Orthodontic decalcification management with microabrasion

Patient home care during orthodontic treatment is often less than ideal. For those patients who routinely let plaque accumulate around orthodontic appliances, there can be white or stained areas of decalcification around the bonded appliances. Management of this esthetic problem can be accomplished in several ways depending on the severity of the defect. This paper describes the very conservative technique of microabrasion which works well in removing superficial markings caused by decalcification. In a sample of 98 decalcified teeth from 20 patients with orthodontic decalcifications and various other unesthetic stains, microabrasion removed most or all of the disfiguring marks on 78.5 percent of the teeth evaluated. At least some improvement was noted 96.9 percent of the time. These results were statistically significant (P > .01). It seems appropriate to employ this technique prior to initiating more aggressive cosmetic dentistry such as resin bonding, Class V restorations, or labial veneers.