Occurrence and Evaluation of White Spot Lesions in Orthodontic Patients: A Pilot Study

Abstract

Orthodontic treatment may cause an increase in the rate of enamel decalcification on tooth surfaces, producing White Spot Lesions (WSL). Orthodontic patients are at a higher risk for decalcification because orthodontic appliances retain food debris which leads to increased plaque formation. Dental plaque, an oral biofilm formed by factors including genetics, diet, hygiene, and environment, contains acid producing bacterial strains with a predominance of Mutans Streptococcus (MS). MS and others metabolize oral carbohydrates during ingestion, the byproducts of which acidify the biofilm to begin a process of enamel decalcification and formation of WSL. This study tests if patients in orthodontic treatment at Temple University can be used as subjects for further longitudinal study of WSL risk factors. Twenty patients between the ages of ten to eighteen after three months or greater of treatment were enrolled to determine if duration of treatment, hygiene, sense of coherence, obesity, diet frequencies, age and gender correlated with development of WSL. Of these, age is positively correlated with the number of untreated decayed surfaces. WSL and plaque levels may negatively correlate with increased brushing frequency and duration, while flossing frequency demonstrated a statistically significant negative correlation. This population may be suitable for further study because of its high incidence of WSL (75%), however difficulty in enrollment and patient attrition necessitates that future studies be modified.