Braces and Receding Gums

Question

I am very interested in getting braces.  I have some receding gums on my lower front teeth.  Would I still be a candidate for braces?

Gabriela Hricko, DDS · Answer

Recession on the lower anterior teeth is a common occurrence, and happens for a variety of recessions, one of them the natural aging process. 
If the amount of recession is severe, then I will refer the patient to a periodontist prior to orthodontic treatment for their expert opinion.
If the amount of recession is mild and then gums are healthy, then I advise my patients that it is possible that tooth movement with braces can make the recession slightly worse, but there are things that we can do to try to prevent that.  Firstly, I advise my patients that we will move the teeth in a slow and controlled manner. Secondly, I advise them that I will try to minimize flaring the teeth as this movement can make the recession worse. I closely monitor the recession and I also advise the patient that if the recession does worsen, they made need a gingival graft from the periodontist after orthodontic treatment. 
I would recommend seeing your orthodontist who can further evaluate your bite and your teeth as well as the amount of recession and keratinized tissue on your lower anterior teeth.

Doug Depew, DMD, MS - Account Suspended · Answer

Recession is a normal occurence that happens with many people as time goes on...even with a lifetime of good oral hygiene.  And it starts occuring at different ages in different people.  Even with the recession, braces are worth looking into. Here are a few things to consider.

If the teeth are not severely crowded or overlapped you may be OK.  If teeth have to be moved forward (advanced) to make them straight, it can further stress the gums leading to more recession.
If there is a concern for stressing the gums, some minor "slenderizing" of the teeth can be done to minimize advancement.
If your periodontal health is otherwise good, as long as your dentist or periodonist sees you regularly during treatment, you should be OK.
As a last resort, a gum graft can be done to strengthen the support for the lower front teeth a couple of months before braces are put on.

I hope this helps.  If you are motivated to proceed, ask your dentist about how he or she feels about the health of your gums, then seek a consultation with an orthodontist about your treatment options.

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