Orthodontic treatment aims to improve functions and facial aesthetics by ensuring harmonious occlusal and jaw relationship; with beneficial effects on the oral health and quality of life of patients.
However, it also associates risks and complications.
Enamel surface demineralization or white spots lesions (WSL) remain by far one of the major adverse sequelae of fixed orthodontic appliance therapy, despite techniques and materials advances in preventive dentistry and orthodontics.
They appear during and sometimes persist after orthodontic treatment; they can compromise the successful outcome of the treatment and result in the early termination of treatment.
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In severe cases of WSL, invasive interventions can be required and clinician responsibility may also be engaged.
WSL seem to be related to the interaction of several factors including inadequate elimination of dental plaque due to intrabuccal appliances that limit the self-cleansing mechanism of the oral musculature and saliva, patient's modifying factors and change in bacterial flora during fixed appliances wear.
Considering how quickly these lesions can develop, prevention, early diagnosis and treatment remain one of the greatest challenges facing orthodontists and requires a thorough knowledge of the caries disease and the risk factors specific to each patient.
Prof. Farid Bourzgui