Caries Process, Prevention, and Management: Demineralization/Remineralization
Course Number: 714
Course Contents
White Lesions
During a clinical examination, an early remineralized carious lesion often appears as a white, opaque area beneath a smooth, shiny, and hard enamel surface—sometimes described as a “white scar.” This appearance is due to partial remineralization of the surface layer, while the subsurface lesion body remains porous and less mineralized, as discussed previously.
The clinical significance of white lesions lies in their potential outcomes. With appropriate intervention—such as improved oral hygiene, fluoride use, dietary modifications, and regular professional monitoring; these lesions can arrest or even show signs of further remineralization. However, without these protective measures, the lesion may progress, particularly if exposed to frequent acid challenges, eventually leading to surface breakdown and cavitation.
Understanding and recognizing white spot lesions as a reversible stage of caries is critical, as it represents a window of opportunity for non-invasive management and preservation of tooth structure.
Figure 9. Inactive, remineralized white spot lesion on anterior permanent teeth. Remineralization occurred by improved oral hygiene and fluoride exposure after removal of orthodontic devices.