Lingual Braces Reduce Risk of White Spot Lesions in Energy Drink Consuming Teens: Study

This study aimed to assess the incidence and localization of WSL in adolescents with high energy drink consumption treated with completely customized lingual appliances (CCLAs). Eligible for inclusion in this retrospective cohort study were adolescents (< 18 years) who underwent orthodontic treatment with CCLAs, consumed ≥ 2 energy drinks daily, and developed ≥ 1 new labial WSL on a non-bonded surface. High-resolution intraoral photographs before (T0) and after (T1) treatment were evaluated for the presence of WSL (yes/no) on maxillary and mandibular incisors and canines.

Differences in white spot lesions rates between labial and lingual surfaces were analyzed using paired t-tests (α = 0.05). Results: A total of 38 patients (mean age 15.2 ± 1.4 years; 11 females, 27 males) with 912 tooth surfaces were included. At T0, 70 (15.4%) labial surfaces and 5 (1.1%) lingual surfaces showed white spot lesions. At T1, white spot lesions increased to 243 (51.4%) labial surfaces and 45 (9.9%) lingual surfaces. Although the appliance was bonded only to the lingual surface, the incidence of WSL per patient was four times higher on the non-bonded labial surfaces: 4.3 ± 2.1 (36.0%) labial versus 1.1 ± 1.9 (8.8%) lingual.

This difference was statistically significant (p < 0.001).

Orthodontic treatment with CCLAs in adolescents who frequently consumed energy drinks was associated with significantly fewer white spot lesions on bonded lingual surfaces compared to non-bonded labial surfaces.

Reference:

von Bremen, J., Kloukos, D., Bettenhäuser-Hartung, L. et al. Energy drink-induced white spot lesions on labial and lingual tooth surfaces in adolescents treated with lingual appliances: a retrospective cohort study. Clin Oral Invest 29, 370 (2025).https://doi.org/10.1007/s00784-025-06445-8