The dreaded white spot

Ron Kaminer, DDS

In a traditional restorative dental practice, patients frequently present with white spot lesions. White spots represent hypocalcification of the enamel and occur for a variety of reasons. While some people are born with white spot lesions, a more common occurrence of white spots is from poor oral hygiene during orthodontic treatment.

A plethora of minimally invasive treatments have been used over the years, most with mild success. Past treatments have included the use of stannous fluoride, bleaching of the entire tooth, and mechanical abrasion of the affected enamel followed by composite bonding. While placing a composite usually results in the best esthetic result, this technique typically requires removal of the affected enamel to prevent the lesion from showing through the composite.

More recently available treatments are dental therapeutic pastes that assist in remineralization. These pastes, such as MI Paste (GC America) and Remin Pro (Voco America), have a stabilized form of calcium and phosphate that can penetrate hypocalcified enamel and restore the diseased enamel to its original appearance. Remin Pro has a combination of nano-hydroxyapatite (nHAP) particles (calcium and phosphate), fluoride, and xylitol. nHAP has been shown in studies to be similar to enamel, making it an effective enamel repair and anticaries agent.¹ Other studies have shown that while fluoride can make enamel harder, nHAP can deposit new minerals into the enamel.² The pastes represent a major breakthrough in the treatment of white spots, as minimal tooth reduction-or none at all-is required to achieve an esthetic result.

Through experience, I have developed a defined protocol that leads to outstanding results. This protocol, if followed exactly, leads to predictable results time and time again..............

No clear mention that Fluoride causes these white spots!