There’s nothing like the joy of getting your braces off. But sometimes there’s a disappointing surprise. Patients often find that bacteria under the brackets cause white spots on their teeth. Several other conditions can also leach calcium from the enamel and cause similar discoloration. The good news is, you can prevent white lesions with awareness and dental hygiene. And your dentist has more tools than ever for treating them if they occur.
What Causes White Spots on My Teeth?
Several issues and conditions can cause white spots on the teeth:
- We often see them in children or adults with braces when they’re not as focused on hygiene as they should be. Wires and brackets can make it harder to clean your teeth. When bacteria get stuck under the braces, they stay in contact with the tooth enamel. Those bacteria deplete calcium and other minerals and lead to discoloration. We see the same issue without braces when a patient eats lots of sugary or acidic food or drinks sugary beverages.
- Dental Fluorosis can cause white spots in young children. When kids eight and younger consume too much fluoride as their teeth are developing, white or brown stains can form. High fluoride levels in drinking water, young children eating toothpaste, or overuse of fluoride mouth rinse can contribute to fluorosis. Usually, we see white spots or flecks in mild cases. More severe cases can have more extensive white areas, pitting, or brown stains.
- Enamel Hypoplasia is another condition that can affect young children. It occurs when genetics or prenatal vitamin deficiencies weaken enamel, causing white spots, pitting, or other discoloration.
How Can I Fix White Spots on My Teeth?
There are several different approaches to treating white spots. The right option depends on the severity of the issue, the cause of the discoloration, and the patient’s age.
- In general, fluoride prevents demineralization and can help repair mild white spots. Your dentist may recommend remineralizing the teeth with a topical fluoride paste as the first step.
- Traditional tooth whitening with a peroxide-based bleaching agent can help in some cases.
- Enamel microabrasion removes a thin layer of enamel using a special tool and abrasive paste. We follow this up with in-home bleaching trays.
- A new treatment called resin infiltration involves removing a thin layer of enamel and applying a tooth-colored resin to the white spots, then hardening with a special light. The resin treatment leaves a smooth, even surface color.
- Your dentist may recommend crowns or veneers for adults with severe white spots or other discoloration related to demineralization.
How Can I Prevent White Spots on My Teeth?
Parents of young children can prevent fluorosis with awareness.
- Keep track of the fluoride levels in drinking water by reaching out to your city or town or testing well water. If fluoride is higher than two milligrams per liter, the Centers for Disease Control recommends using another drinking water source for children eight and younger.
- Swallowing toothpaste can also be an issue for little ones. For children ages, 2 to 6, use a pea-sized amount of toothpaste and supervise to make sure they’re spitting as they brush instead of swallowing.
- Young children generally don’t need a fluoride mouth rinse unless they are at high risk for tooth decay.
- Use fluoride supplements only when needed. Talk with your pediatrician and dentist before use.
For patients with braces, extra attention to dental hygiene makes a difference.
- Diligent brushing and flossing are the best way to prevent white spots.
- Use an electric toothbrush designed for braces or get to those hard-to-reach spots with a water cleaner.
- Limit sugary and acidic foods–especially sodas and sports drinks.
Your Dentist Can Help Prevent and Treat White Spots
It’s essential for all patients, young and old, with or without braces, to see your dentist for check-ups regularly. Sometimes when we’re getting orthodontic care, we spend so much time in the orthodontist’s chair, we forget about routine check-ups with our family dentist. But it’s more important than ever to schedule regular cleanings.
Monitoring for conditions like Fluorosis and Enamel Hypoplasia is one reason families are no longer waiting until preschool for the first dental check-up. We now recommend bringing your little one in between the appearance of their first baby teeth and their first birthday. Scheduling an early visit lets us establish a baseline and look out for genetic conditions that may affect enamel.
