Can we prevent or minimise the occurrence of white spot lesions (WSLs)?
Review
WSLs is not uncommon iatrogenic effect of orthodontic treatment.
The extent of WSLs varies from 4.9 to 84% depending on the examination technique used (Gorelick et al., 1982; Chapman et al., 2010).
WSLs commonly occur in lower canine, premolars, upper canine and laterals especially in the cervical third (Gorelick et al., 1982; Øgaard et al., 1988).
50% of the WSLs spontaneously disappear or become less sever within 6 months after debond (Øgaard, 2008).
Several options have been suggested to prevent or minimise its occurrence including xylotol chewing gum, chlorhexidine, high fluoridated toothpaste, fluoride mouthrinses, tooth mousse, fluoride gels & varnishes, fluoride releasing devices, systemic probiotic and probiotic toothpaste, melaleuca alternifolia dental gel and preventive sealant

Update EJO published the 1-year follow up data of triple-blind randomized controlled trial undertaken by a team from Sweden led by Dr Sonesson in their October, 2020 issue.The paper titled: “Fluoride varnish for white spot lesion prevention during orthodontic treatment: results of a randomized controlled trial 1 year after debonding”
The main finding was that fluoride varnish has a small effect in reducing WSLs in comparison to control.
What do you think?
Link to the paper:
https://pubmed.ncbi.nlm.nih.gov/33009565/
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