Local anesthesia challenges in molar-incisor hypomineralization management and association with burnout among pediatric dentists: A nationwide survey.

BACKGROUND

Molar-incisor hypomineralization (MIH) is associated with hypersensitivity and resistance to local anesthesia (LA), which complicates treatment in children. No nationwide study has examined the frequency of these anesthetic challenges among pediatric dentists or their association with clinician stress and burnout. The aim of the study was to assess the prevalence of LA inadequacy in MIH-affected teeth and its relationship with stress, burnout, and job satisfaction among pediatric dentists.

MATERIALS AND

METHODS

A cross-sectional online survey was conducted among qualified pediatric dentists across India using a validated questionnaire. Convenience and snowball sampling yielded 100 complete responses after exclusion. The instrument covered sociodemographics, MIH clinical experience, anesthetic difficulties, escalation practices, and well-being (modified Mini Copenhagen Burnout Inventory). Data were analyzed using descriptive statistics, nonparametric tests, Chi-squared tests, Spearman correlations, and multivariable linear regression adjusted for confounders.

RESULTS

Most respondents reported routine LA inadequacy in MIH cases, commonly with supplemental buccal infiltration and intraligamentary injections. Higher perceived LA failure was strongly associated with treatment postponement, extraction, and general anesthesia referral. MIH-related anesthetic stress was strongly correlated with higher burnout and lower job satisfaction. Multivariate analysis identified elevated MIH workload, corporate/private college settings, and longer experience as independent predictors of poorer well-being.

CONCLUSION

LA challenges in MIH management are prevalent among Indian pediatric dentists and significantly contribute to occupational stress and burnout. Targeted training in adjunctive techniques and institutional wellness support are recommended to improve clinician resilience and patient care.