9 Reasons Why You Have White Spots On Your Teeth

gingiva with white spots on tooth

When you think about tooth discoloration and dental staining, what comes to mind? Dark brown, black, or even green stains? Believe it or not, another common cosmetic problem is having teeth with white stains. When there are white spots on teeth, it’s different from other types of discoloration. And in reality, it’s more “serious” than dark stains, as white spots tend to indicate issues like weak enamel or irregularities in tooth development.

Although they’re not necessarily “scary” looking like tooth decay, white spots on teeth are often the earliest stage of cavities.

Common Symptoms

White spots on teeth are pretty easy to identify. You might see them as circular patterns where braces once sat, or along the gumlines. At other times, the discoloration is only on one or two teeth.[1] Depending on your history, past issues such as high fevers, where you lived, or a traumatic injury to your mouth could all be warning signs.

Some white spots are less visible. When your tooth is thoroughly dried off, they become more evident. Your dentist or hygienist may use what’s called an “air/water syringe” to blow small puffs of air on your teeth to check for white spots during your exam.

Common Causes

Generally speaking, you don’t get white spots on teeth the same way you would dark discoloration. Teeth with white stains are exhibiting some type of scarring or compromised structure in that area, making the enamel weaker than what’s around it. As a result, it looks different from the surrounding, healthy tooth structure.

Understanding the causes of white spots on teeth can help you prevent new ones and keep current discoloration from getting worse. There are even steps you can take to possibly reverse the white spot (depending on the situation) with the help of your dental team.

1) Fluorosis

Just as you can have too little of a vitamin or mineral, you can have too much of one too. With fluorosis, an excessive amount of fluoride is ingested during tooth and bone development.

Symptoms

Most cases of fluorosis are related to things like well water with abnormally high mineral levels. Some parts of the US are “worse” than others. Working with your soil and water district can help you test the water to make sure its healthy. In other cases, it could be due to swallowing large amounts of toothpaste on a frequent basis.[2]

Treatment

Regulate your fluoride intake by drinking tap water that’s monitored for appropriate mineral levels or choose an alternative water supply for drinking. Never leave children unsupervised with products like toothpaste or mouthwash until they’re old enough to spit and rinse well on their own.

2) Demineralization

Demineralization is the first stage of tooth decay. It occurs when the outer layer of enamel begins to deteriorate and loses minerals, making it weaker and compromising its integrity.

Symptoms

Chalky-white spots will start to form across different areas in your mouth. For people with braces, it’s usually around the brackets. Or if you don’t brush very well, along the gumlines. It depends on how much plaque there is and how long it stays on your teeth.[3] Some people even notice demineralized areas when they’re sick and dehydrated!

Treatment

Start a fluoride regimen ASAP. Believe it or not, you can reverse tooth decay while it’s still at this stage. Although the white spot may not actually go away, you can prevent the lesion from turning into a full-blown cavity.

3) Your Diet

You are what you eat, right? If your diet includes higher acids, processed carbs, or artificial sweeteners, you’ll see a higher level of plaque and enamel erosion in your mouth. Daily oral hygiene is essential. If you’re eating foods that tend to stick around your teeth for a long time (like fruit snacks or caramel) those areas will be more prone to getting white spots first.

Symptoms

Processed, packaged foods make up a large portion of your diet. Snacking on it frequently throughout the day instead of eating at set times can also lengthen the amount of time that those food particles have on your teeth.

Treatment

Opt for whole grains, fresh fruits and vegetables, tap water (it’s fluoridated) and eat at set times throughout the day. If you need a snack, go brush after you eat it!

4) Dry Mouth

Xerostomia (dry mouth) is a lack of adequate saliva flow to lubricate the inside of your mouth. For some people, it’s a chronic problem. Others only experience it now and then. But when you don’t have enough saliva, it allows plaque bacteria and acids to work in overdrive. As a result, you’re at a significantly higher risk of tooth demineralization (aka white spots on teeth.)

Symptoms

It’s pretty straightforward. Your mouth feels dry, sticky, or you get that “cotton mouth” sensation when you wake up in the morning. You’ll probably notice other symptoms like bad breath and more plaque on your teeth. Check your tongue for a filmy buildup as well. If dry mouth goes on for too long, you’ll more than likely see a spike in the number of cavities on your teeth.[4]

Treatment

First, try to pinpoint the cause of your dry mouth. If it’s because of medication, ask your doctor about other alternatives to try. Alcohol intake before bed? Cut back. Cancer therapy? Add a saliva substitute or moisturizing mouthwash into your daily oral hygiene routine. And of course, sip on water often throughout the day! If you’re tempted to suck on a mint, make sure that it’s sugar-free. Chewing a piece of gum that’s made with Xylitol is even better!

5) Medications

Certain types of medications can affect the way your teeth look, especially if they’re taken while the tooth is still developing. Usually this would be in early childhood or when a mother is pregnant and/or breastfeeding. We know that medications like tetracycline can cause severe internal stains that are bluish in color. On the other hand, inhaled drugs such as albuterol can increase the risk for tooth decay. And since white spots are one of the earliest stages of cavities, asthmatics should be aware of the risks.

Symptoms

If medications affect the way your tooth looks, it usually won’t be evident until the tooth develops and erupts through the gums. At that point, surface flaws tend to be visible. On the other hand, medications that are inhaled or liquids that are swallowed may add to demineralization, gradually leading to white spots on teeth.

Treatment

Always discuss medications with your doctor. If you’re pregnant or suspect that you could be pregnant, make sure you tell your medical provider before starting a new prescription. As for adults and children who use inhalers or liquid medications, rinse your mouth thoroughly after each dose. It’s also helpful to supplement with a daily fluoride rinse before you go to bed.

