White Spots on Teeth. What Can You Do?

White spots on teeth can be incredibly frustrating. When you’ve got no idea why they’re there it’s difficult to prevent them. More so, you look after your teeth and apart from these marks, they’re perfect. But fear not. There are a few reasons why white spots can appear and luckily, a few more ways we can remove them.

Let’s find out what causes white spots on teeth and what can be done to remove them

white spots on teeth

What do the white spots look like?

White spots on teeth can come in many shapes and sizes. Commonly, they appear as small, irregular milky patches just on the front teeth and the first molar teeth. In more severe cases they can be larger, incorporate browner areas and can cause the enamel layer of the tooth to break down.

What causes white spots on teeth?

Early decay

Plaque accumulation on your teeth can cause dental decay. Initial decay presents as white chalky areas, before progressing into brown cavities. If you don’t clean plaque off your teeth it dissolves the enamel layer, making it appear white.

Fluorosis

Ah, fluoride. Almighty protector of teeth. But, the occasional reason for white spots, streaks and flecks.  Overuse of fluoride is called fluorosis and can also present in shades of brown and grey with small holes. Fluorosis occurs in childhood if there is excessive fluoride ingested while the teeth are developing under the gums. Note I say ingested. This means the fluoride must be swallowed during teeth development. Use of fluoride in the mouth is extremely unlikely to cause problems, and after the teeth have developed by the age of 8-10 the risk is minimal. Sources of fluoride include toothpaste, mouthwash, supplements and drinking water.

Tetracycline staining

Tetracycline is an antibiotic used to treat infections. Staining can occur when it’s prescribed to a child whose adult teeth are still developing under the gums. Once these teeth have erupted in the mouth, they appear stained with white spots and darkened bands. We now understand about tetracycline staining so it’s less likely to be prescribed to children, but always check with the doctor as it can cause white spots on teeth.

Plaque

Plaque is white. It looks like wet bread and normally accumulates around the gumline, making the gums bright red in the process. Luckily it’s easily removed by a toothbrush.

Braces during orthodontic treatment

white spots on teeth due to previous orthodontic treatment

Poor oral hygiene while wearing braces can cause white spots on teeth. You’ll notice when you’ve had them removed, and you’re left with a lovely white outline perfectly showing where your brace used to be. This happens when plaque builds up around the brackets and the wires and causes early decay.

Dry mouth

Dehydrated teeth appear white and chalky. You’ll notice this more if you’re a mouth breather or have a cold. It’s why you may get a white spot on a tooth overnight. Luckily, as soon as the teeth become wet again the white spots on the teeth disappear. Interestingly, the reason your dentist dries your teeth with the air is to highlight these white spots. We can see them easier and ensure they’re not dental decay.

Hypoplasia or hypomineralisation

If you’ve had white spots on your teeth since childhood, there’s a good chance it’s down to enamel hypoplasia. This fancy word just means the enamel hasn’t formed perfectly. Why is this? Too much calcium, too little calcium, illness while the teeth are developing under the gum, certain medication and difficult childbirth have all been linked to white spots on teeth. Sometimes you’re just unlucky.

How to remove white spots on teeth

Microabrasion

Perfect if the white spots are in the outer layers of the enamel. This simple technique involves removing the stains in these layers, leaving the glossy appearance underneath. A softening solution is placed over the spots and left for a few minutes. We then use a polisher to gently polish out the white marks.

Teeth whitening or bleaching

Boutique teeth whitening

Another simple solution is to bleach your teeth to lighten them to the same shade as the white spots. This can have spectacular results. Something to be aware of when you start is that bleaching causes the white spots to become more prominent initially. Over the course of the treatment these will blend in, so if you have white spots on your teeth after whitening then you may need to whiten a little more.

Composite bonding

There are two ways to do this. Either remove the white spots from the tooth and then refill it with composite to match. Or, cover the whole of the tooth with a composite veneer which will mask the entire surface.

Ceramic veneers or crowns

These act as a disguise. Depending on the severity of the white marks it may be wise to cover the front of the tooth with a veneer or the whole way around with a crown.

Resin infiltration

This is a covering of a resin into the white spot in order to fade and match it. There’s no injection needed and it’s a cheaper option than veneers or bonding. It can be a handy way to get rid of white spots on teeth from braces, however, it normally gives an improvement and not a complete cure in extensive lesions.

Prevention

As always with dentistry, prevention is always better than cure. A great oral hygiene regime will ensure there’s no decay. Use fluoride toothpaste but ensure its spat out and not swallowed. There are different strengths of toothpaste. Check with your dentist the right strength and amount to place on the brush. Your dentist will also know if you’re in a fluoridated water area.


Author

Dr Gareth Edwards BDS (Hons) MFDS RCPS (Glasg) is a dentist who qualified with honours. Based in the Bournemouth and Poole region, he has a keen interest in orthodontics and aesthetic dentistry and is a certified Invisalign provider.