MI Paste Plus is a product that has many benefits in dentistry. Literature clearly demonstrates the benefits of MI Paste Plus for:  

  • Management of tooth sensitivity
  • Post-scaling and root planing
  • Reducing tooth sensitivity
  • Combating acid erosion for those patients who have a high incidence of dental decay

Studies have also shown that the paste can eliminate and restore the acid imbalance caused by severe dry mouth by enhancing salivary function.

White spot lesions - Figure 2
Figure 1: White spot lesions before treatment

Another application for MI Paste Plus is the elimination of white spot lesions (WSL). WSLs are areas of opacity or hypo-calcified enamel on the clinical crown. They are caused by incipient carious lesions secondary to the plaque buildup. This increase in plaque creates an acidic environment that ultimately leads to the demineralization of tooth structure.

WSLs are commonly seen around orthodontic brackets and bands in patients with poor oral hygiene. These areas can then become demineralized. As a result, the enamel surface of the tooth exhibits a milky or chalky white opacity that becomes very unaesthetic. Patients, in turn, can lose confidence in their appearance.

With the advent of MI Paste Plus, it is now possible to treat these areas prior to bleaching, significantly improving a patient's smile. Applying MI Paste Plus to the tooth can re-mineralize the tooth surface, making whitening more successful and resulting in a more symmetric and esthetic tooth appearance.

MI Paste Plus application
Figure 2: MI Paste Plus application

The mechanism of action is achieved by delivering bio-available calcium and phosphate back into the oral cavities that are deficient. MI Paste Plus is the only product that contains both fluoride and Recaldent (CPP-APCP), which is a special milk-derived protein that releases these vital minerals allowing the tooth to re-mineralize. Since it is derived from milk casein, it is contraindicated in patients with a milk allergy.

The recommended protocol for using MI Paste Plus on white spot lesions is as follows:

  1. White spot lesions - Figure 3
    Figure 3: Etch application
    Micro-etch the tooth surface affected then rinse with water.
  2. Apply 37-percent phosphoric acid on the affected tooth surface for two minutes followed by rinsing the dentist rinsing the site with water.
  3. Apply MI paste in pre-made trays (I use standard bleach or fluoride delivery trays). These are pre-made at the consultation appointment.
  4. After application for five minutes, the patient can expectorate the material but should not to rinse. The material will dissolve.
  5. The patient is sent home with two tubes of MI Paste Plus and applies the material two times a day for five minutes each application. The patient should be instructed to not rinse after application but just to expectorate the material from their mouth. The patient should not eat or drink for a minimum of one hour to maximize efficacy.
  6. The patient should return in one month to document their progress. If white spots remain, a second in-office treatment with micro-etching followed by phosphoric acid can be repeated.
  7. White spot lesions - Figure 1
    Figure 4: One month after treatment
    The patient then applies the paste for another month, two times a day.
  8. Once the desired result is achieved, the patient can bleach their teeth if necessary and expect a more even and aesthetic result.

(Click this link to view the Spear course on MI paste uses and benefits.)


Clark, Sarah Elizabeth. "Remineralization effectiveness of MI Paste Plus - a clinical pilot study." MS (Master of Science) thesis, University of Iowa, 2011. http://ir.uiowa.edu/etd/939.


Commenter's Profile Image Heather S.
January 4th, 2016
I saw a patient today interested in this. What is a reasonable fee? Would that change depending on whether the patient wants to whiten or not?
Commenter's Profile Image Andrew C.
January 5th, 2016
Well that's a tough question to answer. You have to base it on your chair time. For example one appointment impressions. Next appoint micro etch and apply material. Usually you need to repeat that's another appointment. Patient who don't need trays I charge less. I would say I charge for maybe 2 hours of chair time and then I give a break on bleach since I had to make trays. Hope that helps. Andy
Commenter's Profile Image Lauren K.
March 7th, 2016
What do you use to micro etch the teeth in step 1? Thanks!
Commenter's Profile Image Andrew C.
March 7th, 2016
http://gromandental.com/ 27 micron Alumina Oxide. The Etchmaster, by Groman, unit has been a game changer for me. I use it on every single case. Cleans tooth prior to etch, cement, bond, stain removal. Love it. Have a unit each operatory .
Commenter's Profile Image Brigitte H.
January 17th, 2019
Would it make any difference if they whitened first and then did the MI treatment? Or more effective the other way around?