Contemporary management of white spot lesions following orthodontic treatment.

Abstract

White spot lesions (WSLs) are a frequent complication of orthodontic treatment. A WSL represents an area of initial surface demineralisation and occurs most commonly due to an excess dietary intake of fermentable carbohydrates and poor plaque control. Management options include the application of topical agents such as fluoride treatments, casein phosphopeptide-amorphous calcium phosphate, BioMin, and self-assembling peptide P11-4. Resin infiltration to mask lesions by altering enamel optics is a further option. This article provides an update for general dental practitioners and specialists on the aetiology and contemporary management approaches for WSLs, including a cost comparison. General dental practitioners are often the primary clinician managing these lesions. This article aims to aid their decision-making by providing an overview of the most contemporary evidence-based information from high-quality trials in addition to a cost comparison. Copyright © 2026. The Author(s), under exclusive licence to the British Dental Association.