomineralized lesions in the second primary molar tooth in comparison to the first permanent molar tooth?
More frequently	23%	–	–	–
Less frequently		9 (41%)	–	9 (45%)
The same as for the first permanent molar		1 (5%)	–	1 (5%)
Never seen it		12 (55%)	2 (100%)	10 (50%)

Note: Significant differences between 11th and 12th semester (P < 0.05, Chi-squared test) are indicated in bold*.

Table 2 Knowledge, Attitudes and Beliefs on Etiology, Management and Education Need of Students Towards MIH

Question	Total Response Rate	Percentage Distribution of Positive Answers
		All Students (N=94)	11th Semester (N=20)	12th Semester (N=74)
Which factor(s) do you think are involved in the etiology of MIH?
Genetic factors	100%	65 (69%)	14 (70%)	51 (69%)
Chronic medical condition(s) that affect the mother during pregnancy		40 (43%)	8 (40%)	32 (43%)
Chronic medical condition(s) that affect the involved child		21 (22%)	9 (45%)	12 (16%)*
Antibiotics/medications taken by the mother during pregnancy		51 (54%)	7 (35%)	44 (59%)
Antibiotics/medications taken by the involved child		42 (45%)	5 (25%)	37 (50%)
Environmental contaminants		32 (34%)	6 (30%)	26 (35%)
Acute medical condition(s) that affect the mother during pregnancy		16 (17%)	3 (15%)	14 (19%)
Acute medical condition(s) that affect the involved child		7 (7%)	–	7 (9%)
Fluoride exposure		3 (3%)	2 (10%)	5 (7%)
None		1 (1%)	1 (5%)	–
Which material do you use MOST in treating MIH molars?
Amalgam	23%	–	–	–
Composite resin		13 (59%)	1 (50%)	12 (60%)
Flowable composite resin		9 (41%)	–	9 (45%)
Glass Ionomer Cement		4 (18%)	–	4 (20%)
Compomer		7 (32%)	1 (50%)	4 (20%)
Resin Modified Glass Ionomer Cement		5 (23%)	1 (50%)	4 (20%)
Preformed crowns		9 (41%)	–	9 (45%)
Which factors influence your choice of restorative material?
Adhesion	23%	10 (45%)	1 (50%)	9 (45%)
Aesthetics		7 (32%)	1 (50%)	6 (30%)
Patient/parent preference		7 (32%)	1 (50%)	6 (30%)
Durability		14 (64%)	1 (50%)	13 (65%)
Remineralization potential		6 (27%)	1 (50%)	5 (25%)
Sensitivity		7 (32%)	1 (50%)	6 (30%)
Personal experience		8 (36%)	2 (100%)	6 (30%
Research findings		7 (32%)	1 (50%)	6 (30%
Do you think MIH is a clinical problem?
	23%	20 (91%)	1 (50%)	19 (95%)
If yes, what do you experience problems with?
Diagnosis	23%	8 (40%)	–	8 (42%)
Aesthetics		5 (25%)	–	5 (26%)
Achieving adequate local anesthesia		2 (10%)	–	2 (11%)
Determining the restorative margins of affected enamel		5 (25%)	–	5 (26%)
Providing adequate restorations		5 (25%)	–	5 (26%)
Long-term success of restorations		14 (64%)	2 (100%)	12 (60%)
Achieving patient comfort (for function, oral hygiene)		8 (36%)	2 (100%)	6 (30%)
Would you suggest including clinical training regarding MIH in your dental course?
Diagnosis	96%	85 (90%)	17 (85%)	68 (92%)
Etiology		44 (47%)	11 (55%)	33 (45%)
Treatment		85 (90%)	19 (95%)	66 (89%)

Note: Significant differences between 11th and 12th semester (P < 0.05, Chi-squared test) are indicated in bold*.