Watch out for those white spots on your teeth when wearing your braces!
A common experience for those who are wearing braces is for white spots to develop on the teeth while wearing braces. These spots are usually more visible on front teeth but on closer inspection they can also be observed on back teeth. They are usually chalky white in colour and contrast with the normal creamy white colour of surrounding enamel. The spots are not caused directly by the braces themselves but the braces can make it more difficult to carry out normal oral hygiene procedures such as brushing and flossing.
To understand how the spots come about you need to understand how the tooth enamel reacts with the normal environment in the mouth. Although tooth enamel is the hardest substance in the body, at a microscopic level, it is constantly changing because minerals in saliva such as calcium, phosphate and fluoride ions are constantly exchanging with mineral ions on the tooth surface. This happens every time you eat food and is a normal process and can be beneficial to the teeth when fluoride ions replace other ions on the tooth surface. When this happens, the tooth enamel becomes harder and more resistant to tooth decay and the colour of enamel stays the same.
White spots develop when the environment of the teeth changes. When the braces are placed on the teeth if oral hygiene is not maintained at a high standard, changes will gradually come about on the tooth enamel. Poor oral hygiene will result in dental plaque biofilm accumulating on the enamel surfaces adjacent to the brace brackets on the teeth. This will result in a steady stream of acidic ions interacting with the teeth surfaces and calcium ions being lost from the outer layer of enamel especially after eating carbohydrate foods. This is the beginning of the process we call dental decay but this process is reversible even after white spots are formed on the teeth. The white spots represent areas of the teeth that have been demineralised through loss of calcium over a prolonged period of time.
However, the good news is that the teeth are capable of completely reversing this condition if the environment around the teeth is altered.
This can be achieved in a number of ways. It is good practice always to use a fluoride mouth rinse at least twice a day first thing in morning and last thing at night while wearing a brace. Ask your dentist to prescribe a high dose fluoride tooth paste (at 2,500 parts per million fluoride) to be used while you are wearing the brace and for about six months afterwards to insure that the tooth surfaces directly under the brace brackets completely re-mineralised. Your dental professional will advise you about the correct standard of oral hygiene you need to practice in order to keep your teeth and gums safe while wearing a brace. This will include information about the correct type of tooth brush, inter-dental cleaners, toothpaste and mouthwash you should be using.