The Dreaded White Spots

 

Many parents fear the dreaded white spots.  They ask regularly during their child’s orthodontic treatment if their child is getting white spot lesions. What they often forget is that the white spot lesions are not from the braces. They are from not keeping the teeth clean enough, and they can happen with or without braces.

White spots on teeth are actually white scars, and once they appear, they may become permanent.  The white spots are the first step in the caries process; white spots become cavities. Poor oral hygiene allows plaque to build up on the tooth surface.  Maintaining adequate hygiene is even more difficult when braces are present because the brackets create hiding places for this bacterial accumulation.  The bacteria in the plaque eat the food which is left on the tooth surfaces; they especially like to eat sweet and sugary foods. The bacteria then “poop” on the teeth. This acidic bacterial excrement can erode or “decalcify” the enamel surface of the teeth.  Demineralization (a decrease in the mineral content of the enamel) can happen on the surfaces you can see, but it can also happen between the teeth if dental floss or waterpik irrigation is not used daily. (The decalcifications between the teeth are seen on x-rays as “incipient lesions”, i.e. early cavities.)  As fluoride and the natural minerals of your saliva fight to keep the enamel strong, the decalcified areas are recalcified.  This process of decalcification and remineralization creates unsightly color changes (both white spots and dark areas) of the tooth surface.

White spot lesions are also common in people who have dry mouth issues.  Reduced saliva flow lower’s the mouth’s natural ability to neutralize the acids. Many people with dry mouth “self -medicate” with lemon drops. Although the lemon drops increase salivation, they also feed the bacteria on the tooth surface as well as increase the mouth’s acidity directly (lemons are acidic). Both acid from the bacteria, and acid from the food increase demineralization of the tooth surfaces. Remember, this demineralization is the first step in tooth decay. A better option to increase salivary flow would be using xylitol candies and sprays, such as Xylimelt dry mouth lozenges or Carifree spray, because xylitol inhibits bacterial growth.

Another factor in white spot lesions, in addition to accumulation of bacteria, is the application of dietary acid straight on tooth surfaces. Many foods and beverages are acidic.  When people sip a lot of acidic beverages, like carbonated beverages (seltzer and soda), lemonade, sports drinks, tea with lemon, or coffee, they bathe the tooth surfaces in acid. The longer the period of time during which the acidic beverage is applied, the more damage it does.  This is why Dr. Okun recommends drinking the acidic beverages with a meal so that there is increased salivary flow as well as other foods to decrease the acidity of the mouth. She also recommends limiting the time that sugary foods are in the mouth. (Eat a cookie and then rinse out rather than suck on a candy or lick a lollipop for more than 10 minutes.) Dr. Okun recommends rinsing with water after eating or drinking, to wash the food particles and acid off of the teeth. It is also beneficial to rinse with fluoride daily to strengthen the tooth surfaces and to help the teeth re-calcify following acid attacks.

For help with proper cleaning of the teeth, see our hygiene videos on our website https://www.okunortho.com/brushing-and-flossing.  Be sure to brush thoroughly at least two times a day, and either floss or use the “Waterpik” dental irrigator daily to clean between the teeth.

How Long Does Orthodontic Treatment Take?

 

Orthodontic treatment is a carefully planned process that focuses on both function and appearance. Patients often ask how long orthodontic treatment with braces or aligners like Invisalign will take, and the answer depends on several individual factors. While the average orthodontic treatment timeline is about two years, each case follows a unique path based on the patient’s needs.

In many cases, traditional braces are worn for 18 to 30 months. This timeframe allows for gradual, controlled tooth movement that protects the health of the gums and bone. Some patients may complete treatment sooner, especially if alignment issues are mild, while more complex cases (such as those with impacted teeth) can take longer.

Aligner treatment timelines (for example, Invisalign or Spark clear aligner systems) are often similar, though they can vary depending on how consistently the aligners are worn. Most Aligner (Invisalign or Spark) patients receive a series of custom trays designed to shift teeth step by step. Each set is typically worn for one to two weeks before moving to the next, creating steady progress over time.

Age plays a role in how long orthodontic treatment takes. Younger patients often respond more quickly because their jaws are still developing, making tooth movement more efficient. Adults can achieve excellent results as well, though treatment may take slightly longer due to denser bone structure.

Consistency is one of the most important factors influencing treatment duration. Following instructions, such as wearing elastics with braces, or wearing aligners for the recommended hours each day or maintaining proper care with braces, helps prevent delays. Missed appointments or inconsistent habits can extend the overall timeline.

Orthodontic treatment moves at a pace that protects long-term oral health, not just the speed of results. This approach ensures that teeth are correctly positioned and remain stable after treatment. Rushing the process can lead to complications or relapse, which may require additional correction later.

Patients in Westchester County (including White Plains, Rye, Rye Brook, and Port Chester) often ask how their local orthodontic treatment timeline compares to national averages. In most cases, the duration is similar, as orthodontic principles remain consistent regardless of location. What matters most is the individualized treatment plan created after a thorough evaluation.

Regular check-ins allow orthodontists to monitor progress and make necessary adjustments. These visits are essential for keeping treatment on track and addressing any concerns early. Whether using braces or Aligners (such as Invisalign or Spark clear aligner systems), small changes over time lead to meaningful, lasting improvements.

Ultimately, orthodontic care is an investment in both health and confidence. While two years may seem like a long commitment, the gradual process is designed to deliver stable, functional results that last well beyond the treatment period.

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