Washington Hospital Center

White Spot Lesions in Orthodontics

White spot lesions are the very beginning stage of dental cavities. They are prevalent with the use of orthodontic appliances such as braces. Having braces or other orthodontic appliances in the mouth creates many sites were bacterial plaque can adhere and if this bacteria is not removed with excellent oral hygiene such as brushing and flossing, a white lesion will begin to appear and on the teeth. The process that causes these spots can be prevented or halted by the use of currently available dental products. If the process is allowed to proceed a cavity will form on the tooth. White spot lesions are a common and unsightly occurrence in orthodontics. Orthodontic patients have a higher incidence of white spot lesions than nonorthodontic patients, which may cause long term esthetic problems after fixed appliances (braces) are removed.1 A study by Gorlick et al in 1982 showed that the incidence of what spot lesions in patients who underwent treatment with fixed orthodontic appliances was 49.6% compared to 24% in the non treated control group.2 Many studies have been completed on the use of fluoride in the prevention of white spot lesions. Ten Cate Suggested that even sub ppm levels of fluoride may have a significant impact on the remineralization process.3 There have been many advances in procedures and products for the prevention of white spot lesions over the last decade. Considering that white spot lesions are a generalized problem for all clinical orthodontists, it is of interest to find out if clinical orthodontists are aware of the scientific progress and have modified there regime accordingly. It is also of value to find out their clinical success or failures of these new products to develop future protocol on the prevention and treatment of white spot lesions. This study will provide a summary of currently available products on the market for the prevention of white spot lesions in orthodontics as well as a survey allowing us to gauge the knowledge of and use of different products by practicing private practice orthodontists.