White spots on teeth: what causes chalk dots and stripes, what does it mean and what to do

Sometimes you can notice chalky-colored stains on your teeth. There can be many reasons for this. And they are all different. Chalky spots usually appear on those areas of the enamel where their mineralization is impaired.

If they are formed due to improper dental hygiene or stains occur due to an unbalanced diet, then such stains can be eliminated with the help of whitening pastes that do not contain fluoride. White spots may appear if tooth enamel begins to flake off.

The disease can develop on one tooth or affect the teeth of the entire dentition. Another cause of chalky spots is fluorosis, in which large amounts of fluoride compounds accumulate in the body.

The mechanism of the problem

The health of dental units is ensured by a number of substances: these are vitamins A, C, E, D, group B, potassium, iron, iodine, magnesium, zinc and others. But the two main elements necessary to maintain the functionality of the jaw are calcium and fluoride.

Due to injury, work in a toxic industry, insufficient hygiene, or the accumulation of pathogenic bacteria on the surface of the enamel, it can lose useful compounds, which is why white spots, dots or stripes appear on the teeth (we will consider the result with a photo below).

Treatment at home

Some procedures to eliminate the disease can be performed at home. To do this, you need to visit a specialist who will carry out professional hygiene and prescribe procedures. Treatment of enamel caries in the stain stage can be carried out using professional means: toothpastes, gels, applications. Very popular and quite effective are remineralizing gels (TOOTH MOUSSE, ROCS Medical Mineral and others), medicated toothpastes with a high content of fluoride and calcium (ROCS Medical, Elmex, Biorepair).

The products are used for cleaning teeth, and also in the form of applications - applied to the required surface for 5-10 minutes daily for 1-2 weeks. The active components of the products penetrate into the lesion, promote its remineralization - restoration of the structure with mineral substances.

Self-treatment of caries without consulting a specialist is most often ineffective; the carious process does not stop and affects the underlying tissues. The therapy procedure is quite serious and requires precise, correct implementation of the dentist’s prescriptions.

The use of traditional medicine, unfortunately, will not help eliminate carious defects. There are no herbs or remedies that can stop the disease. Some traditional medicine recipes have an antiseptic, anti-inflammatory effect, and therefore can only improve the general health of the oral cavity.

What does the pathology look like?

Initially, a very small speck is detected, which is difficult to notice with the naked eye. Over time, the focus of demineralization increases. The affected areas lose their natural shine because the crystalline structure of the substance covering the dentin is destroyed: it becomes porous, darkens and, due to a change in texture, turns into a reservoir for pathogenic microorganisms. At first, such microdestructions are painless, which indicates the need for visual control.

Most often, canines and incisors are affected, but sometimes pathology occurs on molars. It is important to notice it in time - the process is reversible with early diagnosis. If it is neglected, only radical methods of treatment will help (drilling, installing a large filling).

Causes of problems in adults

White spots on tooth enamel can have different etiologies. To make an accurate diagnosis, the doctor examines and interviews the patient: he clarifies how oral care is carried out, whether there were injuries or other prerequisites for the appearance of foci of remineralization.

Initial caries

Whitish matte formations may indicate that the pathological process has begun and will soon make itself felt. The main reason for its development is poor hygiene (a person brushes his or her teeth irregularly, not thoroughly enough, or does not floss). The disease can also be caused by an excess of carbohydrate foods in the diet, especially fast carbohydrates (white bread, sweets). The resulting plaque becomes a breeding ground for bacteria and a good “future reserve” for the formation of caries.

If you start therapy at this stage, you can get by with non-invasive procedures, but the neglected process will lead to the destruction of dentin and, as a consequence, to pulpitis (a diagram of pulp damage can be seen in the illustration).

Traumatic impact

It is not so easy to injure the jaw in everyday life, but there is an exception: often the cause of white spots and stains on the teeth is wearing braces and splints. After removal of the orthodontic structure, foci of demineralization are found on the enamel surface; their occurrence could be avoided by observing dietary restrictions and hygiene.

