What can I do about those white spots on my teeth? - Dr. Charles Bell

As a general dentist, I am asked this question almost on a daily basis. Usually it is from a parent expressing concern about their child's teeth after the removal of orthodontic brackets. I understand the frustration and concern. Orthodontics is not cheap, and now the teeth are nice and straight, but in many cases the aesthetics is very compromised by the existence of a mottled or chalky appearance.

This demineralization around the brackets is very common and has been a source of frustration for both parents and dentists for years.  There is a relatively new product that has shown promise in combating this problem.

MI paste and MI plus paste made by GC America have shown great results in both prevention and resolution of these white spots caused primarily by decalcification of the enamel surface at the bracket interface. These products contain Recaldent (CPP-ACP) an ingredient which helps bind calcium and phosphate to the tooth surface... in essence remineralizing the tooth.

Prevention:

We now strongly recommend that all our patients in orthodontics use the MI Paste Plus while they are in treatment.  This is used at nighttime right before bed as toothpaste.  After the teeth are brushed the patient just spits out the excess and does not rinse out their mouth with water.  You want that paste to be active as long as possible on the tooth surface.  This has shown to reduce the decalcification during ortho treatment.

Resolution:

For those who have already developed the white spots there are a variety of techniques possible depending on the severity of the decalcification.

For mild problems the patient can just dab a small amount of the paste on the spot twice a day.  You will see a gradual change over a month or so.

For severe cases we do a combination of in office treatments using the MI Paste Plus as well as home custom tray use twice daily. We have seen some nice progress in cases after only a few office visits over a period of 3 weeks.

So ask your dentist about possible treatment options.