White spot lesions are very common both in kids and adults. One of the challenges with these lesions is how to treat them. There are several approaches from trying to bleach the surrounding tooth structure to make the color difference less noticeable to repairing the area with a composite restoration. The challenge with the bleaching approach is most often these areas are decalcified and need mineral support to the tooth structure. On the other hand taking away the lesion with a bur and restoring seems overly aggressive. In recent years I have been treating many of these lesions with MI paste and seeing great results. I recommend taking before and after photos to document the improvement. Here are the recommendations for using Mi paste to treat white spot lesions.
• Apply etchant (phosphoric acid)to the white spot lesions for 10-30 seconds. Be careful not to over-etch the teeth. 1 minute is the maximum exposure time to the etchant. Only etch the white spot lesion, not the entire tooth.
•Pumice the tooth for 10 to 30 seconds, non-fluoridated, non-glycerin flour of pumice and then rinse.
• Dry the tooth. The tooth will appear frosty after the etch/pumice application. Sometimes it is necessary to etch/pumice a second time.
• Apply layer of MI Paste on the etched tooth surfaces with a prophy cup and leave on the tooth surface a minimum of 5 minutes. More time is better and improves remineralization.
We send our patients home with custom trays to continue to apply the MI paste for 5 minute sessions, twice daily for a week before we will see them to evaluate the results. Post-op instructions include nothing to eat or drink for 30 minutes after leaving the office, and to avoid foods that are likely to stain their teeth like wine, coke, coffee during the remineralization process. We schedule to evaluate the results in 1-2 weeks, and repeated treatments can be done to improve the results.