Effectiveness of Bracket Sealants in Preventing White-Spot Lesions in Fixed Orthodontics

Abstract

AIM: To determine the extent to which sealants applied around orthodontic brackets reduce the risk of white-spot lesions (WSLs) as early signs of enamel demineralisation caused by inadequate oral hygiene.

METHODS: A search of the electronic database PubMed was performed and 35 English- or German-language articles published between 2015 and 2025 were included.

RESULTS: The use of bracket-area sealants can make a relevant contribution to the prevention of WSLs, particularly in high-risk patients. Effectiveness is material-dependent and influenced by correct application technique. In vivo data are heterogeneous, but in vitro studies consistently demonstrate the protective potential of sealants against enamel demineralisation adjacent to brackets.

CONCLUSION: Optimal oral hygiene combined with adjunctive fluoride measures remains the gold standard for WSL prevention. Sealants show promise and should be recommended as part of a comprehensive prevention strategy that includes personalised oral-hygiene instruction, dietary counselling and regular follow-up. Future developments in sealant materials and application methods offer further potential to enhance clinical effectiveness.