White Spot Lesions on Teeth during or Postorthodontic Treatment: A Knowledge Based Cross-sectional Survey of Dentists

Abstract

Introduction: White Spot Lesions (WSLs) observed during or after fixed orthodontic therapy has known to cause several dental problems clinically and aesthetically. It becomes imperative to understand the perception of treating dentists of the paediatric dentists to whom the children first visit, and also of the treating orthodontists and restorative dentists. Aim: To assess the knowledge, attitude, and practices of dentists regarding WSLs related to orthodontic treatment, and also to assess the preferences of these dentists regarding its management. Materials and Methods: A cross-sectional survey was planned for a period of two months (15th August 2020 to 15th October 2020) using a close ended, multiple choice questionnaire directed to evaluate the perspective of 260 dentists of Saudi Arabia towards white spot lesions associated with orthodontic treatment. The self designed validated questionnaire was prepared and mailed to dentists across the Kingdom of Saudi Arabia. Descriptive statistics followed by Chi-sqaure test was done to compare variables in the questionnaire. Results: A total of 52 paediatric dentists, 53 orthodontists, 51 restorative dentists, and 104 general dentists participated in the study. Out of 260 dentists, 236 (90.8%) of them have observed WSLs in their patients during/after orthodontic treatment. Adolescent patients more commonly complained of undesirable aesthetics due to WSLs. Incisors were the most commonly affected teeth. All dentists except orthodontists believed that they were proficient in diagnosing superficial or deep WSLs (p-value=0.005). Most dentists preferred professional application of high concentration topical fluorides. Most patients demanded an instant correction of these WSLs as reported by all groups of dentists. Conclusion: WSLs are commonly observed by dentists during the initial 7 to 12 months period of starting orthodontic therapy, more commonly on incisor teeth among the adolescent age group. The dentists recommended maintaining good oral hygiene as the most effective way of preventing WSLs. They also believed that high concentration fluoride agents are well suited for treating superficial lesions and composite resin restorations for deeper lesions.

Keywords

• fixed orthodontic therapy
• initial caries lesion
• subsurface demineralisation