White Spot Lesion Remineralisation Agents in Primary Teeth: A Systematic Review

Oral Health Prev Dent. 2018;16(5):391-400. doi: 10.3290/j.ohpd.a41404.


Purpose: To perform a systematic review of articles related to the clinical efficacy of topical fluoride varnishes/gels, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and other remineralisation agents of white spot lesions (WSL) in primary teeth.

Materials and methods: Electronic and manual searches were conducted through diverse electronic databases. The search was limited to randomised, clinical, controlled trials, and quasi-experimental papers in full-text version. Suitable individual studies were evaluated through a previously reported quality system, their data extracted and carefully analysed.

Results: The search identified 298 citations, and 95 were chosen and reviewed in full text. Nine relevant citations met the eligibility criteria for inclusion in the systematic review. Pair comparisons were made between fluoride varnishes, CPP-ACP, dental lasers, and control interventions.

Conclusions: Clinicians are encouraged to discuss more high-quality studies in order to provide sufficient evidence and to confirm the clinical utility of remineralisation agents of WSL in primary teeth.

Keywords: primary teeth; remineralisation; systematic review; white spot lesions.

Publication types

  • Systematic Review

MeSH terms

  • Cariostatic Agents / therapeutic use*
  • Caseins / therapeutic use*
  • Dental Caries / drug therapy*
  • Dental Caries / radiotherapy
  • Fluorides, Topical / therapeutic use*
  • Humans
  • Lasers, Solid-State / therapeutic use
  • Low-Level Light Therapy
  • Pit and Fissure Sealants / therapeutic use
  • Tooth Remineralization / methods*
  • Tooth, Deciduous*


  • Cariostatic Agents
  • Caseins
  • Fluorides, Topical
  • Pit and Fissure Sealants
  • casein phosphopeptide-amorphous calcium phosphate nanocomplex