It is safe to say that most everyone wants white teeth. It is also safe to say that everyone wants teeth that are uniformly white, and not teeth that are splotchy with white spots here and there. White spots can give a dingy or unattractive appearance to a smile, even when the teeth are perfectly clean. This blog outlines what causes white spots and what you can do about them.
What Causes White Spots on Teeth?
Not all white spots are alike. There are several different things that can lead to splotchy or chalky white spots on the enamel. Understanding the cause of the white spots is a vital tool in knowing how you can treat them.
By far, the most common cause of white spots on teeth is a process called demineralization. This big word means a softening or weakening of the hard outer layer of enamel due to damage from acid. Just as strong acids can etch glass, so they can etch enamel.
When plaque, which contains bacteria and food debris, remains on a tooth surface for an extended period of time, demineralization is likely. The bacteria within plaque eat the carbohydrates present in the food debris and create acid as a by-product. The longer the plaque, and therefore the acid, stay in contact with enamel, the more likely they are to cause white spots.
Demineralization of enamel causes white spots, most frequently, in two forms.
1. White rings around braces
Wearing braces makes plaque removal very difficult. Even the perfect brusher and flosser can miss areas of plaque accumulation around the brackets and wires of orthodontics. Because adolescents and teenagers are not great at oral hygiene in the first place, adding braces to the mix puts them at a high risk for white spots.
2. White crescents near the gum lines
Another common site for white spots is along the gum lines in a half-moon or crescent shape. The reason for this is that plaque builds up more easily right along the gums. Many people miss this area when they brush their teeth, leaving plaque attached to the teeth. This is a high-risk spot for people with dry mouth. Dry mouth makes plaque stickier and more difficult to remove.
Another cause of white spots on the teeth is a condition known as fluorosis. This condition occurs when someone has too much fluoride in his or her system when the teeth are forming. It happens more often in areas with high levels of natural fluoride in the ground, which makes its way into the drinking water. Sometimes fluorosis causes white, chalky, splotchy teeth, and other times it leads to dark brown staining. Either way, it is not pretty!
Another cause of white spots is a defect in the formation of enamel. If there is an injury to a developing tooth bud via trauma or even a systemic illness, the tooth can have defects in the enamel. The photo shows an enamel defect called hypomineralization (meaning under-hardened enamel) on the edge of one of the front teeth. This was most likely the result of trauma to the baby tooth that preceded this permanent tooth.
What Can I Do to Prevent White Spots?
White spots cannot always be prevented, but in general, when we evaluate the causes of white spots, we can do certain things to lower the risk for developing them.
Preventing Demineralization White Spots
This is the easiest type of white spot to prevent. All you have to do is have great oral hygiene and support healthy, strong enamel. Ask your dental hygienist about tips for better plaque removal and oral hygiene products. Some people need to add a cavity-fighting mouthwash, especially if they are in braces. Colgate’s PhosFlur mouthrinse was created specifically to prevent white spots from braces.
Preventing Fluorosis White Spots
This one is a little more difficult. It involves monitoring fluoride intake during pregnancy and early childhood. You need to know how much fluoride is in your tap water and adjust accordingly. A small amount of fluoride is vital for building healthy teeth. Once you pass the optimal level, though, white spots can occur. Ask your dentist or pediatrician how much you should get versus how much is in your drinking water. You may need to drink bottled water and take a small fluoride supplement to get just the right amount.
What Can I Do to Get Rid of White Spots?
What if you already have white spots? You do not have to just live with them. There are several treatments available to lessen the appearance of white spots. The treatments for demineralization white spots is very different from that of fluorosis white spots. In addition, areas of enamel defects need a different treatment, as well.
Treating White Spots from Demineralization
When white spots occur as a result of demineralization, you must reverse the process and stimulate remineralization. Several minerals are important for remineralizing enamel, including calcium, phosphate, and fluoride. We aid remineralization by applying these minerals to the teeth with a custom tray (like a teeth whitening tray).
We can also treat demineralization by infiltrating a resin (tooth colored filling material) into the enamel. This process seals the weakened area and restores it to the natural tooth color.
Treating White Spots from Fluorosis
Teeth with fluorosis do not need more fluoride. They have too much of that mineral already. In mild and moderate fluorosis cases, you can lessen the appearance of white spots with teeth whitening, which we can take care of in our Cantonment office. Whitening the whole tooth evens out the splotchiness and makes the white spots less noticeable. Using the above-mentioned infiltration of resin can also reduce the appearance of fluorosis white spots.
Treating White Spots from Enamel Defects
This is the toughest type of white spot to treat. Because the enamel did not form properly, usually we must remove it and replace it with either tooth-colored filling material or cover over it with porcelain. The reason for this is that the enamel is not structurally sound and cannot do its job in protecting the underlying tooth structure. Therefore, we must replace it to ensure the health of the tooth.
Do You or a Loved One have White Spots on Your Teeth?
Call today to schedule a consultation with our cosmetic dental experts! We can answer any question you have about white spots, diagnose the specific cause of yours, and help you choose the treatment option that is best for you.