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Can we prevent or minimise the occurrence of white spot lesions (WSLs)?


  • 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:


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