The root cause of lesions under braces is the accumulation of food debris (especially acidic and carbohydrate-rich foods). This is why doctors advise regularly using an irrigator after installing jaw retainers. The surface areas under the locks are poorly moistened with saliva, which aggravates the situation.

Patients who have not been treated by an orthodontist also have white spots on their teeth. They are associated with a constant load:

• frequent consumption of seeds, nuts and other solid foods;
• bruxism (involuntary clenching of the jaws both during sleep and while awake).

Athletes involved in contact martial arts are also at risk.

Industrial or occupational fluorosis

He can be:

• streaked or spotted (mild form);
• chalky-mottled (moderate severity);
• erosive and destructive (severe course of the disease).

It occurs due to excess fluoride in the patient’s body and also leads to the appearance of chalky or transparent spots, specks and stripes on the teeth. The disease manifests itself in people who have worked for a long time in industries with high fluoride concentrations:

• glass, ceramic, cement;
• woodworking;
• oil producing

Workers of hazardous enterprises are recommended to regularly visit the dentist to identify pathology in the early stages and undergo timely treatment.

Hypoplasia

Many dental diseases in an already born baby are a consequence of the incorrect lifestyle of the expectant mother, lack of vitamins, and poor ecology.

White spots on a child’s baby (less often permanent) teeth often occur due to underdevelopment of the enamel. The foundation for its formation in children is laid during the period of intrauterine development - at the 7th week of pregnancy. Permanent incisors and molars are formed from 5 months to 7–8 years.

The most popular prerequisites for the spread of pathology:

• hypovitaminosis D in the mother;
• toxicosis;
• transferred rubella;
• frequent inflammation of the gastrointestinal tract;
• birth injury.

The problem cannot be prevented with a 100% guarantee, but you can make every effort to reduce the likelihood of its occurrence.

Dental troubleshooting

If the chalky stains on the teeth are carious in nature or the situation is advanced, you should immediately consult a doctor. The sooner you visit the dentist, the easier and more effective the treatment will be.

The solution to dental problems occurs as follows:

• In case of loss of minerals , a remineralization procedure is performed. It is carried out by applying a protective layer of a special paste, which gradually saturates the enamel with minerals and has a strengthening effect. In case of excess fluoride, the supply of minerals is replenished using electrophoresis and applications.

Teeth restoration procedure is very popular , which whitens the enamel and restores their beauty and health.

• Hypoplasia is treated with silvering or fluoridation , which will preserve baby teeth until permanent teeth appear.

• In severe cases, plates with a special chemical composition are installed .

What diseases cause white spots on teeth to appear in children?

There are several options here:

1. Lack of vitamins or minerals - in this case, in addition to visiting the dentist, it is worth visiting the pediatrician to take tests, prescribe medications or adjust the diet.
2. Endemic fluorosis - most often occurs in babies living in industrial areas due to excessive saturation of drinking water with fluorides, if the expectant mother works in hazardous industries during pregnancy. In addition to medical intervention, you should, if possible, reconsider your lifestyle and eliminate the use of fluoridating pastes (they are not recommended for children under 4–5 years of age).
3. The hypoplasia described above is a common cause of white spots found on dental photographs.
4. Hardly started caries is the most common option.

The pathological process, which can develop in an adult for several years, in the case of a child often occurs rapidly and leads first to darkening of the stripes on the enamel, and then to the formation of large carious cavities. If the situation is neglected, the crown will collapse completely, leaving behind only a small black “hole” in place of the element. In addition to physiological reasons, this also occurs due to the difficulty of carrying out hygiene procedures, especially since older relatives often treat the baby with sweets (soda, sweets, fine flour bread). To avoid complications, it is recommended to visit the dentist with your child every 2-3 months.

