White spots on teeth usually are caused by hypomineralization in a tooth’s enamel. As such they are part of the enamel matrix that are not fully mineralized and appear like chaulky white spots on a tooth. Normally when a patient asks this question, the first thing I suggest is bleaching their teeth, since after a patient has completed whitening their teeth, the yellow portion becomes lighter and white spots can appear less noticeable. Of course in the initial phases of bleaching, whitespots become even whiter, but after the process is completed the brightness of whitespots tends to diminish as the teeth rehydrate. The areas of the tooth that have lightened tend to remain lighter, so that white spots may appear less noticable.
But what should be done for patients who have finished bleaching and still object to how their white spots? Usually I suggest micro abrasion (or Macro abrasion in this case) of the white spot, followed by a small application of a bonded composite. This is accomplished by either complete or partial removal of the chalky enamel and its replacement with color matched bonded filling material. The before and after photos below demonstrate one of the cases that I have treated this way. It was accomplished in one two hour session without the need of any local anesthesia.