White spot lesions risk management prior and during the orthodontic treatment

To evaluate the efficiency of various interventions performed before and during orthodontic treatment which aim to reduce the incidence of WSL.

Using PRISMA guidelines in search of clinical trials published between 2017 and 2022, a literature analysis was performed. This search was conducted using following Medical Subject Heading (MeSH) terms in 2 databases: "prevention and control" AND "Orthodontics" AND "Tooth Demineralization". Supplementary, a manual search was conducted in Google Scholar.

The literature search resulted in a total of 3626 study articles, of which 8 publications were used in the present review, according to a selection based on the pre-established eligibility criteria. The review showed that F varnish, 10% Xylitol varnish had positive outcomes in comparison with placebo. 0.44% APF formulated daily oral rinse and nanosilver mouthwash were better than 0.2% NaF weekly rinse and CHX, F mouthwashes respectively. NovaMin toothpaste (TP), MIPP and MIV, examined in different studies, proved no significant difference over regular F TP. MIV compared to ProSeal provided no statistically significant between-group differences as well. Clinpro 5000 provided superior protection against enamel decalcification when compared to Clinpro Tooth Creme and MI Paste.

The white spot lesions have improved, regressed, or eliminated using topical agents including fluoride, xylitol, or casein phosphopeptide-amorphous calcium phosphate during the fixed orthodontic treatment. More research is needed in order to determine the most effective therapeutic approach for the treatment of surface and subsurface demineralization of the enamel.