White Spot and Black Line on Tooth

Hi Dr Ellie, 

I have a 1.5 year old toddler, and I noticed her front four teeth has white spot lesion about 2 months ago. I brought her to the dentist and was prescribed GC tooth mousse to be applied on her teeth twice a day. I have been diligently put it on her teeth, brushing her teeth 3x a day. However recently, I notice on one of the teeth, it had developed a black line near the gum line where the white spot used to be. Do you think the white spot has progressed into a cavity? If so why is it black instead of brown color? How does a cavity progress and what’s the color? I also give her cod liver oil which contains calcium phosphate. I read in the Internet that too much calcium or phosphate can cause stain in the teeth. Also the GC tooth mousse contain bio-available calcium phosphate. Do you think this can be the reason for the stain? Should I start using your system of xylitol? I live in Indonesia so I am not sure there is Spiffies. What do you think the black line is? Since she is 1.5 years old, I am still afraid to use toothpaste containing fluoride. Thank you so much for your advise. Your website is very informative, especially for concerned mother like me!!


Hi M,

I think it is important for concerned mothers, like you, to try and figure out what is causing the white spots on your daughter’s teeth. Tooth damage is caused by acidity the acidity leaches minerals from teeth and makes them soft and porous. Damaged, soft enamel does not reflect light properly so the softened tooth surface appears chalky and whiter in color. A cavity is the second stage of this softening process as the white spot caves in, creating a hole in the tooth. The tooth will usually look yellow or brownish just before it disintegrates into a cavity.

The most likely reason for white spots is a toddler drinking juice frequently. Apple juice is very acidic ( pH 2.2) and will quickly damage teeth, especially if sipped throughout the day. The problem is made worse if the child breathes through his or her mouth for some reason ( nasal allergies, sinus, frequent colds). Many other drinks can cause acidity in the mouth orange juice, lemonade etc. The important thing to realize is you don’t have to give up the drink just protect the teeth after the drink with some xylitol.

It is possible to reverse white spots on teeth and even possible to reverse early cavities. You can wipe a little xylitol solution over the teeth 5 or 6 times a day (Spiffies.com provides an easy method or you can make your own wipe from a solution of xylitol in water). You could also make a bottle of water and add 4 grams of granular xylitol to the water using it as a “tooth wash” after other drinks. You can even dip some fruits ( banana or strawberry) into some xylitol as a snack food. Cubes of cheese will also be protective of teeth, and can be used to take away the acidity after a juice drink for a toddler who tends to sip a juice cup during the day.

I understand the concept of not wanting to use fluoride toothpaste for very young children (we do not want young children to eat fluoride). On the other hand, you need some fluoride to speed up the re-mineralization process and repair these teeth. The combination of applying xylitol AND some dilute fluoride speeds up a natural healing process.

I would suggest putting a small drop of ACT bubblegum rinse on your child’s toothbrush in place of toothpaste. You can also apply a drop of this directly to the affected teeth during a nap or sleep time ( with a Q tip to apply) which would help the healing.

I know many dentists now recommend Tooth mousse and also Prevident products but these are not products that I personally have positive experiences with. My only other suggestion is to ask your dentist if he could apply a fluoride varnish to these teeth. Fluoride varnish releases a small amount of fluoride slowly over about 3 months which should be enough time to see considerable healing. Don’t forget to combine the use of xylitol after drinks/meals and snacks with the oral care that includes some fluoride (such as ACT rinse).

Work hard for 4-8 weeks and you may be able to stop these white spots from turning into cavities. Caring for damaged teeth is quite an effort but it is worth it! This may change your child’s whole experience about dentistry for life!

I do not think the fish oil is any problem in fact it should help. I would not worry too much about the black line I would focus on getting the white spots healed asap!

Good luck,

Ellie Phillips DDS

Categories: Uncategorized


%d bloggers like this: