The first clinical sign of demineralized enamel typically begins at which location?

• A. Occlusal surfaces
• B. Gingival margin
• C. Palatal aspect
• D. Cervical third of roots

Answer: (B)

White spot lesions on smooth enamel signal early demineralization, and they most often appear at the gingival margin. That area tends to retain plaque where acids from bacteria accumulate, and the enamel there is relatively thinner and more prone to subsurface mineral loss before any cavitation occurs. Occlusal surfaces are more typical sites for pit-and-fissure caries that develop later, the palatal aspect isn’t a preferred early site for enamel demineralization, and the cervical third of roots involves cementum and dentin rather than enamel, so it’s not the first place where enamel demineralization is seen.