White Spot Lesions in Patients with Orthodontic Appliances

Abstract

White spot lesions (WSLs) can appear during and after fixed orthodontic treatment as undesirable situation on the teeth and can compromise results of the treatment and facial esthetic. White spots lesions are defined as areas of demineralization on tooth enamel surface that can occur during the treatment with fixed orthodontic appliances, around brackets, tubes or orthodontic rings. They are located on the labial surface of the teeth mostly on the labial - gingival part on the crown of the teeth. The white spots can be seen even after 1 month of bonding fixed appliances or after 6 or 12 months. The reason for the appearances of WSLs is the process of demineralization of the enamel of the tooth. Orthodontist can and should minimized those undesired complication during the orthodontic treatment. There are several risk factors for appearing of WSLs. The most common reason for this phenomenon is inappropriate and poor oral hygiene. For avoiding side effects of having orthodontic braces, maintaining excellent oral hygiene is require, before bonding fixed orthodontic appliances. 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-amorphous calcium phosphate (CPP-ACP) in topical crème, micro abrasion and using resin to full fil lesions, can greatly contribute to the process of remineralization of enamel and gave successful results of treatment of WSLs.