It depends, but yes, I treat them. Pit and fissure decalcifications will usually be at least an enamoplasty and seal, possibly a larger PPR, and sometimes it ends up being a filling despite not looking like one.
Buccal white spots are also treated IF the patient is young and has poor oral hygiene cause they can't control their own hygiene and upkeep. Yes, you can remineralize these, but the fact is that most of the time, that doesn't happen because of patient and parent compliance. You're best intentions to be non-invasive and not treat these small white decalcification with anything but fluoride end up at recalls with cavitations into dentin requiring larger fillings and in many cases SSCs. Happens all the time. I've learned from my mistakes and have become far more aggressive. The first time you sit and talk to mom about the white spots on all the anterior baby teeth and how if you have really good hygiene and use fluoride varnish, etc. etc, you can save these teeth from filling and the mom is like...OMG, that's great. I'll totally do that instead of paying for the fillings and you are such a great doctor. So you apply the varnish and tell her not to let the kid eat or drink or brush for 30 minutes so the varnish doesn't come off, the parent promises to be much better with the kids hygiene and starts walking out and as they pass the front desk, the mom hands the kid a sippy cup of juice or some food.