Have you ever looked in the mirror and wondered what those white spots are on your teeth? Well, you and many people have. They’re called white spot lesions and can provide you with information about your oral health. Sometimes preventable and other times not so much… let’s take a look at the “what,” “why,” and “how” of these pesky white stains.
What Causes White Spot Lesions on Teeth
There are a few different reasons we may develop these bright white spots on our teeth. What you are seeing may be demineralization of the tooth's enamel, or enamel decalcification (a sign of fluoride overexposure), or fluorosis (an enamel defect that was present within the tooth from development), or enamel hypoplasia (a diet lacking calcium), or early signs of tooth decay.
1. Enamel Decalcification
Enamel decalcification is the result of bacterial plaque that has accumulated on the tooth. It is common to see white spot lesions on individuals who wore braces because proper oral hygiene can be challenging around fixed orthodontic appliances. Buildup of plaque in certain areas creates higher concentrations of acid which prevents the enamel from remineralizing.
2. Fluorosis
Fluoride is needed for dental health in the fight against cavities as it makes the outer surface of the teeth stronger and more resistant to decay. However, when overexposure to fluoride happens before permanent teeth come through, the teeth can develop white spots, called fluorosis. Luckily, fluorosis is only a cosmetic concern and will not impact oral health.
3. Enamel Hypoplasia
Enamel is the hardest part in the human body and protects the inner layers of the teeth where nerves reside. Proper oral hygiene is essential in maintaining the integrity of the enamel because once it is gone, it is gone. Unfortunately, some people are born with an enamel defect where the enamel is either thin or absent on some, or all, of a tooth. This is called enamel hypoplasia. Enamel hypoplasia can present itself in a few ways—one being white spots.
4. Diet
Diet plays a role in all areas of our bodies, including our teeth. A diet lacking calcium may present itself in the form of white spot lesions on some of your teeth. Add a little extra calcium into your diet to help prevent the development of white spot lesions. Calcium, and other vitamins and minerals, are needed throughout your whole body, not only for your teeth, so it’s important to prioritize your diet.
5. Oral Health
The most preventable contributor to white spot lesions is poor dental health. Brush for two full minutes twice daily, floss daily, and prioritize a healthy diet. White spot lesions, in this scenario, are an early sign of tooth decay so having a good oral hygiene routine will help prevent controllable dental concerns.
Treatments for White Spot Lesions
1. Fluoride
Before you begin treating your teeth with anything, talk to your dentist. It’s common for the initial treatment to involve applying a fluoride paste or gel to the affected teeth. A low concentration of fluoride that’s applied to the white spot lesions can aid in remineralization of the enamel.
2. Saliva
Saliva is a magical fluid our bodies produce. It is needed for tooth mineralization and digestion, and contains many essential enzymes. If decalcification is the fate of your enamel, your dentist may advise you to increase your saliva production because your saliva deposits calcium and minerals on your enamel. This can be done through chewing sugar-free gum that contains xylitol, sucking on sugar-free candy, and drinking lots of water.
3. Teeth Whitening
Teeth whitening is a way to help blend your tooth color. Whitening your teeth can remove stains from the healthy portion of your teeth so that the color differentiation is muted. Depending on the severity of your white spot lesions, some teeth whitening products may be better than others so chat with your dentist about what will benefit you best. If your dentist suggests an at-home teeth whitening option, try this easy, mess free, and effective teeth whitening kit!
4. Enamel Microabrasion
If you aren’t too keen on using teeth whitening products, or desire other options, ask your dentist about enamel microabrasion. This is an in-office treatment where an abrasive agent is applied to your teeth and gently scrubbed to remove a clinically imperceptible amount of enamel. This will not rid the white spots, but will whiten your teeth to achieve a blended tooth color.
Preventing White Spot Lesions
Preventing the development of white spot lesions will save you time and effort in the end.
- First and foremost, following a rigid dental hygiene routine is the best way to avoid developing white spot lesions, and lots of other oral concerns. It is imperative to brush your teeth twice a day for two minutes each time, focusing 30 seconds per quadrant (upper right, upper left, lower right, lower left). Floss your teeth once daily, at bedtime is best. Visit your dentist for bi-annual cleanings and tend to their findings. Eat and drink healthy options to make sure your entire body is getting the nutrients it needs to function properly.
- If you have fixed orthodontic appliances in your mouth, take extra care around these areas. It’s easy for plaque to get trapped along these appliances. Brush, brush, brush! Brush with fluoridated toothpaste while taking extra care in these harder to reach areas. Using a mouth rinse with fluoride will further protect your teeth from decalcification of enamel.
- Getting enough fluoride is super important but getting too much isn’t helpful; therefore, be aware of the quantities your family is consuming. If children consume too much, this is when fluorosis can develop in their permanent teeth. Commonly, fluoride is added to city water so check with your municipality (or see if your water supplier is listed here on the CDC website). If fluoride isn’t added to your drinking water, chat with your dentist because they may recommend adding a fluoride supplement, primarily for children.
- Enamel hypoplasia can’t be totally avoided as it’s a developmental defect, but research suggests that certain scenarios can put a child at a greater risk of this enamel defect. Some include: premature birth, low birth weight, malnutrition, rickets (vitamin D deficiency), diabetes, gestational diabetes (in pregnant woman), hypoparathyroidism, and dental trauma. Women taking proper care of themselves during pregnancy can help avoid some of these scenarios, but anything can happen no matter how careful you are.
