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Invisalign clear aligners are a popular alternative to traditional metal braces used to gently straighten crooked and misaligned teeth. Orthodontic treatment with traditional fixed metal braces can create an environment that makes gum recession more likely to happen. One of the benefits is that gum recession with Invisalign is rarely seen.
This post answers the questions we’re frequently asked about Invisalign and gum recession, including whether Invisalign causes gum recession and whether Invisalign can fix receding gums.
So the answers make sense. We start with a bit of background…..
What is Gum Recession and What Causes It
Gum recession, or to give it its technical term, gingival recession is when the edge or the margin of the gum tissue gets lower. It shrinks back exposing the tooth roots.
The gum can be worn away by mechanical forces such as aggressive tooth brushing and oral piercings.
Gum recession also occurs when there’s a loss of bone. Healthy gum can only exist when there is healthy alveolar bone underneath which supports and gives structure to the gum tissue. When bone is lost, the gum tissue recedes. There are a number of factors that can cause bone loss including periodontal disease and tooth movement.
Braces and Gum Recession
There are reports that traditional braces have caused gum recession in 400,000 people in the USA. Whilst there is no data to back up this claim and studies have shown that braces do not cause gum recession it is known that treatment with braces can result in periodontal disease and move the tooth roots too far, too quickly which both make gum recession more likely to happen.
Periodontal Disease and Braces
When you wear fixed braces it can make it hard to maintain first-class oral hygiene. It’s difficult to clean the interdental spaces (the spaces between the teeth) and along the gum line. This can lead to an accumulation of plaque bacteria which irritates the gums causing gingivitis.
When untreated this progresses to periodontitis – the gums pull away from the teeth creating periodontal pockets and chronic inflammation leads to the destruction of alveolar bone and gum recession.
Orthodontic Movement
When traditional braces have moved teeth quickly and/or too far towards the lips or cheek this can cause the tooth roots to become exposed, they are moved out of the alveolar bone that surrounds them. This results in bone loss and gum recession. This doesn’t happen when the teeth are moved inwards towards the roof of the mouth.
With this in mind….
Do Invisalign Clear Aligners Cause Gum Recession?
The good news is that Invisalign Clear Aligners rarely cause the gums to recede.
However periodontal disease and bone loss which lead to gum recession could happen just like with traditional braces if you don’t follow the advice of your dentist and return for frequent checkups.
There are a number of reasons why Invisalign is less likely to cause gum recession than traditional braces.
Slow and Gentle Orthodontic Movement Prevents Gum Recession
Highly trained, and expert dentists are aware that moving teeth too quickly in some directions can put some teeth at risk of gum recession. These dentists take steps to ensure that at-risk teeth are moved slowly allowing adequate time for the bone to remodel around the moving tooth roots. This helps prevent bone loss and gum recession.
Continual Monitoring
The advantage of investing in Invisalign aligners, (when obtained through an Invisalign-trained dentist) is that you are continually monitored. You return to the dentist every month to collect new aligners.
During these appointments, the dentist checks that your teeth are moving in the right direction and can check to see if there are any signs of gum recession or factors such as periodontal disease that would lead to receding gums. Steps can be taken immediately if any issues are observed.
Clear Aligners Can Be removed & Good Oral Hygiene Can Be Maintained
Clear aligners can be removed so first-class oral hygiene can be maintained. Plaque bacteria can be disrupted twice daily and the interdental spaces can be cleaned daily with a gum pocket brush. This prevents gingivitis and its progression to periodontitis. Bone loss and gum recession are avoided.
Recent scientific studies have shown that those using aligners have less plaque accumulation and lower levels of bacteria when compared to those using fixed braces. Studies have also shown that those treated with aligners have a better periodontal health status than those treated with fixed metal braces (1).
What Happens If Gum Recession Develops During Treatment
If you or your dentist notices that gum recession is developing during treatment it’s imperative the cause is determined and addressed. It could be due to tooth movement but it may also be due to habits such as smoking, traumatic contact or periodontal disease.
The dentist will first look for signs of periodontal disease, a major cause of gum recession. He will check that you are using the correct technique and tools to disrupt plaque bacteria twice a day gently.
If there is a significant accumulation of plaque professional gum health treatments will be recommended to clean above and below the gum line.
When excessive tooth movement is the cause, treatment would be slowed or paused to slop further recession. However, once bone loss has developed it will not regenerate to replace lost tissue.
Can Invisalign Make Gum Recession Worse?
If you already have gum recession, the cause will need to be addressed and treated before Invisalign. There’s good news…if you follow the advice given by your dentist you are no more at risk of gum recession than the general population.
Can Invisalign Fix Gum Recession?
No, Invisalign cannot fix gum recession. Once the bone and/or gum tissue has been lost it cannot grow back.
In some instances
- When teeth are moved inwards towards the roof of the mouth, the thickness of bone and gum tissue on the cheek side of the mouth can get thicker.
- Treatment with Invisalign will improve the appearance of your gum recession or reduce your chances of it developing in the future.
Extreme gum recession can be fixed with gum grafting or disguised with alternative treatments such as composite bonding.
To Summarize
Invisalign is less likely to make changes in your mouth which lead to gum recession. Gum recession caused by bone loss and periodontal disease is less likely to happen if you seek treatment from a skilled dentist and follow their advice.
You can prevent gum recession caused by periodontal disease by taking the following steps
- Avoid smoking
- Eat a nutrient-rich, low-sugar diet
- Control blood sugars
- Sip water throughout the day
- Brushing the teeth twice a day and cleaning the interdental spaces with the correct technique and tools.
Knowledge is power where beating gum disease is concerned. Gum Disease: Solved online education tool arms you with the information to understand why you have gum disease and how you can beat it in only 10 minutes per day at home, without the need for costly and ineffective dental visits.
Sources
- Levrini, L., Mangano, A., Montanari, P., Margherini, S., Caprioglio, A., & Abbate, G. M. (2015). Periodontal health status in patients treated with the Invisalign® system and fixed orthodontic appliances: A 3 months clinical and microbiological evaluation. European Journal of Dentistry, 9(3), 404-410. https://doi.org/10.4103/1305-7456.163218
