Getting rid of white spots on front teeth
Wearing braces can lead to some very visible color changes.
Very often some parts are darker than others and "white spots" appear.
Heavy brushing of the teeth is not a good idea since this will not work well and also erodes too much of the enamel.
If a professional teeth whitening performed by a dentist is not preferred or not an option then other remedies that are often recommended include special toothpastes, sodium bicarbonate or over the counter whitening strips.
These options may be unsafe or ineffective.
What options do exist to improve the aesthetics of the teeth in such a situation?
Mainly this means: how were these spots formed and how to get rid of the white spots safely?
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Currently, there are three options to deal with white spots in frontal teeth after orthodontic treatment:
remineralization,
micro-abrasion, and
resin infiltration.
There are several case report about micro-abrasion and resin infiltration, and some clinical trials about all, but a recent systematic review found the evidence of effectiveness was rated as low, that means that the results are inconsistent or there is a high risk of bias, i.e. the manufacturers of the products published the results.
The three options are different:
Remineralization uses fluoride aiming to add something to the surfaces layer of the tooth. There are some clinical trials showing positive results (ncbi.nlm.nih.gov/pubmed/19887683) and others showing no effect (ncbi.nlm.nih.gov/pubmed/27480987). But the advantge of a non invasive therapy is that there is no loss of enamel surface, hence there is no irreversible alteration to the tooth surface.
Microabrasion on the other hand smooth irreversibly the surface of the eroded enamel with an acid.
Finally, infiltration, also irreversibly treatment, use an acid to remove a small layer of the eroded enamel and then add a resin layer. From the esthetic point of view this solve the issue immediately, but the lack of prospective studies add an interrogation mark to the long term results.
Hence, from all the three options, currently the remineralization is the only that is non-invasive.
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