There are obvious differences in the MIH prevalence among previously published studies, possibly due to differences in the populations, research methods, diagnostic criteria, etc. Compared to unaffected children, children with MIH had higher risks of caries and required more dental treatments [15]. Severe MIH can affect both the quality of life and oral function in children [16]. Without intervention, after two years, molars affected by mild MIH progress to moderate or severe MIH, with enamel breakdown [17]. If we do not initiate preventive measures, the cost of treating MIH will become a heavy burden on the country and the individuals [18]. Therefore, it is important to study the aetiology, treatment, and awareness of MIH.
Judging from the current data, the situation is not optimistic. Although 80% of students had heard of MIH, only 20% of the respondents thought they could accurately evaluate it. Student enthusiasm for learning MIH-related knowledge was very high, which showed that we need to increase the teaching of MIH-related theoretical knowledge.
For the question of "How often do you encounter MIH clinically?", the results showed a far lower frequency than the frequency experienced by the authors in encountering patients with MIH in clinical settings. This discrepancy might be explained by several reasons. First, the authors work in the paediatric dentistry department; thus, we have come into contact with a large number of patients with MIH. Second, the authors have a better understanding of the theoretical knowledge of MIH. In contrast, the respondents were studying different majors and lacked sufficient opportunities to encounter patients with MIH clinically or to study MIH systematically.
We found no difference among the different academic levels in regards to wishing to learn more about MIH. Most students desired to learn the clinical manifestations, differential diagnosis, and treatment for MIH. This result reflected the urgent clinical need for knowledge about the principles of MIH diagnosis and treatment.
The different academic levels acquired knowledge through different sources. As the respondents aged, they gradually changed their ways of acquiring knowledge, from textbooks to journals, lectures, and then social platforms (e.g., blogs). On the one hand, this trend reflected the convenience of current networks; on the other hand, it also reflected the dentist’s growth process, from passive learning to active learning. By searching for reading materials, students can improve their knowledge reserve and build their own experience system.
In this survey, nearly 40% of interviewees had observed MIH clinically, but only 10% had experienced treating MIH. At present, there is no global consensus on MIH treatment methods, and treatment principles often lack clear indicators. In 2017, Steffen et al. proposed an MIH treatment-need index (MIH-TNI) with an MIH treatment-need coefficient, which could assist in establishing an MIH treatment system [19].
Compared with the data in the two published studies thus far, the awareness of Chinese students is lower than that of students in Germany and Saudi Arabia [12, 13]. However, Chinese students’ ability to diagnose MIH increases with grades, which may be due to their increase in clinical experience. In addition, we also compared the awareness between students in our study with oral health care practitioners (OHCPs) who have been practising for many years, including general dental practitioners (GDPs) and oral health therapists (OHTs) [10]. As many as 70% of OHCPs recognise MIH, which is much higher than that of the dental students [13, 20]. In the future, accordingly, the introduction of MIH in paediatric dentistry courses at the undergraduate and graduate levels is necessary, and surveys should be conducted before and after teaching and learning to evaluate the outcomes.
