White spots and lines are demineralized areas of enamel that represent the first clinical signs of caries.
Appearance & Symptoms
- Caries typically affects the teeth that emerge first and are least protected by saliva (e.g., the upper incisors).
- White spots or white lines typically begin at the gingival margin.
- If the disease process is not managed, the lesions will progress and the demineralized enamel will break down to frank cavities that initially appear pale yellow.
- In time, these lesions will progress to larger brown cavities.
Treatment & Referral
- Immediate dental referral should be arranged.
- If the clinician cannot determine whether an enamel lesion represents enamel hypoplasia or early caries, refer to establish a dental home, as the child is at high risk for ECC in both scenarios.Use topical fluoride to reverse or arrest lesions.
- Dietary and oral hygiene counseling should be given.