They are confined to remineralization of superficial white spot lesions and cannot entirely prevent their development. These preventive strategies have been employed to avoid the initiation, to arrest or reverse the progression, or to mask the WSLs. They may be utilized before or after the fixed appliances are bonded. Application of CPP-ACP, or bioactive glass, are more recent techniques to minimize the white spot formation. Although fluoride's capacity to remineralize enamel is well established, there are little data to support its use in post-debonding white lesions. Fluoride-containing varnishes, toothpastes, mouth rinses, and gels are examples of fluoride delivery. Fluoride treatment results in a less soluble, acid-resistant fluorapatite on the enamel surface. Great attention has been paid to non invasive therapy of enamel carious lesions with remineralizing agents such as fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), or the use of therapeutic sealants for occlusal lesions. Direct and indirect restorations produce good and predictable results as well, but they should be limited to cavitated lesions. Deeper lesions always cause concave tooth surfaces. Microabrasion therapeutic option is best appropriate for very superficial lesions, less than 0.2 mm. Consequent active white spot lesions may develop enamel cavitation if left untreated.

The self-cleaning mechanism of the oral musculature and saliva is prohibited by the irregular surface of the brackets, wires, and bands. The appearance of these lesions is mainly caused by the prolonged accumulation of dental plaque and bacterial colonization around the orthodontic brackets, under the arch wire, or between the brackets and the gingival margin with difficult tooth cleaning. Fixed orthodontic appliances are usually accompanied by enamel demineralization or white spot lesions (WSLs).

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