The occurrence of pathology during the gestational period

Pregnancy is stress for the body and a time during which a woman requires an increased concentration of nutrients in food. The fetus needs minerals and vitamins for the correct formation of all systems and organs, so the expectant mother may experience a deficiency of them. It happens that foci of demineralization occur as a result of toxicosis, when, due to constant nausea, an overly acidic environment is created in the mouth.

If a white spot appears on a pregnant woman’s tooth, this means that it is worth visiting not only a dentist, but also a gynecologist to rule out metabolic disorders and alleviate unpleasant symptoms.

Causes of caries in the spot stage

There are quite a lot of theories about the occurrence of caries and the factors that cause the pathological process. Nowadays, experts adhere to the modern theory of origin. Under unfavorable conditions in the oral cavity, an acid-base imbalance occurs on the surface of the teeth. Dental deposits in the form of plaque and stone contain pathological microorganisms and food debris. Microbes process simple carbohydrates and release acids that damage the enamel structure.

At the spot stage, the enamel loses trace elements in the subsurface layer and the lesion looks like a white spot. In the absence of treatment and good hygiene, further tissue destruction occurs and a cavity forms in the tooth. In a chronic course, pigmentation of the spot may occur, then a defect appears in the form of a brown spot.

Factors that contribute to the occurrence of caries:

1. Poor or insufficient hygienic care of the oral cavity. The accumulation of plaque on the dental surface is a favorable environment for the growth and development of pathological microorganisms. The infection causes various diseases of the oral cavity, negatively affects the body, and can cause exacerbation of chronic pathologies or decreased immunity. Dentists recommend regularly and thoroughly cleaning your teeth and tongue from plaque.
2. Genetic predisposition. Some hereditary factors contribute to the development of the carious process: malocclusion, thickness and composition of saliva, thickness of enamel, etc.
3. Disturbances in the process of formation of tooth germs. If during pregnancy there was insufficient intake of vitamins and minerals into the body of the mother and baby, then there is a risk of disruption of the normal process of formation of dental tissues. As a result, after teething, the baby’s teeth have a weak structure and are quickly susceptible to carious lesions.
4. Diseases of the body. Some pathologies of the body can disrupt the composition and thickness of saliva. Oral fluid not only mechanically washes the teeth, but also participates in the process of enamel mineralization and neutralizes the effect of acids. In people with viscous saliva, the cariogenic situation in the oral cavity is often unfavorable; multiple dental lesions occur.
5. Diseases of the salivary glands. Pathologies are accompanied by disturbances in the production, composition and functions of oral fluid and can, in combination with other factors, cause caries.
6. Poor nutrition. An elementary lack of vitamins, minerals, and microelements in the diet can be the cause of pathology.

Main symptoms of diseases

The signs of lesions vary, and the prognosis in the absence of timely medical intervention is also different. The final diagnosis should be made only by the attending physician, but the patient can, based on the nature of the pathological process, make an assumption about the root of the problem.

1. If the enamel is injured, the person most likely knows about it - he recently removed braces or the jaw was mechanically damaged. Only the area on which pressure was applied or the part of the tissue hidden under the orthodontic structure is treated.
2. If a child or adult has white spots on the front teeth (incisors) and molars, the reason is often the development of caries. Such neoplasms are localized randomly, but quickly progress, turn black, and deepen. The focus of the disease is single or few.
3. With fluorosis, chalky or pale yellow stripes appear, which later darken.
4. Hypoplasia is diagnosed in children and adolescents - and neighboring elements usually suffer.

Diagnostics

Diagnostics is an important stage of the examination, with the help of which the doctor will accurately diagnose and determine the treatment method for caries in the spot stage. The dentist conducts a clinical examination, probing, thermal diagnostics and various diagnostic tests.

When probing, a rough enamel surface is determined. Thermal tests are negative, that is, pain does not occur when exposed to cold or hot water. In some cases, radiography is performed to rule out periodontal disease.

