Gum Recession and Braces

Gum recession happens when the gum tissue around your teeth shrinks back exposing tooth roots. This causes sensitivity and puts you at increased risk of periodontal disease, root caries and tooth loss. It is seen by many as unaesthetic. 

Braces, used to reposition teeth can be used to prevent gum recession and in some cases help with its treatment. There are some claims that braces cause gum recession, however, there is no scientific evidence that braces directly cause gum recession but orthodontic treatment in some cases may make gum recession more likely to happen. 

This post looks at the relationship between braces and receding gums

Can Braces Cause Receding Gums?

receding gums and braces

Well, some sources claim 400,000 people in the US have gum recession as a result of braces and other sources state that braces don’t cause gum recession! That’s a little confusing! Let’s explain!

Braces don’t cause receding gums, however, when braces are used to move the teeth in some directions it can make gums more susceptible to gum recession by several conditions including  

  • Periodontal disease 
  • Aggressive tooth brushing
  • Hormonal changes
  • Oral piercings
  • Poor oral hygiene

When Do Braces Make Gum Recession More Likely? 

When teeth are moved towards the lips, the tooth roots can be moved towards the outside of the alveolar bone (the jaw bone which surrounds the teeth and forms the tooth sockets). Bone is lost from the outer side of the tooth root and the gum tissue becomes stretched. It becomes thinner. 

The thin gum tissue is more prone to be affected by the factors leading to gum recession. 

How Do Braces Cause Gum Recession?

Braces can make gum recession more likely in the following ways.

Thin Tissue Is More Susceptible to Damage and Inflammation

As indicated above thin tissue can develop when the teeth are moved outwards towards the lips. 

This thin tissue is more likely to be damaged or worn away by tooth brushing. 

The thin tissue is also more prone to becoming irritated and inflamed by a build-up of plaque bacteria. Inflammation leads to the loss of gum tissue. The area of inflammation is usually just a couple of millimeters thick. If the gum tissue is thick, only a small amount of tissue is affected. However, when the gum tissue is thin, the entire gum tissue could be affected and it recedes. 

Braces and Periodontal Disease

Periodontal disease is a major cause of gum recession. It is caused by a buildup of plaque. Plaque contains bacteria which irritate your gums, this is called gingivitis, a mild form of gum disease. 

When left untreated it leads to periodontitis, an advanced form of gum disease which leads to bone loss and gum recession. 

Failure to gently but effectively clean your teeth twice a day can lead to a build-up of plaque along the gumline. As wearing braces can make it harder to clean your teeth and plaque can accumulate it is recommended that you gently clean your teeth for 4 minutes three times a day. 

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How Common Is Gum Recession From Braces?

Limited scientific research addresses this question. One study did conclude that 40% of patients developed gingival recession in one or more teeth during orthodontic treatment. However, other studies find that there is no correlation between braces and gum recession.

Gum recession is common in society. According to studies, around 50% of people in the US have some degree of receding gums. Those who had braces as a child are more likely to present with a recession around teeth 5, 12, 21 and 28 when those teeth were moved too quickly. 

Can Braces Help Prevent Gum Recession

Whilst braces can cause gum recession they can also help protect the gums. 

When the teeth are moved by braces inwards towards the roof of the mouth or tongue the gum tissue can become thicker on the cheek/lip side. This thicker tissue is less likely to be affected by plaque, aggressive brushing or other factors that lead to receding gums. 

How Do Braces Help Prevent Gum Recession?

The process of moving the teeth inwards can move the tooth roots towards the center of the alveolar bone. This causes the bone and gum on the cheek side of the teeth to become thicker. 

Who Can Braces Help?

Braces can help prevent gum recession in the following patient groups. 

Misaligned or Crooked Teeth – It’s hard to effectively disrupt plaque bacteria that builds up on wonky teeth and gum disease is more likely to occur. Gum disease is a leading cause of gum recession. Straight teeth are easier to keep clean and thus prevent gum disease and gum recession. 

Bad Bite – If you have a deep overbite, it can lead to gum recession. Moving the teeth can help protect your gums from recession.  

Can You Treat Gum Recession With Braces?

Sadly, braces can’t be used to treat gum recession but they can sometimes be used to make it look better.   

For example, if gum recession has occurred around a prominent tooth, braces could be used to move this tooth back in line with the surrounding teeth, improving the appearance. 

However, once the tooth roots have been exposed, the gum tissue is unable to regrow. You may however be a candidate for a gum graft, where donor tissue is placed over the exposed tooth root

Can You Have Braces if Your Gums Have Receded?

Yes, if your gums are otherwise healthy, even if it is the result of gum disease you will probably be suitable for orthodontic treatment with braces however, you will need to discuss this with your dentist or orthodontist.

If you are suitable for treatment the dentist will monitor your gums to ensure there is no inflammation or gum disease present which would put you at risk of gum recession occurring. 

There is a risk that your gum recession will get worse during treatment. 

How To Prevent Gum Recession

Whether you wear braces or not you can prevent gum recession, or prevent it from progressing with a few simple steps.  

  • Use a Gum Pocket Brush to remove harmful plaque from areas impossible to reach with your toothbrush.
  • Oral hygiene – develop and maintain oral hygiene that’s first class. Brush your teeth twice a day and clean the interdental spaces daily. It’s essential to gently clean the teeth using a technique which effectively disrupts the plaque.
  • Stop smoking – smoking is a primary cause of gum disease and gum recession. Stopping will be beneficial to your oral and general health.
  • Eat a nutrient-rich diet, low in sugars and saturated fat for healthy strong gums and jaw bone.
  • Avoid grinding and clenching your teeth. Wear a mouthguard at night to protect your jawbone and gums from the pressure that grinding and clenching cause. 
  • Avoid oral piercings which can cause damage to the gum tissue. 
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In Summary

Whilst braces can make gum recession more probable when the teeth are moved too quickly in some directions they can also be used to help prevent gum recession in other groups of patients. On some occasions, braces can be used to help disguise or treat gum recession. 

If you are considering getting braces, discuss whether your risk of developing gum recession following orthotic treatment will be increased with your dentist. 

 Sources

  1. Patel, M., Nixon, P. & Chan, MY. Gingival recession: part 1. Aetiology and non-surgical management. Br Dent J 211, 251–254 (2011). https://doi.org/10.1038/sj.bdj.2011.764
  2. Jati, A. S., Furquim, L. Z., & Consolaro, A. (2016). Gingival recession: its causes and types, and the importance of orthodontic treatment. Dental Press Journal of Orthodontics, 21(3), 18-29. https://doi.org/10.1590/2177-6709.21.3.018-029.oin
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Written by Gareth Edwards

Co-Founder & GDG Dentist

Dr. Gareth Edwards BDS (Hons) MFDS (RCPS Glasgow) is GDG Co-Founder and Gum Disease Expert.

He is a practicing dentist based in Bournemouth, UK and has treated thousands of patients with gum-related diseases.

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