White spot lesions in orthodontics: A comprehensive review of prevalence, etiology, risk factors, and management strategies

AIM. White spot lesions (WSLs) are initial carious formations marked by the demineralization of enamel, commonly seen in individuals with fixed orthodontic appliances. This study aims to compile and analyze existing research on the prevalence, causes, risk factors, prevention, and treatment of WSLs in orthodontic patients. MATERIALS AND METHODS. A comprehensive literature review was performed using the PubMed, Embase, and Cochrane Library databases. The review included studies published in English that involved human subjects and focused on WSLs in orthodontic contexts. RESULTS. The occurrence of WSLs in orthodontic patients ranges significantly (8–97%), influenced by diagnostic techniques and patient demographics. Key factors include inadequate oral hygiene, high sugar intake, decreased saliva production, and the design of fixed appliances. Effective preventive and treatment methods include fluoride-based solutions, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and resin infiltration. CONCLUSIONS. Timely detection and tailored preventive measures are essential to lessen the frequency and effects of WSLs. Future studies should aim to enhance minimally invasive treatments and assess the longterm results of preventive measures.