6) Enamel Hypoplasia

Sometimes when teeth are still forming, there can be physical defects that occur in the tooth structure. Hypoplasia can happen to both baby (primary) and adult (permanent) teeth, causing thinner enamel that’s more prone to getting tooth decay.[5] Depending on the type of defect it is, enamel hypoplasia (also called amelogenesis imperfecta) can be congenital or due to specific medical syndromes. It’s also linked to vitamin deficiency, childhood illnesses (like having a severe fever) or health habits of the mother during pregnancy.

Symptoms

With hypoplasia you don’t just see white spots; there are also pits in the surface of the enamel as well as possible yellow or brown areas. Sensitivity is also a concern. The enamel isn’t glossy and smooth like what you would see in a healthy tooth. This type of dental defect is evident as soon as the tooth erupts.

Treatment

Treatment for amelogenesis imperfecta/enamel hypoplasia is usually cosmetic and/or restorative.[6] It depends on the severity of your enamel defect and how many teeth are involved. For instance, a small spot caused by a childhood fever may not need attention unless you want to cover it for aesthetic reasons. On the other hand, extensive pitting may require several crowns to protect affected teeth from sensitivity, enamel breakage, or future decay.

7) Braces

Orthodontic appliances like brackets and wires are a huge risk factor for white spots. If your oral hygiene isn’t up to par or you don’t clean around all of your braces thoroughly each day, a thin layer of plaque will adhere to them and start to eat away at the tooth in those areas. That’s why “white circles” may be prevalent once the braces are taken off at the end of your orthodontic therapy.

Symptoms

White spots during braces are easier to spot after the appliances actually come off. Looking at the teeth, you’ll be able to see where the brackets were once bonded in place, because a white circle or partial circle will be scarred into the enamel next to it.

Treatment

Parents should help their children make sure they’re cleaning well around their braces. Supplementing with a professional-grade fluoride gel or rinse is also extremely beneficial. Making it easier to clean around your braces can help, so consider investing in an electric toothbrush, water flosser, and/or angled proxy brush to clean between brackets. Even if your child wants to brush on their own, try to go back behind them every now and then to make sure there’s no plaque buildup. Ask your dentist or orthodontist for a few disclosing tablets to identify which areas aren’t getting cleaned as well.

8) Plaque Accumulation

Any time plaque sets on your teeth for an extended period of time, the acids inside of the biofilm start to etch away at your enamel.[7] And as your enamel gets dried out, it loses its integrity and luster. That’s why white spots on teeth are also the first signs of a developing cavity. Intercepting it early can prevent the plaque from causing further damage (such as rupturing through your outer layer of tooth, creating a hole in your enamel.)

Symptoms

Since heavy plaque causes white spots, you may not catch the discoloration if you’re not brushing and flossing well. But a thorough brushing and flossing session should remove almost all of the biofilm so that you can see your entire tooth surface. Pay specific attention to areas along the gums, where teeth touch, and around orthodontic appliances. These are the areas where plaque tends to be heaviest and thus, are more prone to white spots.

Treatment

Brush, brush, brush. Use an electric toothbrush if you can because it will help you be more efficient when it comes to plaque removal. The key is to remove all of the plaque at least once a day, minimum. Twice is better. Brush for at least two minutes at a time.

9) Sleeping With Your Mouth Open

Some people claim to see white spots on their teeth when they first wake up in the morning. Since they’re more obvious when your teeth are dry, it’s more common to see them if you’ve been sleeping with your mouth open all night long. Some people are mouth breathers because they snore, have sinus problems, or suffer from sleep apnea.

Symptoms

How can you tell if you’re sleeping with your mouth open? Typically, you’ll wake up with what’s called “cotton mouth”, where your mouth feels dry and sticky. You might even have a sore throat. And of course, if you look at your teeth in the mirror first thing, you’ll see white spots on those areas where your enamel is weak.

Treatment

Dry mouth can raise your risk of cavities and halitosis. So naturally, most people want to do something about it even if white spots in their enamel doesn’t bother them. If you have some type of an airway blockage or sinus infection, work with your doctor to determine the best course of treatment. Using a lubricating mouthwash before bed (and avoiding alcohol) can reduce oral dryness.

Preventing White Spots On Your Teeth

It’s easier to prevent white spots on teeth than it is to treat discoloration that’s already there. You’ve heard the old saying, “An ounce of prevention is worth a pound of cure.” Not surprisingly, most of the best ways to prevent white stains relate back to your everyday diet and oral hygiene routine (yes, we’re talking about brushing and flossing.) They’re especially important if you’re in braces or live in an area with irregular fluoride levels in the water.

When To See A Dentist

There’s a difference between white spots that have been on your teeth since childhood and those that are newly developed. If you’re starting to notice white spots where there used to not be any – specifically between your dental checkups – be sure to bring the subject up with your dentist. More often than not, it doesn’t require a same-day emergency appointment.

Make note of any risk factors like common causes of white spots or changes in your oral hygiene routine, then be sure to discuss them with your dentist. Doing a bit of the detective work beforehand can help your dentist properly identify what’s going on and plan the best course of treatment.  

Overcoming White Stains On Teeth

Teeth with white stains usually have discoloration because of weak enamel, early stages of tooth decay, poor oral hygiene, trauma, or mineral levels in water/diet as your tooth was developing. Understanding what causes white spots on teeth can help you to prevent them from forming or getting worse. They can cause both structural and cosmetic concerns, depending on why they’re there. Make sure to see your dentist for a checkup at least every six months to stay on top of your oral health needs!