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Treatment of “White Spot Lesions” after Removal of Fixed Orthodontic Appliances

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Dental News Volume XIX, Number I, March, 201 2 by Dr. Derek Mahony Demineralised white spot lesions occur frequently, after orthodontic  treatment.  Some teeth are more prone to demineralization, typically the maxillary lateral incisors and the mandibular canine teeth.  The disto-gingival area of the labial enamel surface is the area most commonly affected.   (Fig. 1) In the first few weeks after removal of the fixed appliances, there is a reduction in white spot lesion size, and appearance, possibly due to the action of saliva. (Fig. 2) Figure 1:  White Spots - typical: C-shaped or irregular. Figure 2:  Smooth surface caries lesion. Various treatments have been proposed to assist remineralization.  It is important to note that fluoride should not be used, in high concentration, as it tends to prevent demineralization and can lead to further unsightly staining.  Low ...