Background: The authors aimed to evaluate dentists' knowledge of, diagnostic confidence in, perception of, and clinical management for molar incisor hypomineralization (MIH) across countries with varying income levels and identify predictors of MIH familiarity. Methods: A cross-sectional online survey was distributed from February 2024 through July 2025 to general dentists, pediatric dentists, and endodontists in 19 countries representing all World Bank income groups. A validated questionnaire assessed demographic characteristics, MIH knowledge using an 85-point scale, diagnostic confidence, perceptions, and management. Data were analyzed using χ2 and Mann-Whitney U tests and generalized linear models. Results: A total of 4,056 dentists participated. Familiarity and diagnostic confidence increased with country income level (P < .001) and were highest among pediatric dentists (P < .001). Knowledge scores varied; they were higher among dentists from higher-income countries, women, pediatric dentists, and those aged 31 through 40 years, with 5 or more years of experience, working in public settings, and holding advanced degrees (all, P < .001). Enamel hypoplasia was the common diagnostic challenge, and fewer than one-half reported using established MIH criteria. Preventive and minimally invasive strategies were frequent in high- and upper-middle-income countries, whereas low- and lower-middle-income dentists relied on basic restorative materials and extensive tissue removal. Pulpal therapy followed standard protocols, although conservative vital pulpal therapy was common in upper-middle-income settings. Respondents from high-income countries cited technical failures often, and those from low-income countries reported greater behavioral barriers. Regression analysis confirmed income level, specialty, and experience as predictors of familiarity and confidence. Conclusions: Substantial global disparities exist in MIH knowledge, diagnostic confidence, and clinical management strategies. Improved training and resource-appropriate guidelines are essential to reduce inequities in MIH care. Practical implications: The authors highlight the need for targeted training and context-specific guidelines to improve MIH diagnosis, confidence, and management, particularly in low-income settings.
Global survey of dentists' knowledge, diagnostic confidence, and management of molar incisor hypomineralization
Yousaf, Muhammad Abrar;
2026-01-01
Abstract
Background: The authors aimed to evaluate dentists' knowledge of, diagnostic confidence in, perception of, and clinical management for molar incisor hypomineralization (MIH) across countries with varying income levels and identify predictors of MIH familiarity. Methods: A cross-sectional online survey was distributed from February 2024 through July 2025 to general dentists, pediatric dentists, and endodontists in 19 countries representing all World Bank income groups. A validated questionnaire assessed demographic characteristics, MIH knowledge using an 85-point scale, diagnostic confidence, perceptions, and management. Data were analyzed using χ2 and Mann-Whitney U tests and generalized linear models. Results: A total of 4,056 dentists participated. Familiarity and diagnostic confidence increased with country income level (P < .001) and were highest among pediatric dentists (P < .001). Knowledge scores varied; they were higher among dentists from higher-income countries, women, pediatric dentists, and those aged 31 through 40 years, with 5 or more years of experience, working in public settings, and holding advanced degrees (all, P < .001). Enamel hypoplasia was the common diagnostic challenge, and fewer than one-half reported using established MIH criteria. Preventive and minimally invasive strategies were frequent in high- and upper-middle-income countries, whereas low- and lower-middle-income dentists relied on basic restorative materials and extensive tissue removal. Pulpal therapy followed standard protocols, although conservative vital pulpal therapy was common in upper-middle-income settings. Respondents from high-income countries cited technical failures often, and those from low-income countries reported greater behavioral barriers. Regression analysis confirmed income level, specialty, and experience as predictors of familiarity and confidence. Conclusions: Substantial global disparities exist in MIH knowledge, diagnostic confidence, and clinical management strategies. Improved training and resource-appropriate guidelines are essential to reduce inequities in MIH care. Practical implications: The authors highlight the need for targeted training and context-specific guidelines to improve MIH diagnosis, confidence, and management, particularly in low-income settings.
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