Causes
- Fluorosis:
Fluorosis is by far the most common cause of white spots on teeth. It is a condition where the amount of fluoride reaches such a high amount in the body that it affects teeth and other parts of the skeletal system. The main source of fluoride is drinking water, though it normally occurs when the amount of fluoride in the water being consumed is more than 1ppm (parts per million). Dental fluorosis causes hypomineralization of the tooth enamel, which leads to staining. Though only the initial stages of fluorosis cause white spots, if fluoride ingestion levels are not brought under control, it can lead to skeletal fluorosis, which is a much more serious condition. - Fresh Cavities:
One of the most common causes for these spots is tooth decay. In the initial stages of dental caries, the lesion is well a demarcated chalky-white opacity, without any loss of continuity of the enamel. That is, the surface looks discolored as white spots, but there is no breakage on the surface. Enamel, though the hardest structure in the human body, is semi-porous in nature, and hence there is increased permeability of enamel and susceptibility to caries. Such white spots mostly appear on the front teeth, near the inter-dental wall. - Dental Plaque:
Dental plaque is commonly mistaken as a white spot on tooth. It is the microfilm that is present on the surface of teeth. Sometimes, there may also be food particles on the surface of teeth that may be mistaken for white spots. Hence, always brush your teeth, or at least rinse them properly, before reaching the diagnosis of white spots. - Enamel Hypoplasia:
A condition that seriously affects dental health, enamel hypoplasia is a condition where the tooth enamel is incompletely developed in thickness and in quality. It occurs due to defective enamel matrix formation during the development of teeth. It leads to white spots, breakdown of occlusal surface, and eventually the presence of other stains on teeth. - Amelogenesis imperfecta:
Amelogenesis imperfecta is a group of rare hereditary diseases that affect enamel formation. It causes production of abnormal enamel, although the dentin and cementum are normal. This problem can strike at any of the three stages of enamel formation; enamel matrix formation, early mineralization, or enamel maturation. Thus, it can be of hypoplastic type, hypocalcification type, or hypomaturation type. This condition leads to white spots on teeth, as the enamel looks white and flaky. Also, there is often chipping of the incisal edges and discoloration of cusps and tips of teeth, which gives them a snow-capped appearance. - Other Causes:
Other causes include aggressive pin point brushing and excessive intake of sodas, especially when taken with a straw, as it leads to decalcification of the tooth structure in that region.
Treatment
The treatment will depend on the disorder causing the problem. If the discoloration is due to fluorosis, then the person should immediately stop ingesting water containing high levels of fluorides, and switch to water that has less than or equal to 1ppm of fluorides. Similarly, if there are white spots due to incipient cavities or accumulation of plaque, then the person should get cleaning done and should also get those teeth filled. In most of these cases, teeth bleaching is not a very good idea, as the discoloration on the tooth is already in the form of white spots. Additionally, it is a lot more difficult to treat anomalies like enamel hypoplasia and amelogenesis imperfecta, as the tooth structure is too weak to support the fillings.
Thus, white spots on teeth can be a bit disturbing and difficult to deal with. However, with some basic dental care and depending on the underlying cause, the dentist will chalk out a treatment plan to best deal with this unsightly discoloration.
