One of the most exciting days in a person’s life is when their braces come off. That is why it is so disheartening when white spots are revealed right after the braces are removed. This can be extremely frustrating after all the time and money spent to get that beautiful smile. Do braces actually cause these white spots on the teeth? Can they be prevented? Can the white spots be fixed after they appear? By understanding why white spots form on teeth and taking steps to prevent the spots, patients can effectively avoid this common problem all together.
White spots on teeth are also called demineralization or more specifically decalcification. These spots form when dental plaque (the same material that causes cavities) is left on teeth for long periods of time. Acids from the dental plaque remove minerals from the teeth, causing the spots that appear white or chalky. The most common area for white spots to appear is around the brackets where brushing is often difficult. Many times white spots also develop under swollen gum tissue making their detection difficult until after the braces are removed and the swelling subsides.
Preventing plaque build-up is the best way to prevent white spots from forming. Plaque build-up can be prevented by avoiding certain foods and by taking steps to properly care for your braces and your teeth. In our office we provide oral hygiene instruction at the very first appointment. We also provide a list of foods and drinks that should be avoided during treatment. Foods that are very sugary or sticky should be avoided when wearing braces, as these foods are very difficult to remove from the teeth when the braces are in place. These foods, as well as acidic foods and soft drinks, may hasten the process of decalcification. Soda is one of the top food products that patients with braces are warned to avoid, as the high sugar content in soda often sticks to teeth and is more difficult to remove than other foods.
In addition, we explain the importance of removing plaque, show the patients a picture of severe decalcification, and let the patients and parents know that white spots are a possibility if plaque is not removed. We provide an electric toothbrush and floss threaders and we encourage the use of fluoridated toothpaste. During treatment we reward good brushers with wooden nickels which can be redeemed for prizes and we provide additional instruction to patients who are struggling. When we notice that white spots are developing, we point them out to the child and the parents. We have even removed braces early for some patients with severe problems.
Patients with braces may benefit from seeing their dentist every three to four months for regular cleanings and check-ups instead of every six months. These cleanings will help to prevent plaque build-up by removing debris that patients may have missed during regular daily care. While patients may visit an orthodontist for check-ups related to their braces, an orthodontist typically will not clean the teeth. More frequent cleanings by your dentist or hygienist may help patients to prevent white spots from forming.
What about getting white spots when you wear Invisalign aligners? Believe it or not, patients who wear the clear aligners to straighten their teeth also can get white spots. The aligners are meant to be worn 20 to 22 hours each day and removed while eating and drinking. Unfortunately, some patients will drink acidic or sugary beverages such as Gatorade while they are wearing their aligners. They often will not remove their aligners immediately afterward and this will allow the liquid to flow into the aligners bathing the teeth for extended periods of time with the acidic or sugary material. This is akin to bleaching your teeth and unfortunately the teeth become chalky white across their entire surfaces! To prevent this from happening, it is imperative that patients wearing Invisalign aligners follow the instructions of their orthodontist and remove their aligners while eating AND drinking.
What can be done if you have white spots on your teeth after you complete your orthodontic treatment? All white spots improve some with time and minor ones may disappear altogether. One option is to apply a low concentration fluoride rinse or a remineralization paste. These sometimes can be effective in at least reducing the white spots. Bleaching has been shown to lighten the enamel surrounding the white spots and the spots tend to blend in better and actually improve as the effects of the bleaching wear off. For more severe problems, your dentist may perform microabrasion (removing superficial white spots), cosmetic bonding (replacing damaged enamel) or place porcelain veneers (covering badly damaged surfaces).
The bottom line is that white spots on the teeth are caused by plaque and the best solution to preventing these white spots from forming is the proper care of your teeth while your braces or aligners are in place. Keep dental plaque off of your teeth and the day your braces come off will be one of the most exciting days of your life!
By Dr. Gary Reichhold
DEC
About the Author:
Dr. Gary Reichhold and his partner Dr. Stephen Tanner have been proudly serving families in Concord, Walnut Creek, Clayton, Pleasant Hill and the surrounding communities for over 20 years. Their office is conveniently located in central Contra Costa County and their experienced team is committed to providing you and your family with exceptional orthodontic care.