Battling White Spot Lesions

White spot lesions (WSLs) are a prevalent complication arising from fixed orthodontic appliances, causing decalcification of enamel and posing significant esthetic challenges. A recent paper published in Cureus “White Spot Lesions in Fixed Orthodontics: A Literature Review on Etiology, Prevention, and Treatment” evaluates the etiology, formation, risk factors, and current treatment modalities for WSL remineralization.

Through an electronic search of PubMed and ScienceDirect databases, 172 studies from 2013 to 2023 were identified, with 39 studies selected for in-depth review after screening. Various treatment approaches for managing WSLs include antiseptics, fluorides (eg, dentifrices, mouthrinse, and varnish), and remineralizing agents, such as casein phosphopeptides amorphous calcium phosphate (CPP-ACP), biomimetic self-assembling peptides, lasers, bleaching, microabrasion, and resin infiltration. A lack of long-term evidence-based studies, however, highlights the need for further controlled clinical trials to establish best practices.

Despite advancements in orthodontic techniques and diagnostics, patient compliance and consistent self-care are crucial in preventing demineralization around brackets. Orthodontic practitioners play a vital role in motivating patients to maintain oral hygiene and use remineralizing agents to manage WSLs effectively. Comprehensive understanding of WSL formation and progression, alongside evaluating current treatment modalities, is essential for developing preventive measures and minimally invasive treatments to enhance orthodontic outcomes and dental health. Click here to read more.