Molar Incisor Hypomineralization (MIH) is a common condition in New Zealand children and children around the world and can result in a significant defect in first permanent molars. This condition inevitably leads to a large amount of dental treatment for young children and may even result in the removal of their first permanent molars. This lecture will outline the understanding of the physical properties of these teeth and provide an evidence based review of the treatment options for affected teeth.