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White Spot Lesions in Orthodontic Patients: Formation, Prevention and Treatment

Irena Gavrilovic

During fixed orthodontic treatment, white spot lesions (WSLs) may arise on the teeth as undesirable situation. The white spot lesions are defined as areas of demineralization of tooth enamel that can occur during the treatment with fixed orthodontic appliances, around brackets, tubes or orthodontic rings. Their location is mostly on the labino-gingival part of the tooth crown. The white spots can be seen even after 1 month of setting fixed appliances and in some patients after 6 or 12 months. This state of demineralization of enamel is a complication of orthodontic treatment and represents a major clinical problem that can compromise the results of successfully treated case. Orthodontic wont to improve not only function but also the aesthetic appearance of patients, so during the treatment these complications should be minimized. The most common reason for this phenomenon is inappropriate and poor oral hygiene. In this paper there is the contemporary review of risk factors for the formation, prevention and successful treatment of WSLs. For avoiding side effects of wearing orthodontic braces, for each patient, before setting fixed orthodontic appliances, training is require for maintaining excellent oral hygiene. In literature there are numerous studies for the prevention and treatment of white spot lesions. The use of fluoride (in toothpaste, gels and solutions for the mouth, in bonding materials for orthodontic braces, fluoride varnish), Casein phosphopeptide-amprphous calcium phosphate (CPP-ACP0 in topical crème and microabrasion can greatly contribute to the process of remineralization of enamel and successful treatment of WSL.