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Tooth whitening to treat unaesthetic yellow/brown lesions has a strong evidence base and is a routine cosmetic procedure in many dental practices. The management of white lesions, however, is more challenging and is the subject of debate. As traditional whitening procedures may make white lesions more obvious in the short term, there is a risk that patients may be misinformed that limited treatment options are available, and they may be prescribed invasive cosmetic procedures instead. This paper aims to help clinicians accurately diagnose aetiological factors that produce white lesions and describes a hierarchy of treatment options which are both aesthetic and biologically respectful, focusing on the materials, equipment and clinical techniques that are available for the minimally invasive management of white lesions using resin infiltration.
CPD/Clinical Relevance: This paper aims to help clinicians select the optimal materials, equipment and clinical techniques for the minimally invasive management of unaesthetic white enamel defects.
Article
White or coloured inclusions in teeth are relatively common. Although many patients may remain unaware of these lesions, in some cases they can have a significant impact on the patient's confidence and willingness to smile.1
White lesions are challenging to treat using tooth whitening procedures, as treatment with conventional bleaching systems may make them more obvious. Historically, the unpredictability of minimally invasive treatment options often forced clinicians to resort to more destructive restorative techniques, such as direct or indirect veneers, to mask the lesions completely.
This paper provides a practical guide to the diagnosis of tooth discoloration and presents a hierarchy of minimally invasive management options, focusing on the use of resin infiltration.
An understanding of the aetiology of tooth discoloration is paramount for successful management as brown/yellow lesions call for different treatment options compared to white lesions.
The aetiological factors resulting in yellow/brown lesions which affect teeth may be categorized as extrinsic and intrinsic:2
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