Resin Infiltration- Penetrating the white spot lesion (WSL)

Viewed with the naked eye, white spot lesions are exactly what the name describes - white opaque patches in enamel.

Under high magnification, the normal topography of densely packed enamel rods gives way to a porous and disordered enamel structure, making it more prone to decay and stains. WSL are therefore pathological lesions which can be developmental (formed during the development of enamel) or acquired ( formed after the tooth has erupted, the most common of these being the early carious lesion which has not yet cavitated)

Are children prone to WSL?

Yes, 40% of Singapore preschoolers are affected by Early childhood caries, and by virtue of that, you can find WSL in different stages in these children. As for developmental defects of enamel, which resemble a WSL, the prevalence is 5%-55%

Do we need to treat WSL in children?

Yes, regardless of the aetiology, WSL can

1. Develop into cavities
2. Pick up stains making it more unaesthetic
3. Lead to enamel breakdown
4. Lead to tooth sensitivity

What can be done?

Depending on the cause, we can remineralize WSL: Drive calcium and phosphate back into the porosity. This takes time, does not always work, and the opacity often remains)

Or...

Infiltrate the enamel porosities with resin, thus changing the refractive index of enamel, restoring its normal appearance. This minimally invasive technique is called Resin Infiltration.

Can Resin Infiltration be done in children and adolescents?

These groups are ideal, because it requires no drilling, is more affordable compared to other restorative techniques like porcelain crowns and veneers that are unsuitable for young children whose gums have not retreated sufficiently. If the lesions are more severe and require more invasive procedures, Resin Infiltration can be an interim measure while waiting for your child to grow.

What does the treatment entail?

If we have decided that your child's tooth is suitable, it will require 1 visit in which

1. The affected teeth are isolated, cleaned and etched with a 15% hydrochloric acid
2. Alcohol is applied to dehydrate the enamel
3. Resin is rubbed onto the enamel and set with light
4. Finishing and polishing completes the procedure

By Dr Tan Wee Kiat

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