Metal Mouth Message Board

I have had my bottom braces on for about five weeks, and have seen a lot of movement with a tooth that was sticking WAY out in front of the others due to crowding. I was always told by my dentists that this tooth had a lot of gum recession, but it was hard to see it given the position of that tooth prior to braces.

In just 5 weeks it has pulled into the arch, but holy cow do I have a huge embrasure space on each side of it. If you compare it to the teeth you can see around it, you can see how much gum loss I've had. For this reason alone, I'm grateful for the positive changes I've seen already (before the gum recession grew any worse).

I have to ask what the plan is for this when I go in for my first adjustment, but wanted to share a photo in case anyone is wondering about embrasure spaces (I know it was discussed not long ago on the Ask the Doc board).

If you are referring to that little triangle space that is not necessarily gum loss. It looks like it was created because the top of the tooth is wider than the bottom and it is quite common. All of my bottom teeth did that. They are going to shave off the sides of the teeth to make them more straight vertically then pull them together to get rid of the gaps.

I am definitely going to have IPR as part of my treatment (and have the ideal tooth shape for it) but I was definitely told that I have gum loss around that particular tooth (and not any others that I'm aware of). I don't have embrasure spaces around any other teeth (yet!).

Hi Granola,

I can't really tell from your pic, but it looks like tooth 25 (right mandibular central incisor) has about 1 mm of recession. Recession is measured as to the level at which the gums recede below the CEJ (cemento-enamel junction). You will see a difference in tooth color and a little ridge if you have recession.

The space that you are concerned about is actually the papilla. In health, your papilla will grow and fill in the space below the contact area, it gives that nice triangular shape. When a person has advancing stages of gingivitis or even periodontitis that triangle recedes and a crater forms. It is hard to tell from the picture as to your tissue health. But it appears as if you have a nice pink color to your tissue and there does not appear to be much inflamation which are good signs for your prognosis of the papilla filling in. But it is going to take some time as your teeth stabilize so don't expect it to happen overnight.

Granola, everyone has embrasure's. It is simply the space in between your adjacent teeth. I bet you have some already

Best,
Rory

Hi there Granola,

I have this too and I am worried about it. Mine is a little worse than yours. I can see where the tooth changes color on mine as rsprouse said but very, very small amount at the bottom on the inside. My gums have always been very healthy as far as I know but I had some pretty good crowding there. I have 3 black triangles like yours. I am hoping that they will shave my teeth a little - is that IPR? This will help the triangles and help things to move a little quicker. My ortho hasn't mentioned it though. I have very triangular teeth shaped bottom teeth. It bugs me alot - the black triangles, not the triangular teeth. If the gums would grow it wouldn't bother me a bit.

Hi rsprouse: Thank you so much for your response, which was really helpful. I'm glad you educated me about embrasure spaces (especially before I go in to my ortho and ask about this). So is recession referring to the anterior and lateral surfaces of the teeth with respect to gum height, whereas the papilla (gum) is between the teeth? I'm not seeing any difference in tooth color but may have a bit of a ridge there.

Hi jcdamon3: You are correct, shaving is IPR (interproximal reduction). I too am really hoping I will see growth of the papilla - it is scary how much space there is (my photo doesn't even show how big the one space is because of the angle I took it at). Let's just say I can easily floss that tooth, especially on one side, but threading the floss right through that space to the other side before I wiggle it up and down the surfaces of the tooth.

So is recession referring to the anterior and lateral surfaces of the teeth with respect to gum height, whereas the papilla (gum) is between the teeth

I meant to say "anterior/posterior surfaces (rather than anterior and lateral, but couldn't edit my post).

Recession deals with how much the gums are receding away from the tooth surface. It is typically discussed in terms of the facial (front) aspect and lingual (tongue-side) aspect of the tooth.

Granola, I was about to type a reply to this stating that I also had an embrasure gap (black triangle) at the bottom of my lower incisors where there'd previously been a overlap.

I then brushed my teeth just now (three days since my last adjustment and new archwires) and realized it was GONE!

At my first adjustment my orthodontist had done some IPR, but it had only disappeared in the last day.

There is hope! (marks one more fear off "what will happen to my teeth" list)