What Causes White Spots on Teeth?
White spots can develop for several different reasons, and correct diagnosis is essential before any treatment is considered. The most common causes include:
Early Enamel Demineralisation
When minerals are lost from the enamel surface — often due to plaque acids — the affected area can appear chalky white or opaque. This represents the earliest stage of enamel change before a cavity forms.
Dental Fluorosis
Fluorosis occurs when developing teeth are exposed to higher-than-optimal levels of fluoride during childhood. It typically presents as faint white lines, flecks, or patches on the enamel and is usually symmetrical across corresponding teeth.
Orthodontic-Related Demineralisation
Plaque accumulation around orthodontic brackets can cause localised mineral loss, resulting in white spots that become visible once the braces are removed. These are most common on the front teeth.
Developmental Enamel Variations
Some white spots are present from when the tooth first erupts and reflect variations in how the enamel formed during development. These are typically stable and do not indicate active disease.
Previous Dental Trauma
An injury to a developing tooth — particularly in childhood — can disrupt enamel formation, resulting in a white or opaque area on the adult tooth when it eventually emerges.
White Spots from Early Demineralisation
Demineralisation occurs when acids produced by plaque bacteria dissolve minerals from the enamel surface. In its earliest stages, this mineral loss creates areas that appear chalky white or opaque — visibly different from the surrounding healthy enamel. These white spot lesions represent the first visible sign of enamel change, before a cavity has formed.
At this stage, the enamel structure remains intact, and preventive strategies may help stabilise the area and encourage some degree of remineralisation. Improved oral hygiene, dietary modifications, and professionally applied fluoride treatments can all contribute to protecting the affected enamel from further progression.
If early demineralisation is not addressed, it may progress to more significant enamel breakdown and eventually cavity formation. This is why identifying white spots early and understanding their cause is clinically valuable — it provides an opportunity for preventive intervention before more extensive treatment is needed.
Dental Fluorosis
Dental fluorosis is a developmental condition that occurs when teeth are exposed to higher-than-optimal levels of fluoride during the years when enamel is forming, typically in early childhood. It results in characteristic white lines, flecks, or broader opaque patches within the enamel.
Fluorosis tends to affect corresponding teeth on both sides of the mouth symmetrically, which can help distinguish it from other causes of white spots. In its mild form — which is by far the most common presentation — fluorosis is a purely cosmetic condition. The affected teeth remain structurally sound, are not more prone to decay, and do not cause pain or sensitivity.
Because fluorosis develops during tooth formation, it cannot be prevented once the teeth have erupted. However, the appearance of mild fluorosis can be improved through cosmetic dental treatments if the patient finds the marks aesthetically concerning. Your dentist can advise on the most appropriate options based on the severity and location of the spots.
When White Spots May Need Treatment
Many white spots are stable, asymptomatic, and require no treatment beyond periodic monitoring. However, professional assessment and management may be appropriate in certain circumstances:
- The spots affect the appearance of the teeth and are a cosmetic concern for the patient
- There is associated sensitivity, suggesting the enamel may be compromised
- The white areas are suspected to represent early decay that may progress without intervention
- Colour changes are uneven, spreading, or have developed recently
- The spots appeared following orthodontic treatment and the patient wishes to improve their appearance
Your dentist can determine the underlying cause and advise whether active treatment, preventive care, or continued monitoring is the most appropriate course of action.
Professional Treatment and Cosmetic Options
The approach to managing white spots depends on their cause, extent, and whether they represent active enamel changes or stable cosmetic variations. Your dentist will discuss the most suitable options based on the clinical findings:
Preventive Fluoride Strategies
Where white spots represent early demineralisation, professionally applied fluoride treatments and remineralising products may help stabilise the enamel and, in some cases, reduce the prominence of the affected area.
Monitoring Stable Lesions
White spots that are stable, asymptomatic, and not progressing may simply be monitored during routine dental check-ups. Not all white spots require active treatment.
Professional Hygiene
A thorough professional clean can remove surface plaque and deposits that may be contributing to the appearance of white areas, and helps maintain an environment that supports enamel health.
Resin Infiltration
A minimally invasive technique in which a tooth-coloured resin is applied to the porous enamel of the white spot, filling the microscopic spaces and helping to blend the area with the surrounding tooth surface.
Composite Bonding
Tooth-coloured composite material can be applied to mask white spots and create a more uniform appearance. This approach may be suitable for more prominent or cosmetically significant spots.
Teeth Whitening
Professional home whitening may help reduce the contrast between white spots and the surrounding tooth by lightening the overall shade. Results vary between individuals, and suitability should be assessed by your dentist.
Dental Veneers
In selected cases where white spots are extensive or do not respond to less invasive approaches, porcelain or composite veneers may be considered to provide a uniform, improved appearance.
Results vary between individuals and depend on the cause, depth, and location of the white spots. Your dentist will discuss realistic expectations during your assessment.
Professional Assessment for White Spots
A professional dental evaluation helps determine whether white spots on your teeth are cosmetic, developmental, or related to early enamel changes, and whether preventive or cosmetic treatment is appropriate.
Depending on the findings, your dentist may recommend general dentistry and preventive care, composite bonding to mask visible spots, professional home whitening to reduce contrast, or dental veneers for more extensive cosmetic improvement.
Assessment for white spots on teeth is available at our London clinics. You can attend our South Kensington dental clinic or our City of London clinic near St Paul's for a professional dental review.
Can White Spots Be Prevented?
While not all white spots can be prevented — particularly those related to developmental factors or fluorosis — the following strategies can help reduce the risk of demineralisation-related white spots:
- Maintain effective daily oral hygiene with twice-daily brushing and regular interdental cleaning to reduce plaque accumulation
- Attend regular dental check-ups so early enamel changes can be identified and managed promptly
- Follow your dental team’s guidance on oral care during orthodontic treatment to minimise the risk of demineralisation around brackets
- Use fluoride toothpaste as part of your daily routine, following your dentist’s recommendations on appropriate products
- Discuss any concerns about white spots with your dentist, who can determine the cause and advise on management
