The dreaded "Black Triangles"

[Fionisimma]

Just wondering if anyone else out there is currently struggling with the issue of unsightly black triangles appearing as your teeth begin moving....??? While I'm happy to see some movement (albeit slow @9weeks) it's definitely looking worse right now, before it gets better.....

[TheKT]

I have them as well and am curious about the fix.

[kids041]

OH boy I have the mother of a black triangle, with an other one forming on the other side! I asked my ortho about them, and he said that as my teeth move, they will get worse, and better, and when we are all finished he can do some IPR to help them. He said that I should not be overly concerned about them now. I think that they look horrible, and I can't wait for them to be gone.

[kathydell]

I have a honking one right in the front too. I had an inscisor extracted so there is a huge black triangle between the two teeth that were on either side. I will say that it has gotten better and better over time. It's related to how well and fast your gum growth happens after teeth move. My ortho said not to use the proxy brush in that one spot. She said they are very effective at helping to keep things clean but they can inhibit the growth in the area where you're trying to repair the triangle. She did say not get too concerned in that she expects it to be a lot better by the conclusion of treatment - maybe even all the way gone.

[DrJasonKTam]

These are caused by waiting too long to straighten teeth. When the teeth are overlapping, there is no bone or gum tissue in the spaces where the teeth are moved to.

There are 3 things that can help:

1. Growth of the gum tissue over time. Less likely if there is a low bone level.
2. IPR to increase the parallelism of the teeth.
3. Gum surgery

Hope that helps!

[Fionisimma]

Thank you for all the input... it's reassuring to know that we aren't alone and that ultimately these unsightly areas can be fixed - my Orthodontist has indicated that some bonding work will need to be done due to a chipped central and small lateral incisors - this should also ultimately solve any of these black triangles that remain after treatment is completed

In the meantime it just looks as though poppy seeds are permanently stuck between between my front teeth

[plugnickel69]

I unfortunately have some experience in the dreaded black triangle area.

First of all, wait until your braces come off before you go crazy about the problem. My understanding is that black triangles are problematic in adult orthodontics. I remember using the proxy brushes vigorously during my treatment and wouldn't be surprised if that contributed to my problem.

My top teeth are sort of bell-shaped. As I don't smile very big and certainly show no gum when I do smile, probably few would be aware of my black triangles. I asked my dentist if he could do bonding and he responded that veneers would be a much better solution; bonding would be difficult. But he thought about it and was willing to try. I didn't understand why it would be difficult, but it was. In fact, he was very frustrated during the initial attempt. He had to try about three times before he and I were satisfied with the result, and I had to go back a few times for some fixes. They are acceptable now and better than the black triangles, but not perfect.

I may go with veneers in the future, but do not want to end up with an unnatural look. I see people all the time who look like they have fake teeth due to their veneers or crowns.

[Fionisimma]

I may go with veneers in the future, but do not want to end up with an unnatural look. I see people all the time who look like they have fake teeth due to their veneers or crowns.

Agreed.... and there is no going back after teeth are prepped for veneers since you lose so much (though it's a "small" amount , even more so for crowns) of the tooth/teeth... Frankly, veneers seem drastic to me and I really don't want to feel/look as though I have "false/fake" teeth. I am hoping that although bonding can be challenging to get right, with patience and expertise, it will work to solve my central and lateral incisor appearance issues.

[TheKT]

Hi Everyone - war is IPR?

[Fionisimma]

Interproximal reduction - a procedure (often used in Invisalign cases) in which part of the thickness of a tooth's enamel is trimmed where space is needed for orthodontic realignment. Basically your orthodontist polishes away small amounts of enamel to help your teeth fit together better - but using IPR is determined by the shape of the teeth and the height of the gums between them - every case is different....

[Lorianne]

These are caused by waiting too long to straighten teeth. When the teeth are overlapping, there is no bone or gum tissue in the spaces where the teeth are moved to.

There are 3 things that can help:

1. Growth of the gum tissue over time. Less likely if there is a low bone level.
2. IPR to increase the parallelism of the teeth.
3. Gum surgery

Hope that helps!

Dr. Tam, can you tell me how successful gum surgery usually is, assuming one has pretty healthy gums to start with and doesn't smoke or drink? also, what sort of dentist would be the right one to do gum surgery? My ortho also mentioned this as a possible future thing to do and he seemed to think it would be a fairly easy thing to fix. I don't think IPR will work for me at all. My teeth are really triangular and they'd have to shave em down from here to eternity to close the gaps. Thanks in advance!

[wodezuiai0000]

Do you actually prefer bad teeth of black triangles?

[T1braces]

Yep. I have full metal braces to straighten bottom teeth and turn 4 teeth. I have triangle shape teeth and already seeing black triangles. I have been advised composite bonding or veneers. This will be decided at the end of my brace treatment. The cost also concerns me.

[Lorianne]

My black triangles almost completely went away with a bit of IPR. I’m very happy with the outcome. Just wait til closer to the end of treatment to decide.