What is Decalcification?

Decalcification

The white marks sometimes found on teeth after orthodontics treatment

            There are two types of white discolorations that are found on teeth.  In one case there is a defect in the enamel formation when the tooth is being formed under the gums, causing internal white marks that can be found at any position on the tooth, even up around the biting edges.  Teeth just erupt this way and it is not a sign of decay, but they may not look very aesthetic.  Most of the time we do not know why this occurs although infections during early childhood may be a cause.

In the other case, the white marks are caused by acids that have begun to eat away the enamel of the tooth (decalcification).  This is the first stage of tooth decay.  As the enamel starts to dissolve it begins to appear white and chalky.  Eventually the enamel starts to turn brown or black and disintegrates.  At this time it is considered a “cavity”.

Typically these white marks are around the gum line where the patient has not done a good job of brushing and flossing.  As food particles collect in this area they are colonized by bacteria forming plaque.  The bacteria then eats the sugar and excrete acids which then eat away the enamel.  Any additional acids added to the mouth like citrus fruits, soft drinks, sports drinks, sour candy, etc. just make the situation even worse.  Of course sugary things just give the bacteria more to eat, so sugary acidic foods are doubly bad.  Some of the worst things are sports drinks and soft drinks.

          In the “old days” before orthodontist learned to “glue” the brackets directly to the tooth they used metal bands that were cemented around the tooth to which the brackets were welded.  Sometimes the cement would wash out from under a band, even though the band would stay around the tooth.  In those cases plaque would cause decalcification under the band that would not be discovered until the bands were removed and a white “belt” was seen across the middle of the tooth where the band was positioned.  Those were unfortunate discoveries that we just don’t see anymore.

So how do you prevent decalcification in patients with braces?

·       Brush or at lease rinse out your mouth after every meal or soft drink.

·       Make sure you do one GREAT brushing every day to remove all the plaque (it takes days for plaque to form to the point where it produces acid)

·       Avoid stick, sugary, acidic foods as much as possible.

·       Use the fluoride rinse we prescribe to lessen the risk of decay.