Methods used to determine demineralization of enamel associated with orthodontic treatment: a review

Abstract

Demineralization/decalcification of the enamel around orthodontic brackets, seen clinically as white spot lesions, remain a sometimes neglected part of orthodontic care. Even though there are numerous studies on decalcification, most of them are based on subjective evaluation of enamel samples. The various techniques used to determine enamel demineralization associated with orthodontic treatment have not been directly compared and the operator is left with limited choice. Since these techniques have their own limitations, the selection of a protocol for the study of demineralization of enamel should be based on the true merit of the technique and its relevance to the study. Hence, the various methods used to determine demineralization of enamel during orthodontic treatment have been critically evaluated and their application in clinical orthodontics and research discussed. Clinical Relevance: Dental enamel has very limited regenerative capacity; hence prevention of its demineralization is of prime concern to a dentist in general and to an orthodontist specifically. The appearance of white spots/damage to healthy enamel after orthodontic treatment is both unaesthetic and legally questionable. Further, there is a lack of correlation among the various methods suggested to evaluate enamel demineralization. The current article not only summarizes the various methods but also suggests relevant steps to prevent the demineralization of enamel.