Solving Gum Recession Before Braces?

[meemsie]

Hi, Everyone,
I was just wondering if any of you before you got braces, had any gum recession? I think I may have gum recession in two back top molars and at an orthodontist consult, he pointed out I may need to see the periodontist about the recession. Did any of you have orthodontist who refused to proceed until you were in perfect gum health? Did any of you get a gum graft or some other gum surgery? How long did the healing process take? How much time did you need to wait before it was safe to put on braces?

Thanks so much! It's a comfort to read all your posts and feel much better informed.
-Meemsie

[Plumcore]

I had severe gingivitis before my braces, and my dentist was keen on fixing that before any braces got on. And she did. I did not require surgery though, but i do know that it is preferred to have good healthy gums before any braces go on. Braces tend to make things worse for some reason.

[Tasha Fierce]

I think it also has something to do with treatment time. My ortho emphasized that the healthier your teeth and gums were, the faster your teeth would move. Which is also the reason flossing is so important! Hope this helps ! And welcome to the Board!

[felicia]

I found out that I have gum recession on one of my upper molars when I had my cleaning done before being braced. I first thought that I might have a cavity and told my hygienist that my molar is sensitive when brushing and when drinking cold drinks, but she told me it was a gum problem. Two weeks later I got my braces on (i never told my ortho about it) and a molar band over that tooth, and for 1 and 1/2 years I completely forgot about it (i believe that the band was acting like a shield over that tooth)...until I got debraced a month ago and that tooth was sensitive again. Now, a month later I am in braces again due to a little relapse, I do not have molar bands anymore but at my February appointment with my hygienist I am going to ask my dentist to look into it and tell me what I should do about it.

[smilelikeyoumeanit]

I have some gum recession on my top molars as well. My dentist said that in my case, it is from brushing too hard. He also said that getting my bite fixed will help my gums stay healthier.

Now, I'm just keeping an eye on it and really staying on top of my hygiene. My ortho didn't think it was serious enough to postpone treatment.

[luchababe]

I have some gum recession on my top molars as well. My dentist said that in my case, it is from brushing too hard. He also said that getting my bite fixed will help my gums stay healthier.

I have a bit of recession too, all on the side of my TMD and my open bite. I was told I was brushing too hard and I've tried so hard to change that. But why just one side when I brush my whole mouth, you know? Since you say your dentist said fixing the bite will help your gums, it really does make me believe everything is connected. Like maybe because my molars don't meet on one side, the teeth and gums don't get the pressure from eating and talking and such which reduces blood flow to the gums...so when the bite is fixed the gums get "used" and get healthy. This even relates to people who chew gum to relieve the soreness of braces and new wires, since chewing increases the blood flow to your gums. Does that even make sense or am I just blowing smoke up my own butt?

But back to the question, my gums didn't stop me from getting braces.

[BraceFace2o1o]

I have gum recession too, caused by my brushing technique and it hasn't caused a problem for me when getting my braces. My Orthodontist didn't say it would be a problem.

Maybe it depends on why one has gum recession? If one has gum recession because of gum disease then I should imagine that could cause issues because you'd obviously need the gum disease seen to by a periodontist first and to get that sorted prior to any Orthodontic treatment.

Does that even make sense or am I just blowing smoke up my own butt?

It certainly does make sense and I think you have made a very good point

[drgnchsr36]

The one side thing is that you tend to brush harder on the opposite side that you're handed (i.e. I brush harder on my left side since I'm right handed) - my ortho guessed that I was right handed just by looking at my mouth/teeth.

