Taking care of those dreaded White Spots….

There is nothing worse than when a patient comes in for their last orthodontic appointment to get their braces off and they see “white spots” on their teeth.  We try to avoid such disappointment among our patients at Town and Country Orthodontics, but sometimes it is unavoidable.  There is good news though! They can be prevented! The simple way to prevent them is to practice good oral hygiene.

White spots are also known as decalcification or demineralization. They are caused by plaque that sits on the teeth around the braces.  Plaque is also what causes cavities. The white color or “chalkiness” develops by acid made by the bacteria in plaque and this acid is what breaks down or demineralizes the enamel. The most common areas on the teeth where they can be found are between the gums and the brackets where brushing proves to be most difficult.  Adolescents can develop these white spots without braces but the chances of developing them almost double when braces are on the teeth. However, braces do NOT cause them to form, they just complicate plaque removal.



Removing plaque is the ONLY sure way to prevent them from forming.  In our office, we are excellent at coaching our patients with good oral hygiene practice. We demonstrate how to properly brush and floss, we talk about what foods or drinks to avoid, and we show the patient illustrations of what happens to the gums and teeth when oral hygiene is neglected. If there is any concern during treatment for white spot formation, we will let the patient or parent know.  The most important take-home message though is that if the plaque is removed, the white spots won’t form!

Over time, mild white spots can fade and there are ways to remineralize these areas. Applying extra strength fluoride to these areas may worsen their remineralization. The best thing to do is to let the teeth bathe in normal saliva during the first 6 months after the braces come off and use enamel remineralization products like MI Paste or low dose fluoride rinses.  Severe white spot lesions may need a combination of micro-abrasioin techniques and bonding or veneers with the help from your dentist.

We pride ourselves on coaching good oral hygiene at Town and Country Orthodontics. …But we can only do so much.  Just remember that the only way to enjoy that special day when your braces come off is to have good oral hygiene…then the PATIENT and the ORTHODONTIST can celebrate!


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