To summarize and evaluate systematic reviews (SRs) regarding preventive interventions for orthodontically induced white spot lesions (WSLs) and map currently available evidence in this field.

An electronic search was conducted up to 20 June 2024 in the following 7 databases with no restrictions: PubMed, Embase, Web of Science, Cochrane Reviews, Scopus, WanFang, and CNKI. Screening, data extraction, and quality assessment (using AMSTAR 2 and ROBIS) were performed by 2 authors independently and in duplicate. Results were summarized and analyzed qualitatively. Evidence mapping was applied to display current evidence and research gaps.

A total of 24 SRs were included. Only a few SRs were of ‘low’ risk of bias (n = 4) according to ROBIS, or of ‘high’ (n = 1) or ‘moderate’ overall confidence (n = 2) according to AMSTAR 2. The evidence mapping depicted the diversity of interventions, and 27 different comparisons in included SRs were identified. Remineralizing agents were the most frequently assessed types of interventions, while self-applied antibacterial agents and mechanical cleaning procedures were studied in few SRs. Topical fluoride applications, oral hygiene-related reminders and sealants were effective in preventing WSLs compared to control/placebo. No sufficient evidence supported the effectiveness of other interventions.

The number of high-quality SRs regarding the preventive intervention of WSLs is limited. Various preventive interventions for WSLs exist, but most current SRs focus on remineralizing agents. More high-quality randomized controlled trials are required to increase the certainty of evidence and to guide clinical practice.

PROSPERO (CRD42023428516).