Enamel demineralisation as an iatrogenic effect of orthodontic treatment : a clinical review

Abstract

Small areas of demineralised enamel, commonly referred to as white spot lesions (WSLs), constitute an important clinical problem in Orthodontics following treatment with fixed appliances. They are the result of an imbalance between de- and remineralisation of enamel, caused by the interrelationship of several factors. Clinicians and patients are usually so focussed on the alignment of teeth within the arches and the relationship of the jaws to each other, that the iatrogenic effects of demineralisation and WSLs are often overlooked. While attempts should be, and are, made to prevent this clinical problem, it can pose a challenge to manage in high risk patients. Benefit must supersede risk and it is thus of utmost importance that the clinician be aware of and educates the patient on means to prevent or to minimise and manage WSLs. This manuscript is intended to elucidate the presentation, aetiology and management of WSLs, in the hope of promoting more favourable clinical outcomes for both patient and practitioner.