The Great Enemy of Orthodontic Treatment! How to Prevent the 'Mysterious White Spots' That Ruin Your Beautiful Smile
This article is part of the activities of the Japan-Sweden Dental Society, providing easy-to-understand translations and introductions of papers and other materials regarding advanced dental care in Sweden, a country known for its advanced dentistry. Unless otherwise specified, the institutions mentioned in this article refer to those within Sweden. Please note that the content of this article may contain some mistranslations and includes information at the research and clinical stages.
Orthodontic treatment (wire braces) is becoming increasingly popular among adults. While it is wonderful to see crooked teeth becoming straight, there is actually a major risk lurking during treatment.
The problem is that even if your teeth become beautifully aligned, when the appliances are removed, “mysterious white spots” may appear on the surface of your teeth.
In technical terms, this is called “White Spot Lesions (WSL),” but in short, it is “a state one step away from tooth decay.”
In fact, even in Sweden, a leader in preventive care, about half of the children undergoing orthodontic treatment develop these white spots.
What is the true nature of the “white spots” that form on teeth?
The surface of our teeth is protected by a hard tissue called “enamel.” However, the acid produced by cavity-causing bacteria can cause essential minerals like calcium and phosphorus to dissolve from the teeth (this is called “demineralization”).
Enamel that has lost its minerals and become porous begins to look cloudy and white due to light reflection. This is the true nature of white spots.
They are particularly prone to forming around orthodontic appliances on the front teeth, and the troublesome part is that they remain like “scars” even after the appliances are removed, making them very difficult to heal naturally.
[Cause] Why are they prone to forming during orthodontic treatment?
When orthodontic appliances (wires and brackets) are attached, brushing your teeth inevitably becomes difficult, and plaque buildup increases. As a result, the environment inside your mouth easily becomes “acidic,” which cavity-causing bacteria prefer. Furthermore, because minerals needed to repair teeth cannot reach them, the teeth dissolve rapidly, making white spots more likely to form.
[Treatment] What should you do if they have already formed?
Various methods have been tried to treat white spots that have already formed, such as shaving them down and filling them with plastic or applying special medicinal agents, but in reality, a perfect treatment method that “guarantees a return to the original state” has not yet been found.
That is precisely why “preventing spots from forming” is more important than anything else.
[Prevention] The amazing effect of “fluoride” to prevent white spots
The most essential element for preventing cavities and white spots is “fluoride.” Fluoride has the powerful ability to prevent minerals from dissolving from teeth and to restore (remineralize) teeth that have begun to dissolve.
Research has revealed the following surprising effects regarding how to incorporate fluoride during orthodontic treatment.
① Increase the fluoride concentration of your toothpaste
In an experiment targeting young people undergoing orthodontic treatment, compared to a group that used standard commercially available fluoride toothpaste (1450 ppm), the group that used high-concentration fluoride toothpaste (5000 ppm* pharmaceutical level by overseas standards) saw the risk of developing white spots reduced by more than 30%, and the severity of the spots was also milder.
② Have a dentist apply “fluoride varnish”
In addition to brushing your teeth at home, having your dentist periodically coat your teeth with a high-concentration fluoride (fluoride varnish) is also effective. According to experiments, the group that applied a placebo without fluoride developed white spots at a rate of 25%, whereasonly 7% of the group that applied the real fluoride varnish developed them.
Summary
It would be a shame if, after spending the time and money to straighten your teeth, the teeth you reveal are covered in spots.
Once you begin orthodontic treatment, in addition to careful daily brushing, be sure tochoose a higher-concentration fluoride toothpaste than usual, andhave your dentist apply fluoride periodically, so you can achieve the ideal, trouble-free smile!
The
Japanese Society of Swedish Dentistry
, which advocates for Swedish-style dental treatment, a leader in the field,https://swedentis.com/