Can white spot lesions be treated effectively?

Objective: To compare the effects of sodium fluoride mouth rinse, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and the microabrasion technique in treating white spot lesions. Materials and Methods: The study population consisted of 80 patients (46 females, 34 males; 966 affected teeth) who had developed multiple decalcified enamel lesions after fixed orthodontic therapy. The study population was divided into four groups of 20 patients each. The control group (group I) participants were to just brush their teeth, the fluoride group (group II) participants were instructed to use 20 ml of neutral 0.025% sodium fluoride rinse, the participants in the CPP-ACP group (group III) were instructed to use tooth mousse twice a day in addition to fluoride toothpaste for 6 months, and the participants in the microabrasion group (group IV) were to undergo treatment by the microabrasion technique, which is a commonly used mixture of 18% hydrochloric acid. Data were analyzed with the generalized linear mixed model and Tukey HSD at the P < .05 level. Results: The area of the white spot lesions decreased significantly in all groups. Inter group differences in the treatment success rates were significant. The highest success rate was observed for group IV (97/0). The success rate of group III (58%) was significantly higher than that of groups II (48%) and I (45%). Conclusions: The use of CPP-ACP can be more beneficial than fluoride rinse for postorthodontic remineralization. Microabrasion is an effective treatment for cosmetic improvement of long-standing white spot lesions. (Angle Orthod. 2012;82:770-775.)