How to reverse those white spots on your teeth after braces?

White spots after braces wear
Orthodontic treatment is not just about waiting a few months or years for the teeth to straighten. But also about keeping them healthy during the process.
Teeth with braces are more likely to decay. It is not uncommon to see white spots ("early decay") on the teeth after treatment.
Fortunately, it is possible to reverse them and still achieve a stunning, straight smile.

What are these white spots that have appeared on my teeth after I got braces?

White spots after braces often mean the early sign of tooth decay, which happens when your enamel starts to lose its minerals.

This is because braces can cause more plaque to build up on your teeth, which means more bacteria that produce acids that can wear away your enamel.

To check if you have white spot lesions, try this easy test at home. Stand in front of a mirror and dry your teeth well, then shine a light on them. If you see areas that reflect light unevenly or look less bright than the surrounding surfaces, you might have white spot lesions.

You may also notice that the affected areas retain plaque more quickly. This is because they are more porous and rougher than healthy enamel. Clinical image showing early tooth decay after braces

How do white spots appear and evolve?

Enamel is the outermost layer of our teeth. It is also the hardest tissue in our body, composed mainly of minerals.

When our teeth are exposed to acid, their minerals dissolve, resulting in a process called demineralization.

the demineralization/remineralization cycle

Acid comes mainly from the bacteria that live in our mouths. After a sweet meal, the bacteria turn the sugar into acid.

The acidity peaks within 30 minutes, during which the enamel demineralizes. With time and lack of remineralization, this process can cause white spots to appear.

Don't worry, though - there are ways to prevent and treat these spots, and your dentist can help you out.

However, untreated, demineralization can continue to progress deeper into the tooth, reaching the underlying dentin layer.

At this point, the damage is irreversible, and the result is a cavity. Cavities are holes in your tooth that can be painful, cause sensitivity, and even lead to tooth loss if left untreated for too long.

Why are white spots more likely to appear with braces?

The reason is that braces promote the accumulation of plaque. It is a whitish and soft film that provides an ideal environment for the growth of bacteria. It increases their resistance and allows them to work in synergy.

In addition, braces make dental cleaning more difficult, increasing the risk even more.

As a result, plaque build-up increases considerably after braces, and more bacteria means a higher risk of tooth decay.

According to a review, wearing braces changes the quality and quantity of the oral microbiome. Pathogenic bacteria predominate in the mouth, increasing the risk of caries and gum disease.

The risk of white spot lesions from braces is even higher in the presence of other factors. Among them:

  • Your oral hygiene is poor.
  • You consume a lot of sweets and acidic foods.
  • You frequently snack between meals.
  • Your diet is overall unhealthy.

How to get rid of white spots?

Treatment of white discoloration depends on the cause and severity of the lesions. White spots that appear after braces usually refer to early tooth decay lesions.

Fortunately, they are not permanent as long as they are limited to the enamel. Enamel can recover the minerals lost by some fluoride and mineral products. Treatment options include:

1. Remineralizing treatment:

This involves regularly applying products containing fluoride, calcium, and phosphorus to help rebuild the minerals that the enamel has lost. As the enamel recovers its minerals, it will restore its visual properties, making these pesky spots disappear.

However, it's always a good idea to consult your dentist first. They will assess whether these demineralization spots are treatable at home, and will monitor their progress during the remineralization process.

Remineralizing products can be available in gel, cream, toothpaste and mouthwash form. Here are a few examples:

  • R.O.C.S. Remineralizing Gel (contains calcium and phosphorus).
  • CariFree Fluoride Free Gel (contains Nano-Hydroxyapatite).
  • GC Tooth Mousse (contains Recaldent).

Fluoride is also effective in treating these early lesions. A study conducted on the role of fluoride treatment for early decay following orthodontic treatment revealed that:

  • The use of fluoridated toothpaste twice a day allows remineralization after two months.
  • The combination of fluoridated toothpaste and gels accelerates the remineralization process for one month.

2. Enamel infiltration:

Also known as Icon Resin Infiltration, this technique is only feasible when demineralization stains are limited to the enamel surface. It involves applying a tooth-colored resin material to infiltrate and seal the pores of the tooth. This will restore the tooth to its natural appearance.

3. Treatment with filling:

If the tooth spot has turned brown or a cavity has formed, remineralization and infiltration techniques may not be effective. In such case, the decay must be removed using special instruments. The cavity is then filled with a cosmetic tooth-colored material.

4. Treatment with veneers:

Veneers can be a great option if you're dealing with major cosmetic problems, such as severely discolored and misshapen teeth.
These are thin, custom-made ceramic layers that cover the visible side of your front teeth, helping to conceal any abnormalities.
They don't require much removal of enamel and can improve the shape and color of your teeth, giving you a beautiful and even smile.

Prevent white spots

When white spots appear during orthodontic treatment, they often show up around the braces in a square shape. Sometimes these lesions are hidden and appear between the brackets and the teeth, especially if the glue wears away, which allows bacteria to enter these spaces and damage the enamel.

To prevent white spots from appearing, it's essential to maintain good oral hygiene before, during, and after braces. Here are some tips that can help you:

1. Before braces

Before getting braces, your dentist will make sure to remove any cavities, infections, or gum disease. This will allow the treatment to proceed in a healthy condition without complicating an existing lesion.

This is also the perfect time to learn and introduce new oral hygiene tools into your routine to maintain a healthy mouth for the long term.

2. During orthodontic treatment

The key to avoiding dental white spots during orthodontic treatment is oral hygiene.

  • Brush your teeth twice a day with fluoride toothpaste, and do it right! Plaque is the main culprit. So, it's crucial to keep your teeth clean and free of plaque buildup.

  • Flossing can be a little tricky with braces, so try using an interdental brush. Choose a size that fits comfortably between your teeth, and gently move the brush back and forth to remove plaque and food particles.

  • Another great tool to use is a water flosser. It can reach areas that may be difficult to clean with traditional flossing. It also stimulates your gums to prevent gum disease.

  • Ask your dentist if you can use fluoride supplements like fluoridated gel or mouthwash, or any other alternative. Fluoride can help strengthen your enamel, reduce bacteria growth, decrease mouth acidity, and remineralize early lesions.

  • Finally, make sure to get your teeth professionally cleaned regularly at the dentist. It's recommended to get a cleaning 3-4 times a year to prevent tooth decay during orthodontic treatment.

3. After braces wear

Once your braces are off, cleaning your teeth will be much easier. To enjoy your new straight smile for life, make sure to:
  • Maintain good oral hygiene and visit your dentist regularly.
  • Ask your dentist if you can continue to use fluoride supplements, especially if you are at high risk for tooth decay.