White Spots on Teeth

Everyone dreams of having pearly white teeth. Although black spots on teeth are distressful enough as it is, something that most of us would equally not settle for are white spots! White spots on teeth can often be a very disturbing and unsightly view, as they not only mar the person's smile, but also his/her confidence. While most people might notice that they have white spots on their teeth right from the time their teeth began to erupt into the oral cavity, some people might have noticed the presence of white spots only recently. The timing of visibility (that is whether this discoloration was present at birth, or if it's cropped up only recently) greatly helps in diagnosing the condition. Given below are the causes and treatment options to deal with this problem.

Causes

Fluorosis
Fluorosis is by far the most common cause of white spots on teeth. Fluorosis is a condition where the amount of fluoride reaches such a high amount in the body, that it affects teeth and other parts of the skeletal system. The main source of fluoride is drinking water, though normally occurs when the amount of fluoride in the water being consumed is more than 1ppm (parts per million). Dental fluorosis causes hypomineralization of the tooth enamel which leads to stains on teeth. Though only the initial stages of fluorosis cause white spots, if fluoride ingestion levels are not brought under control, it can lead to skeletal fluorosis, which is a much more serious disease.

Fresh Cavities
One of the most common causes is tooth decay. In the initial stages of dental caries, the lesion is a well demarcated, chalky-white opacity, without any loss of continuity of the enamel, that is the surface looks discolored as white spots on teeth, but there is no breakage on the surface. Enamel, though the hardest structure in the human body, is semi-porous in nature, and hence, there is increased permeability of enamel, and thus, susceptibility to caries. Such white spots mostly appear on the front teeth, near the inter-dental wall.

Dental Plaque
Dental plaque is commonly mistaken as a white spot on tooth. Dental plaque is the microfilm that is present on the surface of teeth. Sometimes, there may also be food particles on the surface of the teeth that may be mistaken for white spots. Hence, always brush your teeth, or at least rinse them properly, before reaching a diagnosis of white spots on teeth.

Enamel Hypoplasia
A condition that seriously affects dental health, enamel hypoplasia is a condition where the tooth enamel is incompletely developed, that is, in thickness and in quality. It occurs due to defective enamel matrix formation during the development of teeth. It leads to white spots, breakdown of occlusal surface and eventually the presence of other stains on teeth.

Amelogenesis imperfecta
Amelogenesis imperfecta is a group of hereditary rare diseases that affect enamel formation. It causes production of abnormal enamel, although the dentin and cementum are normal. This problem can strike at any of the three stages of enamel formation - enamel matrix formation, early mineralization or enamel maturation. Thus, it can be of hypoplastic type, hypocalcification type or hypomaturation type. This condition leads to white spots on teeth, as the enamel looks white and flaky. Also, there is often chipping of the incisal edges and discoloration of cusps and tips of teeth, which gives it a 'snow-capped teeth' appearance.

Other Causes
Other causes include aggressive pin point brushing, excessive intake of sodas, especially when taken with a straw, as it leads to decalcification of the tooth structure in that region.

Treatment Options

The treatment will depend on the disorder causing the problem. If the discoloration is due to fluorosis, then the person should immediately stop ingesting water containing high levels of fluoride, and switch to water which has less than or equal to 1ppm of fluoride. Similarly, if there are white spots due to incipient cavities or accumulation of plaque, then the person should get cleaning done, and should also get those teeth filled. In most of these cases, teeth bleaching is not a very good idea, as the discoloration on the tooth is already in the form of white spots, so it will not help to bleach the tooth. Additionally, it is lot more difficult to treat anomalies like enamel hypoplasia and amelogenesis imperfecta, as the tooth structure is too weak to support the fillings.

Thus, white spots on teeth can be a bit disturbing and difficult to deal with. However, with some basic dental care, and depending on the disease present, the dentist will chalk out a treatment plan to best deal with this unsightly discoloration.