Currently, there are three options to deal with white spots in frontal teeth after orthodontic treatment:
- remineralization,
- micro-abrasion, and
- resin infiltration.
There are several case report about micro-abrasion and resin infiltration, and some clinical trials about all, but a recent systematic review found the evidence of effectiveness was rated as low, that means that the results are inconsistent or there is a high risk of bias, i.e. the manufacturers of the products published the results.
The three options are different:
Remineralization uses fluoride aiming to add something to the surfaces layer of the tooth. There are some clinical trials showing positive results (ncbi.nlm.nih.gov/pubmed/19887683) and others showing no effect (ncbi.nlm.nih.gov/pubmed/27480987). But the advantge of a non invasive therapy is that there is no loss of enamel surface, hence there is no irreversible alteration to the tooth surface.
Microabrasion on the other hand smooth irreversibly the surface of the eroded enamel with an acid.
Finally, infiltration, also irreversibly treatment, use an acid to remove a small layer of the eroded enamel and then add a resin layer. From the esthetic point of view this solve the issue immediately, but the lack of prospective studies add an interrogation mark to the long term results.
Hence, from all the three options, currently the remineralization is the only that is non-invasive.