I’m 27 and have only had one cavity in my life. Two weeks ago, my dentist found five white spot areas between my upper teeth and described them as incipient caries. She told me the caries seem to be limited to the enamel and have not reached the dentin, so she recommends watching them rather than placing fillings right away. I am concerned that waiting too long will result in larger cavities.

I searched online and read about different treatment options, including Curodont, resin infiltration, sealants, and silver diamine fluoride. Could wearing a nightguard have caused the white spots? What are the most common causes of this kind of decay?

Which treatment is most effective for stopping or reversing early decay, and which option tends to last the longest? Also, can you recommend any toothpaste, fluoride products, supplements, or other preventive steps I can do at home?

Thanks, Ilyana from TX

Ilyana,

We assume you are referring to white spot lesions on your teeth. Since you used the term “cavitation,” we are concerned that the enamel is already deteriorating, creating a small depression on the tooth surface.

What Are White Spot Lesions?

White spot lesions are the earliest stage of tooth decay. Bacteria produce acid that pulls minerals out of the enamel. As the enamel loses minerals, it turns chalky white.

Decay progresses in stages. First, the damage is confined to the enamel. Without treatment, the enamel weakens, and the decay reaches the dentin underneath. As the dentin loses its integrity, the enamel can collapse, forming a visible cavity.

In the early stages, the tooth surface may look intact, although minerals beneath it are decreasing.

Can White Spot Lesions Heal?

Some white spot lesions can re-mineralize. Saliva contains minerals that help repair weakened enamel. Fluoride can also strengthen the enamel and help it draw minerals from saliva.

However, if the lesion becomes soft, chalky, or develops a surface depression, the tooth usually requires restorative treatment rather than remineralization alone. Careful clinical examination and X-rays help assess the condition of a tooth.

Which Treatments Can Help?

Several treatments may strengthen or eliminate early lesions. The right option depends on how far the decay has progressed.

These treatments work best when the enamel surface remains mostly intact:

• Fluoride toothpastes and prescription fluoride gels help strengthen enamel and encourage remineralization.
• Curodont helps attract minerals from saliva back into the weakened enamel.
• Resin infiltration strengthens the enamel by allowing resin to penetrate beneath the surface.
• Silver diamine fluoride kills bacteria and can stop the progression of decay, though it permanently darkens the area.
• Sealants help prevent decay on chewing surfaces.

Could Your Mouthguard Be Contributing to Decay?

Your mouthguard could contribute to decay if you place it over teeth that are not thoroughly cleaned.

Saliva plays an important protective role in your mouth. It neutralizes acids and supplies minerals that help repair enamel. If food particles and plaque are on your teeth before you wear the mouthguard, the appliance can trap bacteria against the enamel, reducing the protective effects of saliva.

A mouthguard placed over clean teeth should not cause decay.

The Monroe, Louisiana, dentists at Bayou Dental Group sponsor this post. Please read how Dr. Finley and his team offer some of the best dental care in Monroe.