White Marks After Braces: Decalcification and Lowering the Risk
For adults in or just out of braces: what white marks (decalcification) are, why they form, prevention, fading, whitening and treatments after braces. They are an early sign of tooth decay. In studies they shrank after braces, though not to pre-treatment levels in the longest, and treatment evidence is limited.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, principal dentist, reviewed this page. He is a General Dental Practitioner: BDS, BSc (Hons), MSc (Leeds), PG Dip Implant Dentistry, PG Cert Restorative and Aesthetic Dentistry.
What are white marks after braces?
White marks after braces are patches where tooth enamel has lost minerals, also called decalcification, demineralisation or white spot lesions. Decay and tooth colour in general are covered on our pages about how cavities form and why teeth change colour.
North Cumbria's 2025 NHS leaflet calls white marks an early sign of tooth decay.
Why do white marks form with braces?
North Cumbria's leaflet says plaque, a film of bacteria, coats teeth and brace that are not brushed thoroughly, causing gum disease and tooth decay. NHS braces guidance says too much sugary food and drink can cause problems like tooth decay.
How can you lower the risk of white marks during treatment?
NHS sources stress cleaning and less sugar. Our pages on cleaning your teeth with braces and how fluoride protects teeth cover the daily routine. North Cumbria's leaflet says cleaning teeth and brace is needed to avoid marks staying after the brace is removed. Trials of extra fluoride beyond standard toothpaste are mixed.
In a 2023 Swedish trial of 248 adolescents in braces for about 26 months, at least one more mark on the front teeth appeared in 60% using 5,000ppm toothpaste, 58% adding a twice-daily 0.2% fluoride rinse, and 78% using standard 1,450ppm toothpaste alone. Counting all teeth, the three groups did not differ significantly.
A 2025 review of seven rinse trials (704 adolescents and young adults, searched to September 2024, moderate or high risk of bias) found benefit in three and none significant in four, though two of these found significantly fewer new marks on front teeth alone. It found too little support to recommend a rinse generally alongside regular fluoride toothpaste, but did not rule out that individual orthodontic patients may benefit after a full risk assessment.
In a 2023 review (searched to October 2022; 7 trials, 666 people aged 12 to 50), fluoride varnish applied by a professional at least every 3 months lowered the share with marks at brace removal compared with controls, pooling 5 trials, at very low certainty; one trial was significant alone counting patients, two counting teeth. Three of its trials reported on side effects: one person stopped with nausea and five complained of taste and discolouration.
Do white marks fade after braces come off?
They partly faded in the studies found, though in the longest they had not returned to pre-treatment levels after 12 years. In a 2026 trial of 150 people aged 14 to 20, marks reduced by more than half in the year after removal, which the authors call spontaneous remineralisation, with no difference between groups given fluoride varnish, fluoride-releasing bracket glue or placebo during treatment.
A 2010 study photographed four teeth in 59 patients for 2 years after removal and 30 of them for 12 years: marked areas shrank over 2 years, then showed no significant change to 12. The authors call such marks a decay and cosmetic problem for many orthodontic patients.
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What does the evidence say about whitening white marks?
The evidence is too thin to say whether whitening helps. A 2020 review (searched to July 2018) could neither support nor refute it for marks after braces, finding one clinical trial and eight laboratory studies, mostly at high risk of bias, with very low certainty.
In its one trial, at high risk of bias, 10 people with inactive marks had a 60-minute clinic bleach, then 2 weeks of daily home bleaching after a 2-week break, and 9 had none. After 28 days, bleached marks and nearby enamel were both lighter than at the start and closer in colour, and every bleached patient was satisfied.
NHS guidance says whitening is not done if you are 17 or younger or have unhealthy teeth or gums, and is not recommended if you are pregnant or breastfeeding or have crowns, dentures or implants, as it can only lighten natural teeth. It says a dentist should first check your teeth and gums are healthy.
What treatments are there for white marks after braces?
Trials after braces have tested fluoride varnish, calcium phosphate paste, resin infiltration and microabrasion against other options or none. For decay in general, NHS guidance says a hole (cavity) will probably need a filling.
- In a 2013 trial of 115 people aged 12 to 20, braces off within 2 months, one varnish application and 8 weeks of calcium phosphate paste showed no significant difference from home care in any assessment. Professionals rated improvement over 8 weeks at 29%, 21% and 27% respectively.
- In a 2026 Chinese trial of 79 people aged 12 to 25, all using fluoride toothpaste, mark area fell by 24 months 57% after one resin infiltration then 6-monthly toothpaste coats, and 45%, 42% and 35% with 6-monthly calcium phosphate paste, varnish or toothpaste alone. Infiltration beat all three; paste beat toothpaste in one of two analyses. Only 57 of 79 finished; decayed, missing and filled tooth counts rose significantly in all but the toothpaste group, with no difference between groups at 24 months; the authors urge caution.
- Resin infiltration fills porous enamel with a runny resin; a 2021 review of white marks and fluorosis (searched to December 2019; 11 studies, 413 people aged 8 to 30) found it masked marks after braces better than no treatment, pooling 3 trials, at moderate certainty from few well-conducted trials at moderate to high risk of bias.
- Microabrasion removes superficial parts of the mark with acid and fine abrasive particles, says a 2022 review. In a 2019 split-mouth trial of 20 people (16 at 12 months), it and infiltration improved marks within a week, lasting 12 months, its authors conclude; marks were smaller after infiltration, colour change no different. A 2021 review's introduction says it suits very superficial marks, as deeper ones may leave a hollowed surface.
When should you speak to a dentist about white marks?
See a dentist as soon as possible if you think you or your child has tooth decay, the NHS says. It may cause no symptoms at first. NHS braces guidance says to keep having regular check-ups during braces, and a 2019 BOS leaflet says they should continue so your teeth can be checked for decay. If you notice white marks, show them to a dentist.
Frequently asked questions
Do people notice their white marks after braces?
Most in one trial did not. Of patients aged 14 to 20 (150 randomised), 62% did not notice the marks when braces came off, and 95% a year later. In a 2013 trial of 115 people aged 12 to 20, patients rated their own improvement over 8 weeks at 37%, with varnish, paste or home care alike.
How long does resin infiltration last on white marks?
A 2021 review (searched to December 2019) found a median follow-up of 6 months. In a 2019 study, 8 of 20 earlier trial patients aged 12 to 17 were re-measured after about 34 months. The colour gap between their marks and nearby enamel stayed smaller than before treatment, with no significant change from 6 or 12 months to that check.
How common are white marks in orthodontic patients?
Common, by one large estimate. A 2025 review of 57 studies, of 9,101 patients averaging 16 years, put their prevalence at 55% among orthodontic patients (42 studies) and 29% among people with no treatment (21 studies). Prevalence rose with longer treatment and varied with how marks were detected and between ethnic groups.
Other parts of daily life with braces are among the options in this section.
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