Carious white spot lesions
involve active caries with a
porous enamel surface. An
arrested white spot lesion is actually remineralized, with
an intact enamel surface that is no longer an active carious
lesion. A white spot lesion is confi ned to the enamel,
approximately 100-150 microns deep, with an intact but
porous layer. It is best observed on a dry tooth surface,
which will be seen to have lost its surface shine. This
opacity results from the porous enamel surface, which
could be described as a “lid.” The presence of this enamel
lid is essential for remineralization, so do not destroy
this surface. White spot lesions can be prevented through
excellent diet and oral hygiene, the use of fl uoride toothpaste,
fl uoride rinses, and fl uoride varnishes, Dr, Staley
recommends establishing a patient protocol for nutrition
and oral hygiene before placement of fi xed orthodontic
appliances. Educational pamphlets can assist the patient,
and he recommends being positive without dwelling
excessively on the potential negative aspects of decalcifi -
cation.