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Crombie F, Manton D et al. Int J Paed Dent 2009; 19: 73–83

These investigators carried out a systematic search of the literature relating to the causes of molar-incisor hypomineralisation (MIH) although they acknowledge there is a lack of consensus as to what constitutes this condition. The level and quality of evidence were assessed using the Australian national guidelines. From 1,123 articles identified, 53 were interrogated further. It should be noted that the authors did not exclude those papers on the primary dentition. There was 'moderate evidence that polychlorinated biphenyls (PCBs) and dioxins are associated with enamel defects' but not breast-feeding duration per se. Contrary to anecdote, there was only weak evidence for the role of pre-, peri- and neonatal problems although 'such data is complicated by strong associations between many of the variables'. The evidence was even weaker implicating fluoride in the cause of demarcated defects characteristic of MIH.