These spots are called “decalcification,” which is a fancy term for the start of cavities. They result from poor oral hygiene and unfortunately the damage is permanent. The spots form after plaque builds up on the teeth for an extended time. Plaque produces acid which in turn softens the enamel and causes white spots. At each visit we will let you know how well you are brushing and if there are any areas that need improvement. If we have serious concerns, we will provide fluoride to help remineralize these areas to prevent additional decay, and we might refer you back to your general dentist for an additional cleaning and fluoride treatment. In minor cases, the dentist can bleach the teeth or polish the white areas so they blend in. In severe cases, the areas are drilled out and replaced with fillings. Excellent oral hygiene is easier to maintain with the removable aligners used by our Invisalign and Invisalign Teen patients, which drastically reduces the occurrence of white spots during treatment.