Comparative Evaluation of Two Mouthwashes in Preventing White Spot Lesions During Fixed Orthodontic Treatment: A Randomized Clinical Study

Objective: White spot lesions (WSLs) are a common adverse effect of fixed orthodontic therapy. This study compared the efficacy of two commercially available mouthwashes-Colgate Phos-Flur (0.04% sodium fluoride) and Oradox Enamel Care (hydroxyapatite + sodium fluoride)—in preventing white spot lesions in orthodontic patients. Materials and Methods: This randomized clinical trial (registered at CTRI/2024/05/019523 on 15 May 2024. Fifty patients undergoing fixed orthodontic treatment were randomly allocated into two groups (n=25 each): Group A—Colgate Phos-Flur; Group B—Oradox Enamel Care. Patients used the assigned mouthwash once daily for 6 months in addition to standard oral hygiene with fluoridated toothpaste. Standardized digital photographs of maxillary anterior and premolar teeth were analyzed using ImageJ software to quantify WSL area pre- and post-intervention. Results: After 6 months, Group B (Oradox Enamel Care) showed a significant reduction in mean WSL area compared to baseline (1.16 ± 0.29 to 0.54 ± 0.22), while Group A showed a mild decrease in WSL area (1.42 ± 0.32 to 0.92± 0.37). Between groups, Group B exhibited significantly fewer and milder WSLs at 6 months (p<0.001). Conclusion: Oradox Enamel Care containing hydroxyapatite and sodium fluoride demonstrated superior preventive and therapeutic efficacy against white spot lesions compared to Colgate Phos-Flur. The biomimetic hydroxyapatite component likely enhanced enamel remineralization synergistically with fluoride. Trial Registration: CTRI/2024/05/019523./