426 Cottman Street, Jenkintown, PA 19046 | (215) 572-7566 | Request an Appointment >

MI Paste Plus and White Spot Lesions

MI Paste Plus is a product that has many benefits in dentistry. Literature clearly demonstrates the benefits of MI Paste Plus for:  

  • Management of tooth sensitivity
  • Post-scaling and root planning
  • Reducing tooth sensitivity
  • Combating acid erosion for those patients who have a high incidence of dental decay

Studies have also shown that the paste can eliminate and restore the acid imbalance caused by severe dry mouth by enhancing salivary function.

 Figure 1: White spot lesions before treatment

Figure 1: White spot lesions before treatment

Another application for MI Paste Plus is the elimination of white spot lesions (WSL). WSLs are areas of opacity or hypo-calcified enamel on the clinical crown. They are caused by incipient carious lesions secondary to the plaque buildup. This increase in plaque creates an acidic environment that ultimately leads to the demineralization of tooth structure.

WSLs are commonly seen around orthodontic brackets and bands in patients with poor oral hygiene. These areas can then become demineralized. As a result, the enamel surface of the tooth exhibits a milky or chalky white opacity that becomes very unaesthetic. Patients, in turn, can lose confidence in their appearance.

With the advent of MI Paste Plus, it is now possible to treat these areas prior to bleaching, significantly improving a patient's smile. Applying MI Paste Plus to the tooth can re-mineralize the tooth surface, making whitening more successful and resulting in a more symmetric and esthetic tooth appearance.

 
 Figure 2: MI Paste Plus application

Figure 2: MI Paste Plus application

 

The mechanism of action is achieved by delivering bio-available calcium and phosphate back into the oral cavities that are deficient. MI Paste Plus is the only product that contains both fluoride and Recaldent (CPP-APCP), which is a special milk-derived protein that releases these vital minerals allowing the tooth to re-mineralize. Since it is derived from milk casein, it is contraindicated in patients with a milk allergy.

The recommended protocol for using MI Paste Plus on white spot lesions is as follows:

 Figure 3: Etch application

Figure 3: Etch application

 Figure 4: One month after treatment

Figure 4: One month after treatment

  1. Micro-etch the tooth surface affected then rinse with water.
  2. Apply 37-percent phosphoric acid on the affected tooth surface for two minutes followed by rinsing the dentist rinsing the site with water.
  3. Apply MI paste in pre-made trays (I use standard bleach or fluoride delivery trays). These are pre-made at the consultation appointment.
  4. After application for five minutes, the patient can expectorate the material but should not to rinse. The material will dissolve.
  5. The patient is sent home with two tubes of MI Paste Plus and applies the material two times a day for five minutes each application. The patient should be instructed to not rinse after application but just to expectorate the material from their mouth. The patient should not eat or drink for a minimum of one hour to maximize efficacy.
  6. The patient should return in one month to document their progress. If white spots remain, a second in-office treatment with micro-etching followed by phosphoric acid can be repeated.
  7. The patient then applies the paste for another month, two times a day.
  8. Once the desired result is achieved, the patient can bleach their teeth if necessary and expect a more even and aesthetic result.