A survey of orthodontists on prevention and treatment of white spot lesions development before, during and after orthodontic treatment

The aim of this study was to evaluate the knowledge of orthodontists on the prevention and treatment of white spot lesions before, during and after orthodontic treatment. An electronic survey was distributed to 1744 active Turkish Orthodontic Society members, which consists of academic members, orthodontists and postgraduate orthodontics program students. A total of 355 active members responded to the survey with a 20.3% of response rate. 92.3% of the orthodontists stated that they give information about white spot lesions but a basic practice protocol was missing for 53.3% of the orthodontists before the start of orthodontic treatment. It was reported that only 23.1% of the orthodontists determine DMFT scores and 59.5% of them perform caries risk assessment. The most used methods among orthodontists to diagnose white spot lesions were visual inspection and radiographic techniques. The most preferred applications were to give oral hygiene instructions (94.1%), to inform parents about oral hygiene situation (93.4%), to give recommendations about nutrition (73.4%) and manuel tooth brushing (80.1%). It was determined that during the treatment interdental (82.3%), manuel (79.7%) and powered toothbrushes (45.4%), dental floss (39.1%) and waterpik (34.7%) were recommended at varying rates. Casein phosphopeptide amorphous calcium phosphate (38.6%), xylitol chewing gum (41.1%) and probiotics (31.7%) were also recommended. 70.3% of the ortodontists recommend to rinse with 0.05% NaF mouth rinse while 31.7% of them to rinse with chlorhexidine mouth rinse. It was determined that after orthodontic treatment tooth bleaching (23.6%), resin infiltration (17.7%) and microabrasion (16.2%) techniques were used for the treatment of white spot lesions.Preventive measures before and during orthodontic treatment were used mostly by academic members. 93.7% of the orthodontists considered that it is necessary to develop an evidence based clinical practice guideline to prevent and treat white spot lesions before, during and after orthodontic treatment. Keywords: White spot lesions, orthodontist, orthodontic treatment, oray hygiene, demineralization