title: Critical evaluation of incidence and prevalence of white spot lesions during fixed orthodontic appliance treatment: A meta-analysis.
abstract: OBJECTIVE
  Development of dental caries, specifically, white spot lesions (WSLs), continues to be a well-recognized and troubling side effect of orthodontic fixed appliance therapy, despite vast improvement in preventive dental techniques and procedures. The aim of this meta-analysis is to evaluate, determine, and summarize the incidence and prevalence rates of WSLs during orthodontic treatment that have been published in the literature.
  
  
  METHODS
  According to predetermined criteria, databases were searched for appropriate studies. References of the selected articles and relevant reviews were searched for any missed publications.
  
  
  RESULTS
  In the 14 studies evaluated for WSLs, the incidence of new carious lesions formed during orthodontic treatment in patients was 45.8% and the prevalence of lesions in patients undergoing orthodontic treatment was 68.4%.
  
  
  CONCLUSIONS
  The incidence and prevalence rates of WSLs in patients undergoing orthodontic treatment are quite high and significant. This widespread problem of WSL development is an alarming challenge and warrants significant attention from both patients and providers, which should result in greatly increased emphasis on effective caries prevention.
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, SRM Kattankulathur Dental College and Hospital, SRM University, Kancheepuram, Tamil Nadu, India.
authors.forename: Dhinahar
authors.initials: D
authors.lastname: Sundararaj
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, SRM Kattankulathur Dental College and Hospital, SRM University, Kancheepuram, Tamil Nadu, India.
authors.forename: Sudhakar
authors.initials: S
authors.lastname: Venkatachalapathy
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, SRM Kattankulathur Dental College and Hospital, SRM University, Kancheepuram, Tamil Nadu, India.
authors.forename: Akshay
authors.initials: A
authors.lastname: Tandon
authors.affiliation: Department of Orthodontics and Dentofacial Orthopedics, SRM Kattankulathur Dental College and Hospital, SRM University, Kancheepuram, Tamil Nadu, India.
authors.forename: Aaron
authors.initials: A
authors.lastname: Pereira
keywords: Demineralization; incidence; orthodontic fixed appliances; prevalence; white spot lesions