[Prevention of white spots during orthodontic treatment with fixed appliances]

Orthodontic treatment with fixed appliances involves a significant risk of enamel demineralization. The aim of this study was three-fold: to gain insight into a) the preventive measures which are applied as standard practice in The Netherlands in orthodontics, b) when the use of fluoride rinses is initiated, and c) which concentrations and frequencies of use are recommended. A questionnaire was sent to all orthodontists in private practice in The Netherlands. Completed questionnaires were returned by 154 of the orthodontists (response rate 81%). A basic practice protocol for preventing demineralization was used at the start of treatment by 93%. The majority (90%) recommended to use fluoride rinse once daily. They generally (85%) recommended to do this in the evening immediately after toothbrushing. The authors recommend rinsing at another moment than after tooth brushing, in order to increase the number of fluoride moments during the day, which enhances the effectiveness of this measure in preventing caries.