In recent years, clear aligners like Invisalign have revolutionised orthodontic treatment, offering a nearly invisible, removable option for straightening teeth. They promised to spare us the unsightly brackets and wires of traditional braces, along with the dreaded white spot lesions (WSLs) that often accompany them. However, new research is challenging these assumptions, revealing surprising risks associated with clear aligner therapy.
Understanding White Spot Lesions
White spot lesions are chalky white marks on teeth that signal the early stages of tooth decay. Traditionally, they have been a common side effect of fixed orthodontic treatments like braces, affecting nearly half of patients. The cause is often attributed to plaque buildup around brackets and wires, which can lead to enamel demineralisation.
The Clear Aligner Myth
Initially, clear aligners seemed like a panacea for dental aesthetics and health. They are removable, allowing for easier brushing and flossing compared to fixed appliances. However, recent studies indicate that clear aligners do not eliminate the risk of white spot lesions altogether.
Surprisingly, approximately 35% of young patients using clear aligners develop white spot lesions during treatment. While this incidence is lower than with traditional braces, it highlights a significant concern for oral health during orthodontic care.
Why Do Clear Aligners Cause White Spot Lesions?
Clear aligners cover more tooth surfaces than brackets and wires. This extended coverage alters the mouth's natural microbiota and reduces the interaction of saliva with teeth. Saliva plays a crucial role in neutralizing acids and providing essential minerals to tooth enamel. Without adequate saliva exposure, teeth are more susceptible to demineralization and the development of white spot lesions.
Protecting Your Smile
If you are considering or currently using clear aligners, there are proactive steps you can take to minimise the risk of white spot lesions:
- Rinse with water and chew xylitol gum after meals to help neutralise acids and stimulate saliva production.
- Use an oral probiotic to maintain a healthy balance of oral bacteria, which can aid in protecting tooth enamel.
- Avoid brushing aligners with toothpaste to prevent roughening the surface and creating areas for plaque accumulation.
- Choose a toothpaste or varnish containing nano-hydroxyapatite (HAP), arginine, or prebiotics. These ingredients help remineralize enamel and combat white spot lesions effectively.
- Ensure proper nasal breathing during sleep to maintain adequate saliva flow and reduce mouth dryness, which can exacerbate enamel demineralisation.
While clear aligners offer numerous benefits for orthodontic patients, including improved aesthetics and convenience, they do not eliminate the risk of white spot lesions. Understanding this risk and implementing preventive measures can help you maintain a healthy smile throughout your treatment journey. If your dentist assures you that clear aligners prevent white spot lesions entirely, consider sharing this new research and discussing proactive oral care strategies.