White spots often appear on teeth after dental braces are removed. White spots are caused by decalcification, which is the loss of minerals from the surface of teeth that results in a lighter shade of enamel on part of the tooth. Most often white spots, or white spot lesions (WSLs), are caused by the build up of plaque during orthodontic treatment.
Key Statistics:
Research has shown that about 50% of patients experience WSL’s during orthodontic treatment. Interestingly, males are far more likely to develop white spots than females. One study found that 71% of males and 22% of females developed white spots after 12 months of orthodontic treatment, which suggests there are significant differences in how oral hygiene is practiced between the sexes.
- Which teeth: White spots are most commonly found on the facial side of upper front teeth where they are highly visible. White spots rarely occur on the lingual, or back side of the teeth.
- Where: White spots appear particularly around the gumline or in areas difficult to clean.
- How soon: White spots begin to form in as little as 4 weeks and continue to worsen over time unless plaque build-up is removed and hygiene improves.
What causes white spots:
- Oral Hygiene Habits: Patients with poor brushing and flossing routines are significantly more likely to develop white spots.
- Diet: High-sugar and acidic foods increase the risk of plaque buildup and enamel demineralization.
- Saliva Flow: Individuals with lower than normal saliva production are at a higher risk to develop white spots. Some medications cause reduced saliva flow.
- Treatment Duration: The more time in orthodontic treatment, the more likely white spots will develop if oral hygiene is not maintained.
How to prevent white spots:
- Brush Regularly: Brush at least twice a day, especially around brackets and along the gumline.
- Use Fluoride Toothpaste: Fluoride strengthens enamel and helps prevent demineralization.
- Floss Daily: Use a water flosser, floss threaders or interdental brushes to clean between teeth and under wires.
- Rinse with Fluoride Mouthwash: This provides additional protection against enamel demineralization.
- Limit Sugary and Acidic Foods: Reduce intake of candy, soda, and other sugary or acidic items.
- Professional Cleanings: During orthodontic treatment, get regular dental checkups and cleanings, which can help remove plaque and tartar buildup.
- Consider Sealants or Fluoride Treatments: Some orthodontists may recommend fluoride varnishes or sealants to protect vulnerable areas of enamel.
If white spots develop while wearing braces, they can be addressed by a dental professional after orthodontic treatment ends. Some options include:
- Remineralization of enamel using fluoride.
- Enamel microabrasion or polishing.
- In severe cases, restorative treatments such as composite bonding or veneers may be needed.
Alternatives to braces on the front of teeth:
One method that can reduce the risk of developing white spots during orthodontic treatment is to consider hidden braces, also known as lingual braces or braces placed behind the teeth. While hygiene is critical for good oral health, placing braces on the back side of the teeth can reduce the chances of creating visible discolorations on front teeth for everyone to see.
- White spots rarely develop on the lingual, or back side of the teeth
- Saliva flow is more prominent around the tongue than the front of the teeth
- Even if white spots develop they are hidden from view
While hidden braces are not as common as braces placed on the front of the teeth, many orthodontic professionals offer this option for patients who want their treatment to be as discreet as possible.
