DEAR DR. COLUMBUS: I notice I have a lot of little white spots on my front teeth. What are these and how can I get rid of them? – Mike, Laconia, NH
DEAR Mike: There are a few different causes of white spots on the teeth, depending on how long you’ve had them. If the spots have been present since you were a child, you may have experienced a disruption in enamel formation—or enamel hypoplasia —as your teeth grew. White spots can also appear in childhood when kids use—and ingest—too much fluoride toothpaste. This is called hyperfluorosis. Both of these causes are common in childhood, and can cause lasting spots on teeth.
A professional tooth whitening may make the spots less noticeable by removing surrounding stains. Another alternative is composite dental veneers, which are thin shells of tooth-colored, composite resin, that are bonded directly to the tooth giving the appearance of whiter enamel.
However, if the white spots have formed more recently on adult teeth, the culprit may be plaque build-up, which can cause hard, scaly spots near the gum line and make the teeth look discolored. A thorough dental cleaning can help remove this plaque and decrease the discoloration.
Finally, and most concerning, the beginning stages of tooth decay or cavities can sometimes look like white spots. As bacteria produce acids that digest and thin out the tooth enamel, the enamel may begin to look bright white.
White spots caused by decay require examination and treatment by a dentist. The earlier decay is detected, the better your dentist will be able to stop it in its tracks.
Whatever the cause, I would definitely suggest you visit a dentist. He or she will examine the spots, find the underlying cause, and determine what, if any, treatment is needed.