Determinants of the Emergence of ‘White Spots’ and Tooth Hypersensitivity in Orthodontic Patients

Background. Decalcification of the enamel, which manifests as “white-spot lesions” localized around fixed orthodontic appliances, is a serious issue during and after the orthodontic treatment. At a certain moment, this process can provoke painful sensations, aka sensitivity, which leads patients to experience physical and psychological discomfort. This research aims to establish the determinants of the emergence of white-spot lesions and critical time limits during treatment with fixed orthodontic appliances. Methods. To analyze the degree to which the teeth were impacted, our team examined 58 patients, ages 18–44, who were referred to the Dental Medical Center of the National Medical University of O. O. Bogomolets in the years 2023–2024 for alternating reasons, including the prospect of orthodontic treatment. Results. White-spot lesions were detected in 53% of patients with fixed orthodontic appliances. They occur primarily on the buccal surface of teeth around brackets and archwire, especially in the area nearest to the gums. In particular, the labio-gingival region of the upper incisors and premolars is the most common place of appearance. The analysis of the frequency of white-spot lesion emergence depending on the time limits of the orthodontic treatment demonstrated that the most rapid spread of the damage is registered three months after its beginning (62%). This period is characterized by a significant increase in the average Oral Hygiene Index (OHI) value and intensifying painful sensations. The gradual decrease in these factors is observed after 6 months since the treatment was administered. Conclusions. A sharp rise in the number of white-spot lesions and hyperesthesia in patients proves the conduction of critical evaluations of the oral cavity to be essential during the first three months of treatment with fixed orthodontic appliances. The crucial strategy in preventing the occurrence of white-spot lesions is to ensure that demineralization processes are absent, the biofilm is not being formed, and appropriate methodology is used to remineralize the damaged areas. Keywords: “white-spot” lesion, demineralization of the enamel, hyperesthesia, orthodontic treatment, prevention.