Periodontal disease and braces

Periodontal or gum disease results from bacterial plaque and your own body’s response to the plaque. It is often seen as gum tissue that becomes swollen and red. There are four stages of periodontal disease, ranging from mild inflammation in the gums (gingivitis) to advanced periodontal disease – a serious condition mostly seen in adults that compromises the connective tissue around your teeth, causing bone and tooth mobility and eventually tooth loss.

Is there a connection between gum disease and braces? We explore the ins and outs below.

Can you get braces with periodontal disease?

That depends on the severity of your gum disease. Before undergoing braces treatment, your orthodontist may refer you to a specialist periodontist for ‘periodontal clearance’ – an exam to ensure your gums, teeth and surrounding bones are healthy enough safe treatment with braces. Keep in mind, underlying inflammation and infection in the gums won’t just make your braces treatment less effective. Periodontal disease can result in loose teeth, compromise your bite and significantly reduce the overall longevity of your teeth.

Both children and adults can experience mild gingivitis, often seen as swollen and bleeding gums (especially when brushing or flossing), although it may still be possible to receive braces treatment, your orthodontist will always recommend that you treat the condition first by improving your daily dental hygiene at home and booking in for a professional clean with your general dentist. Good cleaning reduces the amount of bacterial plaque (which is the true cause of most gum problems)! As periodontal disease advances, however, the underlying infection causes more severe symptoms such as receding gums, tooth mobility due to bone loss around the teeth – which may make standard orthodontic treatment very challenging or unsafe. Treatment and stabilising the periodontal disease is essential prior to commencing any type of orthodontic treatment. In this case, your periodontist and orthodontist will work as a team to devise the best treatment plan for your individual circumstances. Once appropriately treated and stabilised, many patients with periodontal disease can undergo carefully managed orthodontic treatment, with additional monitoring by a periodontist.


Can braces lead to gum disease?

Because braces make it harder to maintain good oral hygiene, braces wearers may be more likely to suffer from gum inflammation. In most cases, puffy swollen gums with braces indicate a mild case of gingivitis – a condition that’s highly treatable. To prevent inflammation of the gums from turning into a more serious problem, it’s important to brush regularly (three times a day at a minimum!) and floss at least once a day. Effective daily home care is the most important, however, it’s also crucial to book in for regular professional cleans with your general dentist. Together, these actions should prevent swollen gums from turning into more advanced periodontal disease.

Because clear aligners (e.g. Invisalign®) can be easily removed to eat, brush and floss, patients undergoing clear aligner treatment may be less likely to suffer from gum disease, provided that their oral hygiene is excellent. But this form of treatment isn’t suitable for everyone. Unsure? As always, it’s best to book a consultation with your specialist orthodontist to discuss whether this treatment option is best suited to you.

Can braces help with gum recession?

Unfortunately, no. Receding gums can’t be cured or reversed, and braces treatment won’t help. In fact, braces may exacerbate the problem by increasing the likelihood of plaque build-up and inflammation – which can cause your gum tissue to slowly pull away from your teeth. Other symptoms of gum recession are reddened gums prone to bleeding, bad breath, pain or tenderness around the gum line, loose teeth and a change in the appearance of your overall bite.

But while you can’t reverse gum recession, you can certainly manage it. Make sure you’re brushing regularly yet gently with a soft-bristled toothbrush (hard bristles and over-brushing are a leading cause of gum recession), floss at least once a day, and book in for regular professional tooth cleaning.

metal braces

The real problem with gum disease

The main problem with gum disease is that the early stages such as gingivitis do not result in pain. This means that many patients with gum problems do not know about them! Therefore the gum disease can progress to a more severe periodontal disease without the patient even realising. Bleeding gums are often a warning sign though. Unfortunately, the first time many adult patients find out about their periodontal disease is when their teeth become loose because of significant bone loss. As with most medical and dental health problems, prevention is key! Diligent and effective oral hygiene at home, regular check-ups and professional cleaning with your general dentist are the most important ways to prevent serious gum disease. If you are considering orthodontic treatment, rest assured that your specialist orthodontist understands how important good oral hygiene prior to commencing orthodontic treatment. If you have pre-existing gum disease problems, your orthodontist may work alongside a periodontist (i.e. gum disease specialist) to ensure that you receive the best and safest treatment.

While there’s undoubtedly a relationship between periodontal disease and braces, a vigorous approach to dental hygiene combined with professional advice from your orthodontist and periodontist will help you devise a treatment plan that’s right for you.

Unsure of where to start? Book a consult with an expert specialist orthodontist using our simple Finder tool and get started on the path to a straight and stunning smile.

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