White Spots: Prevention in Orthodontics—Systematic Review of the Literature

Assunta Patano, Giuseppina Malcangi, Roberta Sardano, Antonio Mastrodonato, Grazia Garofoli, Antonio Mancini, Alessio Danilo Inchingolo, Daniela Di Venere, Francesco Inchingolo (), Gianna Dipalma () and Angelo Michele Inchingolo ()
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Assunta Patano: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Giuseppina Malcangi: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Roberta Sardano: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Antonio Mastrodonato: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Grazia Garofoli: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Antonio Mancini: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Alessio Danilo Inchingolo: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Daniela Di Venere: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Francesco Inchingolo: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Gianna Dipalma: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
Angelo Michele Inchingolo: Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy

IJERPH, 2023, vol. 20, issue 8, 1-19

Abstract: Early-stage dental demineralization, called white spots (WS), get their name from the characteristic colour that enamel takes on due to the acid attack of salivary cariogenic bacteria. They are often associated with fixed orthodontic therapy (FOT) and, if left untreated, evolve into caries with repercussions on oral health and dental aesthetics. This review aims to identify the most effective prophylaxis strategies to prevent WS during FOT. The search for the reviewed studies was conducted on the Pubmed, Scopus, and Web of Science databases, selecting English-only articles published in the 5 years from January 2018 to January 2023. The keywords used were “WS” and “fixed orthodontic*”, using “AND” as the Boolean operator. A total of 16 studies were included for qualitative analysis. Prevention begins with maintaining proper oral hygiene; fluoride in toothpaste, mouthwashes, gels, varnishes, and sealants can be added to prophylaxis and used regularly. Using a laser in combination with fluoride helps prevent the occurrence of WS and assists in the repair processes of initial lesions. Further studies are needed to establish international guidelines for preventing WS in orthodontically treated patients.

Keywords: white spots; fixed orthodontic; prevention; demineralization; treatment; fluoroprophylaxis; oral hygiene; fluoride; laser CO 2; enamel (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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