The presence of clinically detectable, localized areas of enamel demineralization, observed as white spot lesions of different opacity, is a sign that the caries process has begun.
Dental caries results in the dissolution of apatite crystals and the loss of calcium, phosphate and other ions, which eventually leads to demineralization of the tooth substrate.
The subsurface porosity caused by demineralization gives the lesion a milky appearance that can be found on the smooth surfaces of teeth.
White spot lesions are not only the result of demineralization, however, as fluorosis, hypomineralization/hypomaturation and hypoplasia can also cause lesions.
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While fluoride remains an important factor in the prevention and management of dental caries, widespread exposure from different sources has increased the risk of fluorosis in communities, regardless of whether or not the community uses a fluoridated water supply.
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