Samples are necessary to differentiate caries in the spot stage from hypoplasia, fluorosis and other non-carious defects. Before using dyes, the tooth is cleaned and any dental deposits are removed. The enamel is dried and a special preparation is applied (methylene blue or red, tropeolin, carmine). The stage of caries development and the boundaries of its distribution are determined by the degree of staining of the defect. Non-carious defects are not stained with dyes, so the doctor excludes them.

Methods of treating pathology for initial caries

Inflammation at the initial stage is treated without the use of a drill and anesthesia: this is a painless manipulation that prevents damage to dentin, and the enamel can be considered healthy after treatment. In some cases, only the doctor at the appointment sees white spots on the teeth, so it is better to carry out these procedures immediately after identifying the problem.

Remineralization

Remotherapy is the process of artificially saturating tissues with micro- and macroelements. It is also indicated after prolonged use of splints or braces.

Calcium gluconate is most commonly used by dentists. A swab soaked in the solution is applied to the previously cleaned and disinfected jaw and left for exposure for several minutes. Sometimes the procedure requires repetition.

To ensure long-lasting results:

• brush your teeth with a soft brush and low-abrasive toothpaste;
• exclude too cold and hot, spicy, sour foods for a day or two.

Fluoridation

There is significantly more calcium in bone tissue than fluoride. But the latter plays a decisive role in the process of absorption of calcium compounds. The best results are obtained by alternating saturation procedures.

The doctor performs the operation manually using gel, varnish or tampons containing the desired element. After manipulation, it is not recommended to use medicinal pastes for 2 months.

Electrophoresis, infiltration, ozonation

These are more complex, but nevertheless non-invasive or micro-invasive processes that allow you to restore enamel that is beginning to decompose without pain relief using:

• microcurrents delivering the necessary substances (electrophoresis with calcium or fluorine ions);
• ICON lamps, thanks to them the desired material penetrates the pores of the surface, restoring the enamel layer (infiltration);
• gas that disinfects the entire dentition, ridding it of pathogens, followed by the use of a material that prevents the development of caries (ozonation).

The attending physician will offer the patient several options to choose from, and the final decision on what to do if white spots appear on the teeth is made jointly.

Sealing and silvering of enamel in children

Fissures are depressions and grooves on the chewing surfaces, thanks to which the jaws can grind food efficiently. Despite their usefulness, with insufficient care they become a source of inflammation and proliferation of microbes, especially in children who, due to their age, do not yet fully observe hygiene. Considering the fragility of the tissues of a child’s body, this leads to almost instantaneous development of caries. Sealing (filling) is done with a material similar to a filling material.

After manipulation, dentists recommend a coating - for example, with silver nitrate, a bactericide, which prevents further destruction of the units and keeps the oral cavity sanitized.

How to get rid of chalky stains yourself

You can try to remove light spots yourself.

Based on the factors of occurrence, various methods are used:

• In case of fluorosis, it is necessary to begin eliminating the problem by changing the water. To do this, you need to install filters or purchase purchased bottled water. In addition, it would be a good idea to change your toothpaste to one without fluoride.
• If the problem is nutrition , the main recommendations will be to change your diet. It is recommended to include vegetables, fruits, and dairy products. But it is better to avoid strong tea, coffee, fatty meat and fish.
• In cases where the reason lies in improper dental care , whitening agents will help. You can use special teeth whitening strips or tooth whitening toothpastes, but without fluoride.
• Among children, the method of enamel microabrasion has gained the greatest popularity in the fight against chalky stains. It involves treating damaged areas with special abrasive treatments that have a medium acid content, followed by the use of a fluoride-based gel.

Therapy and restoration work for hypoplasia

For minor lesions, remineralization can be done; in complex situations, more serious intervention will be required. The problem is rarely localized to the molars and premolars. More often, incisors and canines are underdeveloped. Restoring the enamel in this case is impossible, and the only way out is aesthetic restoration. Depending on the degree of tooth decay, a veneer, crown or filling is placed on it, restoring color and shape.

