The sudden appearance of chalky, opaque areas on tooth surfaces when you are unwell can be alarming, but these marks are a common consequence of changes in oral health during illness. These spots are known as White Spot Lesions (WSLs), representing the earliest visible sign of enamel demineralization. This occurs when the protective mineral content of the tooth surface begins to dissolve, making the enamel porous and causing light to scatter, which results in the characteristic white appearance. While the underlying cause of a white spot may pre-exist, sickness often acts as a temporary trigger, making these areas visible or accelerating their formation.
The Role of Saliva and Dehydration During Sickness
The primary link between being sick and developing white spots is the disruption of the mouth’s natural defense system. Illnesses, especially those accompanied by fever, often lead to dehydration and a significant reduction in saliva production, a condition known as xerostomia or dry mouth. This drop in salivary flow is detrimental because saliva is saturated with calcium and phosphate ions, which are necessary to repair or “remineralize” minor enamel damage.
Saliva also acts as a natural buffer, neutralizing acids produced by oral bacteria or introduced from diet or stomach reflux. With a lower volume of saliva, the mouth’s pH level drops and remains acidic for longer periods, rapidly accelerating demineralization. Conditions like nasal congestion often force a person to breathe through their mouth, which dries out the exposed tooth surfaces and makes existing white spots appear more visible and opaque. Acute acid exposure, such as from repeated vomiting during a stomach illness, directly strips minerals from the enamel, exacerbating any existing or latent lesions.
Distinguishing Acute Spots from Chronic Enamel Issues
Not all white spots are caused by temporary illness; it is important to distinguish acute demineralization from chronic developmental issues. Acute white spots are a sign of recent mineral loss and often respond well to remineralization treatments and improved oral conditions. Chronic white spots, however, are a result of defects that occurred while the enamel was forming.
One chronic issue is dental fluorosis, which results from ingesting excessive fluoride during childhood when the permanent teeth are developing beneath the gums. Enamel hypoplasia is a quantitative defect where the enamel is thin or pitted, often caused by nutritional deficiencies or high fevers during infancy. While a current illness does not cause these chronic spots, the accompanying dehydration can make them significantly more noticeable due to the change in how the dried enamel reflects light.
Managing and Preventing White Spots
The focus should be on restoring the mouth’s natural balance to halt demineralization and encourage remineralization. Maintaining consistent hydration is key, as drinking water stimulates saliva flow and washes away acids and bacteria. Using a fluoride-containing toothpaste or rinse is beneficial, as fluoride ions integrate into the porous enamel structure, making it stronger and less susceptible to acid attack.
If an illness involves vomiting or severe acid reflux, avoid brushing immediately afterward, as the enamel is temporarily softened by the acid. Instead, rinsing the mouth with plain water or a solution of water and a small amount of baking soda can neutralize the acid before gently brushing about 30 minutes later. If the white spots persist, darken, or become sensitive after recovery, consulting a dentist is advisable to determine if the lesions require professional intervention, such as prescription-strength fluoride varnish or a minimally invasive resin infiltration procedure.