**5. Preventive and therapeutic methods of white spot lesion**

After the completion of the orthodontic treatment process, demineralization is expected to slow down. Although demineralized enamel surfaces may partially remineralize after treatment, white spot lesions have been noted to be irreversible. **Figure 3** shows white spot lesions after orthodontic treatment. However, WSL formation can be prevented by ensuring the oral hygiene of the patients during the treatment [2]. Once WSL is diagnosed, it is important to treat the cause. Social, medical, and dental histories of the patients should be taken, and caries risk assessment should be done.

While taking anamnesis; systemic and topical fluoride intake, dietary habits, snacking frequency and foods consumed between meals, bottle use, reflux, vomiting and eating disorders, salivary flow, drugs used by the person or the effect of health status on saliva flow, socioeconomic status, information status about dental diseases, dental treatment needs, value given to oral health, efforts to change habits, dental history, regular check-ups, and the amount of caries should be evaluated [37].

Numerous studies have been conducted to ensure oral hygiene of patients undergoing orthodontic treatment and to increase the resistance of teeth to demineralization. In these studies, fluorine mouthwashes, fluorinated gels and polishes, chlorhexidine mouthwashes, chlorhexidine polishes, and gels, fluorine or non-fluoride sealants covering the enamel surface around the bracket, xylitol lozenges, fluorine-releasing elastomers, and fluorine-releasing bracket bonding materials were used [38–40].

In the study investigating the effects of resin-based sealant, fluorine-containing sealant, fluorine polish, and glass ionomer cement on the initial caries lesions and the proximal surface of the adjacent tooth, it was determined that the most effective material was glass ionomer cement. The effectiveness of the other materials was determined as fluorine polish, fluorine-containing sealants, and sealants, in order from most effective to less effective [41].

The risk of enamel demineralization in patients undergoing fixed orthodontic treatment can be reduced or prevented by the following:
