White spots on teeth can appear before, during, or after orthodontic treatment. Braces do not “create” these spots on their own. In most cases, white spots happen when plaque and acid sit on enamel long enough to pull minerals out of the tooth surface.
If you notice white spots developing, it is a signal to tighten home care and schedule a dental evaluation. Early changes can often improve your chances of preventing them, but spots can become permanent if mineral loss continues.
In this guide, the expert orthodontists at AAO break down what causes white spots on teeth and how to prevent them.
Bite-Sized Facts About White Spots on Teeth
- Braces do not directly cause white spots. White spots usually happen when plaque and acids remain on enamel for long enough to pull minerals out of the tooth surface, a process called enamel demineralization.
- White spots can appear chalky, cloudy, or matte, and they can be an early warning sign that a cavity may develop if the underlying cause is not addressed.
- Orthodontic appliances can increase the risk by trapping plaque. Brackets, wires, and tight spaces make it easier for plaque to hide and harder to clean thoroughly.
- Clear aligners can also lead to white spots. Risk increases when aligners are worn after eating without brushing, when trays are not cleaned thoroughly, or when anything other than water is consumed while aligners are in.
- Sugary and acidic drinks are a major contributor. Frequent sipping on soda, sports drinks, sweet tea, and energy drinks repeatedly exposes enamel to acid, which speeds up mineral loss.
- White spots can happen even without braces. Other causes include dry mouth, diet patterns that increase acid exposure, enamel changes during tooth development, and mild dental fluorosis in childhood.
- Most white spots related to orthodontic treatment are preventable. Prevention depends on reducing plaque exposure time and strengthening enamel.
- Daily prevention basics:
- Brush at least twice a day, and ideally after meals
- Clean between teeth every day (floss, floss threaders, interdental brushes, or a water flosser)
- Use fluoride as recommended by your dentist or orthodontist
- Choose water most often, and cut back on frequent sugary or acidic drinks
- Keep regular dental cleanings during orthodontic treatment
What Are White Spots on Teeth?
White spots are areas of enamel that have lost minerals. Healthy enamel reflects light evenly, so it looks smooth and glossy. Demineralized enamel reflects light differently, so it looks chalky, cloudy, or matte.
These spots can be an early sign that a cavity could develop if the underlying cause is not corrected.
What Causes White Spots on Teeth?
White spots form when enamel is repeatedly exposed to acids, most often from plaque bacteria and frequent consumption of sugary or acidic drinks. Over time, minerals leave the enamel faster than they can be replaced.
Sometimes, orthodontic treatment can cause demineralization from:
- Aligner trays are not cleaned properly, or when anything other than water is consumed while aligners are in
- Insufficient cleaning around braces or other appliances
- Sugary or acidic foods are eaten and trapped within appliances
Wearing Aligners Too Long
One of the benefits of clear aligners is that they can be removed for activities like eating or drinking. In fact, aligners are designed to be taken out and cleaned regularly. If aligners are worn for extended periods without proper cleaning, they can harbor bacteria and food particles, creating a conducive environment for white spot formation. Additionally, failing to remove aligners while eating or drinking anything other than water can also expose your teeth to substances that can lead to white spots.
Improper or Rushed Brushing, Flossing, and Cleaning
When you wear an orthodontic appliance, it is extremely important to brush and clean all the nooks and crannies daily. Plaque can quickly accumulate around brackets and wires, leading to decalcification if it is not removed promptly.
Frequently Eating Sugary, Sticky, or Acidic Foods
There’s a reason your orthodontist gives you a list of banned foods when you first start your treatment. Sugary, sticky, or acidic foods can easily become trapped in hard-to-reach places where your braces hold them against your teeth. This creates the perfect conditions for cavities to form, and is one of the reasons we tell our patients to put a lot more effort into brushing frequently when they have braces.
How Do You Prevent White Spots On Your Teeth?
Prevention is mostly about reducing plaque exposure time and strengthening enamel. Here are some simple daily habits to help prevent white spots on your teeth:
- Brush at least twice a day, and ideally after meals
- Clean between teeth daily (floss, floss threaders, interdental brushes, or water flosser)
- Use fluoride as recommended by your dental team
- Limit sugary and acidic drinks, especially frequent sipping
- Keep regular dental cleanings during orthodontic treatment
Expert Brushing Tips to Prevent White Spots During Treatment
During your orthodontic treatment, you’ll need to put more effort into brushing and flossing each day. This includes cleaning places you normally wouldn’t think to clean. Here are some tips to help you reduce the chances you’re leaving food and plaque behind when you brush:
- Angle the brush toward the gumline and around brackets or aligner attachments
- Brush above, below, and directly on the bracket or aligner attachment area
- Spend extra time on the upper front teeth, where white spots commonly appear
- Brush before bed every night, even if you are tired
Additional Tools to Help You Prevent White Spots from Braces
To make cleaning your teeth convenient and thorough, equip yourself with handy tools like interproximal brushes, floss threaders, floss holders, water irrigators, and electric toothbrushes. Additionally, make sure you’re using a toothpaste with fluoride in it to strengthen enamel.
What Do You Do if You Already Have White Spots on Your Teeth?
First, never ignore them. They’re early warning signs you may be developing cavities, not just a cosmetic issue.
Recommended next steps include:
- Scheduling a dental evaluation to confirm the cause and check for active decay
- Tightening brushing and interdental cleaning immediately
- Asking whether fluoride or remineralizing products are appropriate for you
- If spots are more noticeable, ask about cosmetic options your dentist may recommend
Some early white spots can improve in appearance over time when enamel is strengthened. Deeper spots may be harder to fully reverse, but treatment options can still improve how they look and help protect the tooth.
Consult With An AAO Orthodontist
By being diligent about oral hygiene and limiting sugary, acidic foods and drinks, you can prevent the development of white spots on your teeth. Maintaining a beautiful, healthy smile is within reach with the right tools and a little extra time. Have questions? Your orthodontist and their team are always ready to help ensure your treatment results in a smile you’ll both be proud of.
Choosing an AAO Orthodontist for your orthodontic treatment ensures you’re in the hands of a skilled specialist dedicated to giving you the best smile possible. Locate an AAO Orthodontist near you and start your journey towards a healthy, beautiful smile today.
Frequently Asked Questions About White Spots on Teeth
Are white spots after braces permanent?
Some early white spots can fade when enamel is strengthened, and plaque control improves. Results depend on how deep the mineral loss is and how quickly the cause is addressed. A dental evaluation can determine whether the spot is early and reversible or deeper and more likely to need cosmetic help.
Are white spots the same thing as cavities?
Not always, but they can be an early warning sign. White spots often reflect early enamel mineral loss. If the cause continues, the area can progress to a cavity, which is why early evaluation matters.
Can clear aligners cause white spots?
Aligners can be associated with white spots when teeth are not brushed after eating, aligners are not cleaned well, or beverages besides water are consumed with trays in. Good hygiene habits and proper aligner wear help reduce the risk.
How can I prevent white spots with braces?
Brush thoroughly at least twice daily and ideally after meals, clean between teeth daily, use fluoride as recommended, limit sugary and acidic drinks, and keep regular dental cleanings. The most important habit is removing plaque around brackets or aligner attachments and along the gumline before it sits for long periods.
