Abstract:

Molar–incisor hypomineralization (MIH) is a qualitative, systemically induced enamel defect affecting one or more first permanent molars and often the permanent incisors, frequently associated with demarcated opacities, post-eruptive enamel breakdown and marked hypersensitivity, which complicate oral hygiene and dental treatment and negatively affect quality of life. The aim of this case report was to demonstrate the effect of a combined protocol of professional fluoride varnish application and home use of CPP-ACP (Tooth Mousse®) on MIH-related tooth hypersensitivity. A 7-year-old girl with a history of acute lymphoblastic leukaemia in remission presented with hypersensitivity of the first permanent molars. Clinical examination revealed extensive demarcated opacities with creamy-yellow to yellow-brown discoloration and porous, matte enamel surfaces, consistent with MIH, and baseline sensitivity scores of 2–3 on the Schiff Cold Air Sensitivity Scale (SCASS). The patient was treated with four weekly professional applications of 5% sodium fluoride varnish (Clinpro™ White Varnish) combined with daily home use of CPP-ACP cream (GC Tooth Mousse®) for 12 weeks and a 1450-ppm fluoride toothpaste. Reapplication of the fluoride varnish was performed at 3 months following the four-application protocol. Subjective improvement was reported after the first week, while after one month SCASS scores decreased to 1 for all first permanent molars and remained stable at the 6-month follow-up, with almost complete resolution of discomfort. In conclusion, the combined use of professional 5% NaF fluoride varnish and home-applied CPP-ACP resulted in a clinically meaningful and sustained reduction of MIH-related hypersensitivity, supporting this minimally invasive, biologically based approach as an effective strategy for managing sensitivity and improving enamel stability in children affected by MIH.
Keywords: MIH, tooth hypersensitivity, fluoride varnish, Tooth Mousse