"White Spots on Teeth: Cosmetic or Something More Serious?"Beautiful teeth are always trendy, now more than ever. It comes as no surprise that 47% of Americans choose a person’s smile to be their most important physical feature. Luckily, more than half (64%) of those surveyed like their smile. Unfortunately, those who are unhappy with their pearly whites attribute their disappointment to the color of their teeth. White spots and yellow/gray tinting are a few of the factors that motivate patients to seek the advice of their dentist about enhancing their smile. Improving tooth color can be as simple as whitening at home or a dental office, however not all tooth imperfections can be corrected this way. White spots can leave a patient feeling self-conscious about their smile and at a loss of how to get rid of them. Aside from being a cosmetic concern, white spots can be a primary indicator of tooth decay. Fortunately, treatments are available to help reduce their appearance or eliminate them altogether.

White spots can be found on any tooth but are a bigger cosmetic concern when they are easily seen in your smile. White spots are an indication of weak or demineralized enamel, which could lead to a cavity. Some of these spots can be genetic or due to trauma, but most are caused by a breakdown of the enamel layer making it appear opaque. The bacteria arising from poor oral hygiene and a high-sugar diet produces acids that destroy the intact enamel creating white spots. After braces, white spots can be visible around the brackets indicating plaque was not adequately removed during orthodontic treatment.  Over the counter whitening strips are also more acidic, which can demineralize your tooth’s enamel with misuse.

Prevention is key, so the best way to treat these lesions is to stop them from ever occurring. Eating a diet low in sugars and avoiding highly acidic foods such as sour candies, sodas, juices and acidic fruits like lemons. Maintaining good oral hygiene by brushing twice a day, flossing and rinsing with an alcohol-free fluoride rinse daily, helps to keep the bacteria in plaque from creating white spots. At the very least, rinsing your mouth out with water after sugary or acidic foods aids in neutralizing the oral pH level.  If you are prone to dry mouth, often due to medications, use a lubricating oral rinse or sugar-free hard candies to help produce a good salivary flow and a more neutral pH.

If you suspect you have white spot lesions, visit your dentist for a proper diagnosis to determine the best course of treatment. Since white spots vary so greatly with their severity, noninvasive treatments require variable amounts of time. Unless the lesion is a cavity or a very deep white spot, it is always best to start with the most conservative approach before resorting to alternative options.

Noninvasive treatments can be as simple as topical pastes/gels or sealants. One option involves opening the pores of the tooth and applying a high concentration of a paste that releases calcium and phosphate to the enamel surface, helping remineralization. This treatment, though effective, may require several applications before results can be noticed. Another minimally invasive treatment option is the placement of a very thin layer of resin to fill in the weakened pores. The resin material blends into the color of the tooth, minimizing the appearance of the white spot. A major benefit of these two types of treatment is they do not require any anesthesia or drilling. Of course, if these options are not sufficient enough to minimize the appearance or get rid of them, a more invasive treatment can be used. These may include microabrasion, composite fillings, and porcelain options such as veneers or crowns.

While white spots can be disappointing or embarrassing, the good news is there are many treatment options available that will drastically improve the condition of your teeth. Whether it is a cosmetic condition or a cavity concern, it is important to reach out to your dental professional to discuss your individual needs and all the treatment options you may have.

Laura Sharbash, DDS is a general dentist at Seidner Dentistry & Associates and an attending advisor at Morristown Medical Center.  Dr. Sharbash is a magna cum laude graduate of the State University of New York at Buffalo School of Dental Medicine. She is a member of the American Dental Association, Academy of General Dentistry, New Jersey Dental Association, and Tri-County Dental Society. To learn more about white spots and treatment options, please visit http://randolphnjdentist.com