Pacific Coast Society of Orthodontists Bulletin Summer 2012 - (Page 46)

EARL’S PEARLS WHITE SPOTS … NOT! By Dr. Earl S. Johnson W 1. 2. 3. hite spots can be the bane of our orthodontic existence. One new white spot is one too many. Here are some management pearls to limit the common distress of white spots. When bonding, etch the entire facial surface with phosphoric acid (Figure 1). Seal the entire surface with Pro Seal by Reliance or Opalseal by Opal (Figures 2A and 2B). These are highly filled light-cure sealants that will last. Do not tell the patient that this is white spot insurance. This knowledge tends to encourage complacency about the items below. (All bonding systems will adhere nicely to a Pro Seal/Opalseal treated surface.) Remove all excess bonding material flash with a low speed (Figure 3). Excess bonding material is a plaque magnet. Getting rid of all the bonding flash makes it easier to clean around the bracket bases. Because bonding flash looks very much like plaque to the patient, removing all flash makes it much easier for the patient to know that his or her teeth are truly clean. Emphasize that the patient should restrict the number of times per day refined sugar is eaten. Pigging out a few times per day is much better than constantly refueling bacteria with candy, sugary gum, and especially sodas with sugar, as they are a double threat (being both acidic and sugar-containing). Grade the oral hygiene on a scale of 1 to 5 at every visit (Figure 4): Figure 1. Etch entire facial of tooth before bonding. Figure 2A. Seal entirely etched facial with a heavily filled light-cure sealant. Figure 2B. Opalseal has a filled light-cure sealant with an integrated applicator. Figure 3. Remove all bonding flash with a low-speed carbide bur (#558 carbide). 46 PCSO Bulletin • SuMMeR 2012

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Summer 2012

President's Message
Executive Director's Letter
PCSO Business
AAOF Report
PCSO at a Glance
Practice Management Diary
Faculty Files
Correction to Faculty Files article, Spring 2012
Seasoned Practicioner's Corner
Case Report Pre-Treatment
Portrait of a Professional
From Good to Great in a Tough Economy
Three-Dimensional Volumetric Imaging: An Emerging Diagnostic Tool
Destination Success
Case Report Post-Treatment
Earl's Pearls

Pacific Coast Society of Orthodontists Bulletin Summer 2012