A white patch on an otherwise normal tooth is an area where the enamel is less mineralised than its surroundings. Because the porous enamel scatters light differently, it looks opaque and chalky rather than translucent, and the effect is most obvious when the tooth is dry. What matters is how the spot got there, because the same appearance arises from three quite different histories. Some spots formed while the tooth was developing in the jaw, from fluoride, illness or injury to the milk tooth above, and have been present since the tooth erupted. Others appeared later, usually around the gumline or where braces used to sit, and represent decay in its earliest stage, when the surface is still intact but mineral has been leached from beneath. A third group appear on dried teeth after whitening and fade within days. Our Wimpole Street dentists distinguish them by history, position, texture and sometimes a small light-based scan, and match the treatment to the type: monitoring and remineralisation for early decay, and a range of cosmetic options from micro-abrasion and resin infiltration to bonding for developmental marks.
Chalky white patches near the gumline or around where brackets sat
Post-orthodontic demineralisation; early decay that can still be arrested.
Symmetrical white flecks or streaks on several teeth
Fluorosis from fluoride ingestion during enamel formation; present since eruption.
A single well-defined white or cream-yellow patch on one front tooth
Often a developmental defect from trauma or infection of the milk tooth (a Turner tooth) or molar-incisor hypomineralisation.
Spots more visible when teeth are dry and fading when wet
Typical of porous enamel of any cause; a clue rather than a diagnosis.
A patch that has become rough, brown or has started to cavitate
Early decay progressing; needs prompt treatment.
Uniform white spots appearing across the teeth after whitening
Dehydration of the enamel; resolves on its own within days.
Plaque sitting undisturbed against enamel, typically at the gumline or around orthodontic brackets, produces acid that dissolves mineral from beneath the surface. The surface layer remains intact for a while, so the tooth looks chalky rather than holed. At this stage the process can be halted and partly reversed.
Swallowing fluoride toothpaste as a young child, fluoride supplements in an area with fluoridated water, or naturally high fluoride levels abroad can disrupt enamel formation. Mild fluorosis appears as faint white lines or flecks and is entirely harmless to the tooth; more marked fluorosis produces larger opaque areas and occasionally brown staining.
An increasingly recognised developmental condition in which the first adult molars and often the front teeth erupt with patches of soft, poorly mineralised enamel. The cause is thought to relate to illness or fever around the time of birth. Affected teeth can be sensitive and prone to chipping.
A knock to a baby front tooth, or an abscess on one, can damage the developing adult tooth beneath it. The result is a single adult incisor with a white or yellow-brown patch, sometimes with a small pit.
High fevers, coeliac disease, vitamin D deficiency and premature birth can all interfere with enamel formation during the years the adult teeth are developing, leaving horizontal bands of opacity across teeth that were forming at the time.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
We take a history of when the spots appeared, dry the teeth, examine the texture and position and, where useful, use transillumination or a fluorescence device to gauge the depth. This determines whether we are treating decay or a cosmetic defect.
About this treatmentFluoride varnish, casein-phosphate pastes and improved plaque control harden the surface and stop progression. Some spots fade partially; the aim is that they never become cavities.
About this treatmentA very thin layer of the surface enamel is polished away with a mild acid-abrasive paste, which removes or fades shallow fluorosis spots in a single visit without drilling.
About this treatmentA low-viscosity resin is drawn into the porous enamel, replacing the air spaces so the spot scatters light like normal enamel and visibly blends in. Works well for post-orthodontic and mild fluorosis spots.
About this treatmentFor deeper or discoloured defects, the affected enamel is gently prepared and covered with a layer of composite matched to the surrounding tooth. From £395 per tooth.
About this treatmentLightening the whole tooth often reduces the contrast so spots are less noticeable, and is done first. Where several teeth are affected across a large area, composite or porcelain veneers may be the more predictable route.
About this treatmentAn examination at Wimpole Street to diagnose white spots, including any X-rays, is expected to be £95. Fluoride varnish for early decay spots is a small additional charge, and a hygiene appointment at £89 removes the plaque that keeps them active. Micro-abrasion and resin infiltration are quoted per visit once we have confirmed the type and depth of the spots.
Composite bonding over a developmental defect is from £395 per tooth. Whitening with custom trays is indicative at £399 and is often done first to reduce the contrast. Where veneers are the right answer for widespread marks, composite veneers are indicative at £595 per tooth and porcelain at £1,095. We start with the least invasive option and progress only if needed.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
