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White Spot Lesions — ORE Part 1 MCQ

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EasyOrthodonticsWhite Spot LesionsORE Part 1

A patient undergoing fixed orthodontic treatment develops chalky white areas on the labial enamel adjacent to the upper anterior brackets. What is the most likely cause?

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Correct answer: BPlaque-related enamel demineralisation

The correct answer is B. White spot lesions are early, non-cavitated enamel caries lesions caused by subsurface demineralisation. Fixed brackets retain plaque and make cleaning more difficult; bacterial acid production within this biofilm causes local enamel mineral loss, typically adjacent to brackets on labial anterior surfaces. SDCEP classifies white spot lesions as areas of enamel demineralisation. Fluorosis is a developmental enamel defect caused by excess fluoride during tooth formation, not by an orthodontic bonding agent. Hypersensitivity to bracket materials affects soft tissues rather than producing focal enamel opacities. Acid etching is confined to the bonding procedure and does not cause progressive lesions around brackets. Archwires do not cause intrinsic enamel staining.

Reference: Scottish Dental Clinical Effectiveness Programme. Prevention and Management of Dental Caries in Children, 2nd edition, section 8.3.1: initial anterior caries describes white spot lesions as areas of demineralisation confined to enamel, 2018. https://www.sdcep.org.uk/media/2zbkrdkg/sdcep-prevention-and-management-of-dental-caries-in-children-2nd-edition.pdf