White Spot Lesions: Fixed Orthodontic Treatment Scars - A Review

White spot lesions (WSLs) are one of the common iatrogenic effects seen in patients undergoing orthodontic treatment with fixed appliances. Fixed orthodontic appliances act as food traps leading to prolonged plaque accumulation. The acidic by products of the bacteria in plaque are responsible for the subsequent enamel demineralization and formation of white spot lesions. These orthodontic scars lead to poor esthetics, patient dissatisfaction and legal complications. This concern raises the need for assessing the saliva, oral hygiene status and caries rate before beginning of treatment and initiating preventive measures. Orthodontists must take up the active responsibility to educate patients about the importance of maintaining good dietary compliance and excellent oral hygiene regime. A review of literature suggests that topical fluoride agents such as fluoridated toothpaste, fluoride-containing mouth rinse, gel and varnish prevent or minimize the formation of WSLs during orthodontic treatment.