Enamel Staining (demineralization) adjacent to orthodontic brackets is not an uncommon sequela in patients undergoing orthodontic treatment with poor oral hygiene, wearing braces for an extended period of time. Several approaches exist that can prevent this side effect: (1) Plaque control implemented by the patient, (2) the use of fluoride mouth rinses and dentifrices applied by the patient,(3) the use of fluoride products applied in office by the orthodontist, (4) the use of fluoride releasing cements used by the orthodontist to bond the orthodontic brackets to the patient’s teeth,
(5) frequent hygiene visits to the dentist, preferably every 3-4 months, while wearing fixed orthodontic attachments, (6) compliance with the recommended protocol to wear orthodontic elastics and other removable appliances to avoid extended lengths of treatment, (7) compliance with keeping all orthodontic appointments.
At Saba Orthodontics every patient who receives both fixed and removable appliances is given detailed oral hygiene instructions. We recommend using an electric toothbrush for a more thorough cleaning. We also recommend rinsing with phosflur mouth rinse (Colgate) at least once per day. Our brackets and bands are cemented to the teeth with a fluoride releasing cement, which has the ability to release fluoride under acidic conditions and is capable of re-charging itself in the presence of fluoride, found in dentifrice and mouth rinse. We ask our patients to notify us immediately if a bracket/ band becomes loose, as this condition can trap plaque/food and result in enamel demineralization, if not addressed in a timely manner. For more helpful hints on oral hygiene, become a fan of Saba Orthodontics on Facebook, where you can watch the videos related to this topic. I am proud to say that with all the precautions that we take on a daily basis, we rarely see any patients suffering from enamel staining, or “white spot” lesions, also known as enamel demineralization upon removal of their braces. If these “white spot” lesions however do occur, there is an in office procedure available through application of a paste on the affected enamel which can mask the “white spot” lesions by causing remineralization of the teeth.
For patients, or parents of patients who are considering braces for themselves or their children and are concerned about the possibility of developing enamel decalcification secondary to poor oral hygiene, ask if Invisalign or Incognito lingual braces could be an option. Patients wearing Invisalign aligners in place of traditional braces at a lower risk for developing enamel demineralization. Patients wearing Incognito hidden braces could still develop enamel demineralization due to poor hygiene, but it would be on the back side of the teeth, completely invisible. To learn more about Incognito lingual braces and Invisalign visit our website at www.sabaortho.com.
