title: Development of white spot lesions during orthodontic treatment: perceptions of patients, parents, orthodontists, and general dentists.
abstract: BACKGROUND
  Despite the many advances to improve the practice of orthodontics, white spot lesions, or decalcifications, remain a common complication in patients with poor oral hygiene. The purpose of this study was to assess the perceptions and level of awareness of patients, parents, orthodontists, and general dentists toward the development of white spot lesions during orthodontic treatment.
  
  
  METHODS
  This was a prospective epidemiologic survey of the perceptions of orthodontic patients (n = 315), parents (n = 279), orthodontists (n = 305), and general dentists (n = 191) regarding the significance, prevention, and treatment of white spot lesions.
  
  
  RESULTS
  All surveyed groups indicated that white spot lesions detracted from the overall appearance of straight teeth, attributed primary responsibility for the prevention of white spot lesions to the patients themselves, and thought that the general dentist should be responsible for treating white spot lesions. Patients regarded themselves as ultimately responsible for the prevention of white spot lesions (P <0.05).
  
  
  CONCLUSIONS
  The patients, parents, orthodontists, and general dentists had similar perceptions regarding the significance, prevention, and treatment of white spot lesions. All groups indicated that patients were the most responsible for the prevention of white spot lesions. Communication among patients, parents, orthodontists, and general dentists needs to improve to decrease the incidence of white spot lesions in the orthodontic population.
authors.affiliation: Private practice, Salt Lake City, Utah.
authors.forename: Blake J
authors.initials: BJ
authors.lastname: Maxfield
authors.affiliation: Associate professor, Department of Child Dental Health and Orthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Hamdan
authors.affiliation: Associate professor, Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va.
authors.forename: Eser
authors.initials: E
authors.lastname: Tüfekçi
authors.affiliation: Professor, Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va.
authors.forename: Bhavna
authors.initials: B
authors.lastname: Shroff
authors.affiliation: Associate professor, Department of Orthodontics, School of Periodontics, Virginia Commonwealth University, Richmond, Va.
authors.forename: Al M
authors.initials: AM
authors.lastname: Best
authors.affiliation: Professor and chair, Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va. Electronic address: sjlindau@vcu.edu.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Lindauer
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002327:Cariostatic Agents / Q000627:therapeutic use; D003731:Dental Caries / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D003742:Dental Devices, Home Care; D003815:Dentists / Q000523:psychology; D016021:Epidemiologic Studies; D004955:Esthetics, Dental; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D006267:Health Education, Dental; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009067:Mouthwashes / Q000627:therapeutic use; D009910:Oral Hygiene; D009967:Orthodontic Appliances / Q000009:adverse effects*; D009970:Orthodontics; D010290:Parents / Q000523:psychology; D010358:Patient Participation; D010361:Patients / Q000523:psychology; D011446:Prospective Studies; D017001:Tooth Demineralization / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D014099:Toothbrushing
chemical_list: D002327:Cariostatic Agents; D009067:Mouthwashes; D005459:Fluorides