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Original Article

How to prevent and treat white spot lesions during and after fixed orthodontic treatment

2017, Volumen 47, Número 4
Cristina Nevot González
Profesora asociada de Odontología Preventiva y Comunitaria, Universidad de Barcelona, Barcelona

Introduction: The orthodontic treatment with fixed appliances is a risk factor for the enamel demineralization. Nearly a 50% of patients develop, at least, a cavity in the initial phase: white spot lesion (WSL), during the treatment. The magnitude of the problem, and the fact that more and more people are planning to do orthodontic treatment, creates de necessity to acknowledge and evaluate more effective mechanisms of prevention and treatment. Material and methods: A bibliographic research is done in Pub-Med, Cochrane, EMBASE and SCOPUS until May 2017. Results and discussion: During treatment a proper saliva flux and the use of fluoride acts as preventing therapy. Some treatments for treating and preventing the white spot lesions do not need the patient’ support or motivation because are done at the dental office, and others need the compliance of the patients at home. As a preventing methods sealers, high concentrated fluoride resin, or the usage of CCP-ACP or CCP-ACFP can be used, all of them with positive results. As treatment methods to reduce the aesthetical difference with the rest of the teeth enamel or nearby tooth, dental bleaching, micro abrasion and micro infiltration and the application of Fluoride and CCP-ACP or CCP-ACFP can be used, with different results. Conclusion: Not applying any preventing measure during the orthodontic treatment, and leaving the disease at its own natural evolution, is not ethically correct. Therefore, during the prevention phase, or in the worst of the cases, the treatment of white spot lesions, must be one of the goals of modern orthodontics.  (Rev Esp Ortod. 2017;47(4):190-196)

Key words:
White spot lesion (WSL). Orthodontics. Prevention methods. Treatment methods. Remineralization.
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