I have minor crowding, no bite issues. Bite perfect but on right, teeth dont bite down in perfect zipper pattern like left. 2nd ortho can fix that issue + crowding + widen smile. 1st ortho will get straight teeth + IMPROVE zipper pattern just not 100% (says doing so + widening smile will worsen gum recession). Should I go with ortho who will preserve gum health and give near-perfect results or ortho who wants perfect cosmetic result + bite but could make my gum recession a lot worse?
Am I a Candidate of Invisalign if I Have Gum Recession with Widening of Smile?
Doctor Answers (5)
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Ortho and Recession
Recession can be a serious problem that can lead to tooth loss in the long term. Recession exposes root surface which is much more susceptible to cavities than the crown of the tooth which is covered by enamel. To fix recession areas we use tissue grafts, the gold standard of which is taking autogenous tissue (from the roof of your mouth) and attach it underneath the adjacent gum and over the exposed root surfaces. Recesion is ideally treated before you begin orthodontics. If you have access to a few good gum specialists I would get a few consults and see what they have to say.before beginning orthodontics.
It is hard to make a recommendation without seeing pictures of your moth and having more information about your situation. However, in general. I think periodontal health is more important than an absolutely perfect bite. Better bites usually beget better gum (periodontal) health. But, even excellent bits can suffer recession. I would go with protecting the periodontium (gums) as the primary goal and then protecting the bite or alignment as second priority.
Hope this makes sense,
Invisalign or Ortho Effect on Recession
Ideally I would like to see photos of your recession. While it's true that most orthodontic treatment may worsen recession, if your recession is not severe, then you may still be a candidate for Invisalign. Invisalign does a great job widening the smile -- and is now capable of correcting bite alignment issues. I did it on myself a few years ago, and my moderate recession stayed the same while my smile was perfected and my bite properly aligned. We see this with many of our patients.
Invisalign and gum recession
You basically answered your own question: if you can get a good bite, an improved smile and not suffer gum recession you should probably choose that. You would not be smling if your treatment led to recession that threatened tooth loss or sensitivity from root exposure. You might want to visit a periodontist to get an opinion about your gum recession. Sometimes, depending on the orthodontic treatment plan, the best results are obtained by getting gum grafts before treatment. Another factor to consider is whether braces might offer better options than Invisalign in terms of the final result.
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Gum recession and Invisalign..
Before starting any ortho procedure you should be gum disease free. The gum recession treatment can be done after Invisalign is finished. We actually use the aligner or tray from invisalign to stabile the teeth after surgery and to hold medication in place. If you do gum grafting before then you dont really have that benefit.
Gums must be healthy before starting orthodontics
As long as gum disease is under control, you should be fine with doing orthodontics, however I would suggest a consultation with a periodontist. It is likely that treatment should be done, perhaps before braces, perhaps after. I recommend going for the most ideal orthodontic result as well as dealing with the periodontal (recession) issues.