[meemsie]

Thanks, everyone, for replying so quickly. You all provided such useful info

I've been pretty horrid about my oral hygiene most of my life, and for years, the hygienist warned me about gum disease. But I didn't take it seriously even after two scaling and root jobs. But then when I started looking into braces, a few orthodontists said I have relatively healthy teeth, but part of my gum was inflamed and bleeding. I researched more about periodontal disease and I was duly horrified at the thought of losing teeth. Over the course of the last few weeks, I got very committed to a water pick, floss, and a softer brush. I'm thrilled to say that the bleeding has stopped and the gum is turning pink again. (In fact, I'm kind of shocked how easy it was to stop the bleeding...it's all because of the water pick). But the most recent orthodontist I consulted with pointed out I needed to see a periodontist about my gum recession on my top molars before I could begin. Urgh. I'm going to see my periodontist next Wednesday, but part of me is cringing because I had maxed out my FLEX plan at $5000. I suspect I may need some gum grafting surgery. Sources say it takes about a month to recover from the surgery. But I take it the perio has to wait a few months to be the graft has taken, right?

[Plumcore]

I have no idea about grafting. But i think the only one who will know what to do and for how long is the perio specialist. It's hard to say without actually seeing what is going on. On a positive note though, things may not be as bad as you think. Wait ti'll your appointment and keep making your gums healthy

[BaliGirl]

I had some recession on my lower incisors and a few other teeth in my mouth. I got a few different orthodontist opinions - 2 thought the recession could be treated after the braces came off. The one I went with said that the recession was severe enough that he wouldn't treat me until I got my lower incisors grafted - apparently, if you don't have enough healthy gum tissue, the teeth don't have enough support during treatment and the gums tend to recede even further, exposing the roots and possibly causing eventual loss of the teeth. I have lost enough teeth already, and the root was exposed on a couple of the teeth, so I went ahead with the grafting. Although my mouth was fully healed after 1 week, I had to wait 8 weeks after the graft to get the braces on to make sure that the graft "took." Thankfully, it did, and the results are great. It was VERY expensive, though.

I read some horror stories of other people's experience getting a gum graft, but it really wasn't too bad. My periodontist did everything under a microscope so I think my mouth was less traumatized than it might have been otherwise (he was VERY precise). The procedure was technically called a connective tissue graft - there's a great presentation with pictures on the UCLA website here: http://www.dent.ucla.edu/pic/ppt/Connec ... Grafts.ppt (warning, there are graphic pictures of gum surgery, so you might want to avoid this if you are squeamish)

Be sure to get a couple of opinions before you make a decision. Techniques and prices vary a lot, so just make sure you're comfortable with whatever path you choose. Good luck!

[drrick]

I send lots of pts t the periodontist for gum grafts before braces.
Depending on the individual pts circumstances recession can get worse durig braces ane we do not want straight teeth that then do not have the proper bone support.

Different drs have different opinions about this (and everything else)

[meemsie]

Thanks everyone. I do get anxious about these type of issues, so you helped me calm down over the weekend. I did go to the periodontist today. I told him I was considering braces and he did an extra thorough exam to measure gum recession, gum firmness/weakness, pockets, etc. He also looked at the x-rays for bone loss. He even checked my bite and measured it, and reassured me I wasn't nutty about wanting to fix the alignment. I have a couple of 2mm recessions in the molars, but he said as long as I stayed below 4mm and kept the gums clean, I shouldn't worry about orthodontics negatively doing any more serious damage. (He explained the gum recession probably was from the first time I got braces.)

Basically, he cleared me for braces!

He also said I could switch my perio maintenance to him and he would monitor my gum health throughout the entire process, which is great because I'm irrationally paranoid that my orthodontist might move teeth too fast and they would get unhealthy without me realizing it. So it was just a great relief talking to someone about all my teeth anxieties and get reassured I was ok with actual evidence. I've seen eight different orthodontists because they were all saying different things which was starting to cause anxiety because they were picking up on different problems, so he just sympathetically said so many opinions can get confusing over time. He gave me advice on how to find a good orthodontist, and we talked about the primary one (Dr. R.) I was considering. I've been worried that the treatment time of 14 months was too suspiciously short, when most people said 1.5-2years. But the periodontist said it wasn't an unreasonable, especially if Dr. R mostly does adult orthodontics and has a good reputation.

I just feel so much better, so for those of you considering orthodontics and are worried about your gum health, talking to a periodontist would be worth the money, especially if your dentist office tends to have a hygienist clean your teeth.