White spots on teeth also known as tooth decalcification are a very common concern. The appearance of a chalky white spot on a tooth is the earliest sign of a carious lesion, indicating enamel decalcification. Enamel decalcification occurs when the remineralization process of a tooth is disrupted. This stage is visible before cavitation has occurred, and has the ability to be reversed by saliva induced remineralization.
de-cal-ci-fi-ca-tion – the loss of calcium or calcium compounds within the tooth
Saliva cleanses the mouth of food and debris, removing sources that promote acidity. Saliva also has the ability to dilute and remove organic acids from thin layers of plaque. Saliva is supersaturated with calcium and phosphate ions. It contains electrolytes and organic molecules that act to stabilize acid levels and promote the tooth remineralization cycle.
Decalcification (white spots on teeth) or demineralization is the process in which minerals, primarily calcium and phosphorous, are dissipated from tooth structure by acids formed from bacteria. The multiplication and adhesion process of bacteria begins within seconds of brushing, and plaque formation begins. The bacteria in plaque have the ability to replicate in an oxygenated environment. Without proper oral hygiene care, the bacterial plaque thickens and inhibits saliva penetration; thus causing the calcium and ions of the portion of the tooth in contact, to diffuse into the plaque forming tarter. As a result white spots begin to appear.
Re-mineralization of a white spot lesion on the tooth requires direct exposure to saliva once the plaque or tarter is removed. Unfortunately, due to slow diffusion, the surface enamel is remineralized first leaving the deeper areas of the lesion demineralized. This area will appear as a white scar under a hard, shiny surface.
Demineralization and re-mineralization is a dynamic process of mineral loss of a tooth, and its repair. Maintaining an environment that promotes this cycle is key in optimal oral health. The carbamide peroxide in whitening gel aids in neutralizing critical acid levels. The use of desensitizing gel is recommended to prevent the areas of decalcified (white spots) areas from worsening.