After you spend thousands of dollars and sometimes a number of years wearing orthodontic braces, you expect that you will have the perfect smile when all is said and done. Unfortunately, that is not always the case. Sometimes, a patient will experience what is known as decalcification from their braces. These are white spots that appear on the teeth either around the area of the bracket, up near the gumline, or underneath the wires that connect the brackets of traditional metal braces. But what exactly is decalcification? How can it be prevented? And is there a way to remove these spots once the damage is done?

To answer the first question, decalcification is a process by which white spots develop on areas of the teeth where bacteria (plaque) has been allowed to stay for a long period of time. This happens very easily when you have braces, because plaque, being sticky, likes to attach to smooth areas. And because the smooth areas of your teeth are hard to reach when you have braces, that bacteria can sit in those exposed spots and eat away at your tooth’s enamel, causing the unsightly white spots that can eventually lead to cavities.

Stages of Decalcification

Tooth decalcification typically occurs in stages. Here’s a brief overview of what they are. 

Dental Fluorosis

Many patients develop white spots in they’re younger years as a result of consuming too much fluoride. When this happens, it’s typically harmless, especially it’s before a child’s teeth have broken through their gums.

Enamel Hypoplasia

Enamel hypoplasia is when the enamel on the teeth forms or develops incorrectly. It’s similar to dental fluorosis in that it only occurs in the childhood phase when teeth are still developing. This condition, however, can raise the risk of tooth decay.

Carious Lesions

If you notice a chalky white spot on your teeth, you have a carious lesion, which means that your decalcification has set in. It is visible but can be reversed through a special treatment.

If you have a good orthodontist, he or she will be on the lookout for those potential decalcification spots, and will of course be encouraging you to brush. There are flossing and brushing products made especially for those people wearing orthodontic braces, which you should take full advantage of. I have compiled a comprehensive list of these products here. Use these tools to help you keep your mouth especially clean while you are wearing your braces.

Now, what happens if you and your orthodontist miss the signs that a decalcification spot is forming? All hope is not lost. You can purchase over-the-counter brands of toothpastes and mousses that will help to restore the eroded enamel, and strengthen the enamel you already have. You can also get a prescription from your orthodontist for a rinse that will do more of the same. Finally, there are treatments that can be done by your orthodontist or dentist that will restore your smile to its normal shade.

We also recommend that you invest in a quality electric toothbrush as this can keep your teeth free from plaque to prevent decalcification. In addition, be sure to keep up with your flossing regularly with traditional floss, a Waterpik, or oral irrigator. When you’re brushing your teeth, try to pay special attention to those areas that are obstructed by brackets, wires, or other orthodontic devices. You should stay away from sodas and sugary foods as they build plaque quickly and go for foods that are packed with calcium such as broccoli, milk, and almonds.

As long as you are vigilant about your dental care while wearing your braces, decalcification should not be a problem, and you will be well on your way to enjoying your new smile once your braces are off.

Also, keep in mind that while you may not like the way white spots look, they are rarely a cause for concern. We understand, however, that they take away from the beauty of your teeth and smile and want to remove them. In addition, it’s important to note that while you can’t completely reverse decalcification when it has occurred, you can reduce it and stop it in its tracks.

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