Molar incisor hypomineralization (MIH) is a defect in the enamel of permanent and/or primary molars and incisors. This disorder allows for rapid breakdown of the teeth and often calls for extensive restorative procedures. Due to the chronic pulpitis condition that is often associated with hypomineralized teeth, local anesthesia complications can result. This paper is a systematic review of the literature for the purpose of investigating adjuncts to traditional local anesthesia techniques in the case of hyper-responsive, hypomineralized-involved teeth during restorative procedures.