You will learn in detail how you can restore the beauty of your smile using ceramics from the video:

How is caries treated in the spot stage?

Treatment of caries at the white spot stage is carried out using several methods:

1. Remineralizing therapy. The most popular and effective treatment method, which is carried out at the stage of only the white spot. It involves saturating the affected tissues with microelements and minerals through the application of medicinal substances. Procedures are carried out daily or every other day, the course consists of 10-15 procedures.
2. Fluoridation. Treatment consists of saturating the enamel with fluorides, as well as other microelements. Fluorapatites are more durable than hydroxyapatites, thus strengthening the enamel.
3. Silvering. The method involves impregnation of carious lesions with a special preparation. During the procedure, silver ions are released, which settle in the enamel and stop the destructive carious process. Currently, the method is used extremely rarely, since it is not able to eliminate caries and stains the teeth in a dark color.
4. The Icon technique is the most modern technology that has many advantages. It consists of layer-by-layer application of several drugs to the white spot. The products eliminate the porous layer, remove germs and seal the enamel. In this way, the cavity is filled without the use of boron. The treatment is very effective, painless and simple.
5. Grinding. If other methods are ineffective, sanding the stain, usually brown, is used. The dentist, using a special bur or brush, carefully removes the affected tissue, followed by a course of fluoridation and remineralization.
6. Classic filling. If treatment with other methods is impossible, filling is used. To do this, the doctor uses a small bur to remove the destroyed tissue, and then restores the tooth with filling materials.
7. Physiotherapeutic procedures. Physiotherapy procedures are used as complex therapy: electrophoresis and phonophoresis of calcium gluconate, phosphorus, sodium fluoride and other trace elements.

How is the treatment carried out?

Dental treatment consists of the following stages:

• Examination of the oral cavity, diseased tooth and collection of the patient’s medical history;
• Diagnostics, accurate diagnosis - clinical tests, x-ray diagnostics;
• Choosing the most appropriate treatment method;
• Professional teeth cleaning;
• Prescription of a course of applications, grinding or filling, depending on the method of treatment;
• Strengthening enamel and preventing hyperesthesia;
• Recommendations and advice to the patient after the procedure.

Preventing the appearance of white spots

If a person is already an adult, it is too late to prevent hypoplasia, but the development of other pathologies can be avoided. To do this you should:

• brush your mouth twice a day, floss after meals, use a medium-hard brush or soft, low-abrasive paste;
• undergo a preventive examination at the dentist 2 times a year, following all recommendations;
• eat well (eat enough vegetables and dairy products);
• in case of confirmed deficiency of nutrients (only in consultation with the doctor), use vitamin and mineral complexes.

The result of treatment is

A positive result is more often observed when the patient follows all recommendations on oral hygiene, nutrition, and also after completing the full course of treatment. As a result, complete remineralization of the foci of demineralization may occur (or the spots decrease in size), the shine of the tooth enamel will appear, in addition, it will become denser and smoother. A negative result is observed in patients who do not follow all recommendations for oral hygiene, and in such patients, carious defects form over time in place of the white spots.

Treatment of foci of enamel demineralization requires the complete elimination of bacterial plaque and food debris in the oral cavity. This is possible if the patient is willing to floss after every meal and brush their teeth after every meal (while avoiding snacking between meals and drinking sugar-sweetened beverages). In fact, the patient is required to devote only 4-5 minutes to hygiene, 3 times a day. It is also important to exclude easily digestible carbohydrates, starchy, salty, acidic foods and drinks (wine, fruits and fruit juices) from the diet.

→ How to brush your teeth properly

If the patient has only achieved a reduction in the size of the white spots, but they have not disappeared completely, a repeat course of mineralization is prescribed after 1 month, and so on until a lasting positive effect is achieved in the form of complete remineralization of caries at the white spot stage.