“White Spots”
©2001 PFPC

“What one investigator will address as discolouration, another one will validate as caries...”(Rozeig, 1963)

   “White Spots” are the first visible signs of enamel demineralization. The aspiring dentist is taught to watch for these “white spots” as the first sign of caries.

   The University of Michigan teaches:

• “The goal of examining a patient for presence of dental caries is to detect the earliest signs of this disease in enamel and root surfaces. If early signs of demineralization are detected, advise the patients and provide preventive care to reverse the caries process.”
• “These areas are identified visually as "white spots" when the tooth is dried, or are seen visually without drying when large microporous areas develop in enamel.”

   “White Spots” on the enamel are areas of demineralization.

   Demineralization of enamel is seen as the first sign of caries.

   Ever so incidentally, “white spots” are not only the first sign of caries, they are also the first sign of dental fluorosis, something which has been known for over 80 years.

• “Fluorosis is the most widespread side-effect of fluoride use and appears as discrete white spots on the enamel up to severe enamel dysplasia.” (Bottenberg et al, 2001)

   Although it has been shown countless of times that the fluorosed enamel predisposes to caries (see: Effective?), it is STILL considered a “cosmetic effect” by dentists.

   Dr. Hershell Horwitz, of the American Dental Association, says:

"Those little white specks is strictly a cosmetic problem, it's not a health problem. The teeth that are affected are highly resistant to dental decay and is not a matter of health at all." (ABC News, 2002)

See:
White spots on the teeth - early signs of tooth decay?

   Incidentally, “white spots” also show up in other oral tissues of our children, otherwise known as yeast infections and oral cancer (see: Newsletter #9).

References:

ABC 7 News - "The Debate Over Fluoridated Water", April 10, 2002

Bottenberg P, Declerck D, Martens L - “Fluorosis: diagnosis, risk assessment and epidemiology” Rev Belge Med Dent 56(4):291-309 (2001)

Rozeig F - “Über den Einfluss Toxischer Fluordosen auf Zahnhartsubstanzen und Knochen” in : "Toxicology of Fluorine" Gordonoff, ed., Symposium  1962, Schwabe &
Co. Basel  (1963) [Karies-Forschungsinstitute und Klinik und Poliklinik f.. Zahn-, Mund-, und Kieferkrankheiten der Johannes-Gutenberg-U. Mainz, Dir.: Prof. Dr. M. Hermann]

Trimpeneers LM, Dermaut LR - "A clinical evaluation of the effectiveness of a fluoride-releasing visible light-activated bonding system to reduce demineralization around orthodontic brackets" Am J Orthod Dentofacial Orthop 110(2):218-22 (1996)