Gum recession due to braces?

[wearetheborg]

Anyone have any experience with gum recession due to orthodontic treatment? I have significant gum recession on my upper central incisors.

[wearetheborg]

Forgot to say, its so frustrating when after 2 years in braces you find out about gum recession and bone loss and all the other complications which are not possible or very difficult to fix. Its like the universe doesnt want some people to have good teeth no matter what.

[wearetheborg]

I SO miss the edit button, anyway, I also forgot to say my upper central incisors were moved a lot (and now I have missing lateral upper incisors, space created with springs etc).

[jenniebaby]

I have heard of recession in adult ortho cases, and root resorbtion. I saw two orthos before beginning treatment and neither mentioned it to me at first consult or even now that I'm in braces. I wonder why it wasn't mentioned as a risk? I would rather have my crooked teeth than have recessed gums I think.

I think if you have a predisposition to recession it would be (or should be) apparant to a dentist upon inspection by the time your an adult, as you would present with thin gums or some primary recession.

The primary problem with recession that is associated with orthodontic treatment is that many times the patients do not have heavy, thick layers of bone over the roots of the teeth which are to be moved. This is the case with a lot of adults who may already have periodontal problems starting.

If the teeth are very crowded before orthodontic treatment, the only way to put the teeth into a good alignment may be if the roots of the teeth are made more prominent. The finest of orthodontic treatment can not overcome the lack of enough space in the jaw where the teeth could be moved without making the roots of the teeth more prominent. In this case it may be better to discuss extractions or a less than perfect outcome with your orthodontist, as opposed to extractionless orthodontics or a picture perfect bite.
You should also be wary of teeth that move too fast, as that can affect the underlying bone.

Recession can also occur as a result of over brushing. Especially in people who already have naturally thin gingiva. Soft toothbrush and extra special care at the gum line are a must.

The biggest concern besides the look of the gums receding is the exposed roots. The roots of your teeth have no enamel. The enamel protects your teeth from sensitivity and cavities. Exposed dentin ( what your roots and teeth are made of underneath the enamel) is prone to cavities and hurts when exposed to cold.

There is surgery to treat recessed gums. I have not ever seen it done, or known anyone who had it done. But it may be worth looking into if your recessed gums are really bothering your, either esthetically or otherwise.

I hope this helps. I would definetely talk to your dentist or ortho about it. A referral to an periodontist would probably be in order, even if you don't have a true "periodontal disease"

Good luck.
Jenn

[jenniebaby]

Sorry...by periodontal problems I mean beginning of bone loss (your bones start losing density slowly at thirty) and a less than tight periodontal ligament ( we aren't eighteen any more ) and other usually normal non issues that affect everyone as they age (deeper pockets ect)

[wearetheborg]

Thanks jenniebaby!
I have scheduled a consult with a periodontist.
I hope it does not go too bad

[DrJasonKTam]

Recession can occur for a number of reasons. Some can be attributed to treatment, others to hygiene practices, and others genetic factors.

Teeth that are moved too far out of the bone will have a lack of support. A key premise is that the gums will follow the bone. One major problem that can happen in non-extraction treatment, where extractions should have been employed, is that the roots are moved too far out of the bone and teeth lose the surrounding support apparatus.

Overbrushing can also cause recession. Using a soft brush, brushing away from the gums, and not brushing too hard will help minimize recession. One bad cycle that a lot of people fall into is brushing areas around the gum that are yellow, and trying to scrub them clean. Unfortunately, this is often the area of the root, which is actually yellow in colour.

There are many studies showing a predisposition to periodontal disease. Generally, these factors should be known before orthodontic treatment and will not usually commence because of treatment.

[jenniebaby]

Good luck at the periodontist. I know they can do amazing things in the treatment of recession.

[wearetheborg]

Thanks DrJasonKTam for the info, teeth movement into area where the bone ridge was much higher seems to a be cause for the gum loss on my central incisors.

Also thanks jenniebaby.

[alimommy1]

The perio may recommend a gum graft - I had to have one done after an accident caused me to have to have two root canals, and one of my lower teeth in the front had recession that exposed a lot of root. It didn't interfere with my treatment, and it looked much better once there was gum up around the neck of the tooth again. I have never had problems with it, no pockets, no bleeding, and the tooth is still stable.

[wearetheborg]

Saw the periodontist today. She said gum loss was due to orthodontic treatment, but said I dont need gum grafts.

She also told me I'm supposed to brush away from the gums, and not in a up-down motion :-\

[AnnR]

I've only had my braces a week and I can see my teeth underneath my gums (lower jaw) I'm not sure if it's gum recession, I can definately see more of my teeth than I could before. I have overcrowding so is this because my teeth are trying to move too fast? There is no gum swelling like other people have had, but at this rate I feel like all the front of my teeth will bulge out of the gum and fall out! Should I worry? Maybe I should phone the ortho to put my mind at rest! Plus my teeth are extra sensitive now!

[Theresa48]

Gum recession and resorbtion was not even mentioned to me before I got my braces. I probably would have thought twice about braces. I will bring this up at my next appointment. My teeth weren't even that bad before...grrrrrr.

[barryoak]

[quote="DrJasonKTam"]

Teeth that are moved too far out of the bone will have a lack of support. A key premise is that the gums will follow the bone. One major problem that can happen in non-extraction treatment, where extractions should have been employed, is that the roots are moved too far out of the bone and teeth lose the surrounding support apparatus.

.[/quote]

I think this may have happened to me on some of my molars. I had crowded teeth and my orthodontist pushed my molars out to make room. Now I some of my molars are sensitive which I believe is because of pushing the teeth out. I just wish he had to tell me this was a possibility when I told him I didn't want extractions. My question is, if I get the extractions I should have gotten in the beginning, and then got braces again and the teeth pushed in to ideal positions within the bone, will the gum go back and cover the bit of teeth that became exposed caused by pushing my teeth out?

[england]

I haven't gotten braces on the bottom yet, but my ortho told me that I will need gum grafting on 2 of my lower front teeth after I'm done with treatment. I have extremely sensitive teeth already, and use sensodyne toothpaste daily. I am an overly aggressive brusher too, but have since switched to a SPAM SPAM SPAM SPAM SPAM SPAM SPAM SPAM sonicare toothbrush so I'm not scrubbing as hard now. I guess I'll just have to wait and see how things go...kinda scary.