From the Waterpik November 2012 Professional Oral Care Newsletter

Carol A. Jahn, RDH, MS, Editor  

http://professional.waterpik.com/newsletter/november-2012.html#WSL-ortho?utm_source=November+2012+US+&utm_campaign=UK-Email-Feb-2012&utm_medium=email

Preventing White Spot Lesions in Orthodontic Patients

White spot lesions (WSLs) are areas of decalcification that appear opaque or chalky white and represent the early stages of the caries process. The white appearance is due to increased demineralization coupled with a lower rate of remineralization generally resulting from a low pH level. With treatment, WSLs can be arrested and in some cases reversed.
Orthodontic treatment increases the risk of WSL. A recent study found that the incidence of developing at least one WSL during orthodontic treatment was 72%.¹ Poor oral hygiene both before and during orthodontic treatment has been shown to increase the risk of WSLs.² Not surprisingly, gingivitis has also been shown to be positively associated with WSLs.³
Preventing and treating WSLs involves improving oral hygiene and targeted fluoride application.⁴ Fluoride varnish applied every 3 months during 12 months of orthodontic therapy resulted in 44.3% less demineralization.⁵ Having good oral hygiene can be challenging and time consuming with orthodontic appliances. Helping patients find the tools they like and use can make a big difference in getting them to adhere to a regular routine and a happier orthodontic outcome.

1. Richter AE et al. Incidence of caries lesions among patients treated with comprehensive orthodontics. Am J Orthod Dentofacial Orthop 2011; 139:657-64.
2. Chapman JA et al. Risk factors and incidence and severity of white spot lesions during treatment with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 2010; 138:188-94
3. Tanner AC et al. White spot lesions and gingivitis microbiotas in orthodontic patients. J Dent Res 2012, 91:853-8.
4. Hamdan AM et al. Preventing and treating white spot lesions associated with orthodontic treatment: a survey of general dentists and orthodontists. J Am Dent Assoc 2012; 143:777-83.
5. Vivaldi-Rodrigues G et al. The effectiveness of a fluoride varnish in preventing the development of white spot lesions. World J Orthod 2006; 7:138-44.