To study the incidence and risk factors of white spot lesions (WSL) among adolescent patients treated with clear aligner technique and to provide clinical basis for prevention and treatment.

About 203 adolescent patients accepted with clear aligner technique treatment from March 2017 to March 2022 were selected from the Orthodontic Department, Stomatological Hospital, Air Force Medical University. And the general oral conditions and orthodontic treatment data of different stages were collected by questionnaire. The incidence of WSL was calculated by direct visual inspection method in the two groups of patients. One group contained 131 patients without WSL while the other contained 72 patients with WSL. Chi-square test, non-parametric test and regression analysis were used to explore the risk factors.

The incidence of WSL is 34.6% in adolescent patients who accepted clear aligner technique treatment. The risk factors of WSL are: gender, frequency of brushing per day, duration of each brushing, type of toothpaste, frequency of mouthwash, frequency of drinking carbonated beverage, present caries before orthodontic treatment, frequency and duration of wearing clear aligner during eating, frequency of cleaning clear aligner after eating with it (P<0.05) . Logistic regression analysis showed that the significant risk factors are frequency of brushing per day, present caries before orthodontic treatment, whether have caries before treatment, frequency of tooth brushing per day, frequency of drinking carbonated beverage and frequency of cleaning clear aligner after eating with it (P<0.05) .

There is a high incidence of WSL in adolescent patients after receiving clear aligner treatment. Patients with less daily brushing, pre-treatment caries, more frequent consumption of carbonated beverages and less frequent cleaning of aligners after eating are more likely to develop WSL.