Ask Dr. White: What are those white spots on my teeth?

You know those white spots that sometimes appear on teeth? Well we were curious and wanted to know, so we asked Dr. White to explain them. Here are his responses:

What causes white spots on your teeth? Some are developmental, like a flaw in a diamond called an inclusion. Some are related to different minerals absorbed during enamel formation. Some are caused by damage to the cells that produce enamel either by systemic infections and fevers or direct from a baby tooth infection or trauma.

Can they be cavity-related? They can be the initial signs of enamel decalcification caused by the acid produced by plaque.

What about fluoride in your water, can that cause white spots too? How do you know how much fluoride is in your water? Fluoride can also cause enamel discoloration and opacity but not usually the typical white spots. Call the local water provider or the local health department.

Can white spots appear after braces? How can you best prevent that from happening? The white spots after braces are decalcified areas from plaque acid not removed by good hygiene during braces. They can be prevented by good hygiene and fluoride.

What about white spots that appear in the morning and fade as the day progresses, what does that mean? Usually this means mouth breathing causing dehydration of the enamel on the front teeth.

Are white spots on your teeth genetic? Sometimes - see above.

Can nutrition and diet affect the white spots? Early in life yes, after teeth are erupted the changes are to the surface rather than internal.

What are the best ways to prevent these white spots from appearing? Proper fluoride levels in drinking water. Water testing for heavy metals in environment. Knowledge of which antibiotics and other chemicals that can damage developing enamel. And proper hygiene.

If white spots are already present, how are they treated? Recalcification with fluoride, microabrasion of shallow lesions, and restoration by the dentist.