White spots

White Spots- Why Worry?

August 31, 2017

It’s easy enough to see a brown spot on a tooth and know something is wrong. Teeth should not have brown spots; people know and recognize brown is an unnatural, unhealthy color on a tooth. But, what about white spots? Are white spots on the teeth a cause for concern?

The short answer is yes.

Whiter and Weaker

White spots on the tooth surface are properly called white spot lesions. The white, rough looking surface is a demineralized, weakened spot on the tooth enamel. Close examination shows the white spot is dull, lacking the natural luster of healthy teeth. Under high magnification (or a microscope) the enamel has its underlying, ladder-like structure exposed where the minerals have been stripped away. This naked structure is far weaker than healthy enamel.

Too Much of a Good Thing

There are several reasons that white spot lesions develop. Fluorosis is one common cause in small children, particularly children who live in areas where fluoride is added to the water supply and who tend to swallow toothpaste. Parents should be vigilant while teaching small children to brush their teeth. While fluoride can help teeth strong, too much of anything can be dangerous, and fluoride is no exception.

Appliance Woes

Braces, mouth guards, retainers, and whitening trays can all be important tools in gaining and maintaining dental health. They also, unfortunately, can cause hard to clean spots on the teeth. The accumulation of plaques from inadequate brushing let acids build up on the tooth surface. This acid then strips minerals from the tooth enamel, causing the unhealthy and unappealing white spots. Someone having braces removed wants the best smile of their life, so extra vigilance in an oral care routine is warranted while using dental appliances. Patients should use proper brushing technique, avail themselves of specialty tools to aid in cleaning the teeth, and consider adding a rinse the keep the mouth pH in balance.

Plaque is Back

Of course, the accumulation of plaque is never healthy for the teeth. Skipping dental visits, spotty hygiene habits, or poor brushing technique can lead to white spots near the gum line where plaques were heaviest. Any time plaque acids build up on teeth, it will strip away vital minerals from tooth enamel. Removing the plaque does not, by itself, cause the teeth to regain lost minerals. Unfortunately, plaques are likely to recur for the same reasons they occurred in the first place, making it all the more important to treat white spot lesions before they progress to full caries (cavities).

So What Can Be Done?

The most important treatment goal with white spot lesions is to arrest the damage process and remineralize the tooth surface before the lesion progresses to full cavitation. CariFree products are an excellent tool to consider when attempting to remineralize the tooth surface. The fluoride and biomimetic Nano-hydroxyapatite are excellent for remineralizing enamel.

A white spot lesion that has been properly treated will regain luster and lose its odd matte appearance when dry. Preventing further damage or a recurrence or the lesion is vital to continued tooth health. Maintaining a healthy pH in the mouth and ensuring sufficient salivary flow to protect the tooth should be top priorities for long term management.

Once the white spot has been properly treated, it remains visible. Aesthetic concerns can be managed by careful tooth whitening to blend the color with the rest of the tooth. Whitening should be done under the supervision of a dentist.

With proper care, a white spot lesion need not progress to a full cavity, and can be successfully brought back to strong and aesthetically pleasing natural teeth.