Post-Invisalign Gap. Is This Normal Or Should I Seek a Second Opinion?

I have finished my Invisalign treatment and am now wearing retainers. Where my teeth were crowded, gum sections are missing. Now I have small gaps between a couple of my teeth where my gum should be. My dentist, the one who provided the Invisalign treatment, tells me this is just the way it is. Is this true or should I see someone else?

Doctor Answers 8

Black triangles may be due to lack of papilla caused by the shape of the teeth

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While there is some merit to each of the posts below, it is important to note that the inherent shape of the teeth may be responsible for the spaces.  Often times, the width of the teeth at the biting surface of the teeth is larger than that at the gum.  Therefore, even if the roots are moved and the teeth are in fact parallel/straight, unless there is gum coverage, you will expect these "spaces".

Keep in mind that the teeth themselves are actually touching each other, so there is no true "orthodontic space".   Therefore, if the gums do not grow back (which they may or may not, depending on a variety of periodontal criteria) you may need to have the teeth reshaped interproximally (IPR).

Hope this helps!

Toronto Orthodontist

Spaces between teeth after Invisalign

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As mentioned previously, spaces sometimes result when crowded teeth are uncrowded as no tissue is present to fill the space.  This can usually be anticipated and discussed so there are no surprises at the end of care.  There are several options that can be discussed to correct this problem including bonding, refinement with inter proximal reduction to pull the teeth closer together, or possibly veneers in problem areas.  Discuss these options with your dentist as refinement by Invisalign has to occur soon after Invisalign is completed.   Best of Luck.  It can work out.

Loss of bone between teeth can show gaps

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One of the risks of uncrowding teeth in an adult is potential loss of papilla, the pointed gums between teeth.  A rule of thumb is tissue will remain 5 mm above the crest of bone, so if there is a lot of bone loss the papilla may never return.  The blunting of the tissues were not obvious when the teeth were crowded because they overlapped, but now that they are straight they can be seen.  Sometimes the tissue returns over time, but maybe not...

After Invisalign I have a gap

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Can you go to the doctor who treated you with Invisalign and discuss your options?  I would consider a refinement with more trays and slenderizing the contact area where the teeth touch (lower) to see if the space could be smaller.  This a normal occurance when teeth were crooked and now in alignment.  Invisalign will line up teeth, not grow bone between them if it was already missing.


Invisalign shortcomings

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The reason you have these so called "black triangles" is because invisalign does a good job moving crowns of teeth but not so much moving the roots.  Reason for these areas with not gum coverage is that the crowns of the teeth were brought together with invisalign but since the roots did not move, you ended up with these black triangles.  Time may improve them but not appreciably in my experience.  I would ask your dentist about "refinement" which is part of invisalign treatment and have him order "attachments" to be placed on the involved teeth to try to bring the roots closer together.  This is a situation where conventional braces would handle the correction much better than invisalign.  Hope this helps.  Good luck!

Michael Firouzian, DDS
Columbus Dentist

Give This Some Time

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My Rule of Thumb...Always Inform before you Perform! This is a very comon issue that should be discussed as a potential side effect BEFORE treatment is intiated so that you understand what the potential side effects to treatment are.  Had that been done, you would not be so upset as you would have known ahead that this could happen.  That being said, this is a very common side effect of straightening previously crowded teeth.  The bone below that area has modeled itself to the crowded situation and as Dr. Timmerman said the rule of thumb is 5mm from crest of bone to contact point.  Any more and the area wont fill.  I would give this 6 months to a year to see what happens as the bone remodels to the new position of the teeth.  I have seen areas like this fill-in over time and others not.  If it does not fill, and this still bothers you at that time,  you may be able to discuss flattening the point contact of the two teeth, then retracting them thereby moving the teeth closer together and lowering the contact point.  This may allow the papilla to fill-in.

Best of Luck!!

Gary Nack, DDS
Philadelphia Dentist

Post Invisalign Gap

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You have what we refer to in the dental field a black triangle.  As you can see from the picture you provided your teeth are actually touching but the gap is at the base where the gum should be.  You can treat this with bonding to close the gap which would be the most conservative treatment available to you.

Leonard Tau, DMD
Philadelphia Dentist
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Black triangles

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It looks like you got lots of good responses here. Black triangles as explained above are the after math of crowded teeth. I like to warn they will exist, that said they are better for you than crowding. If they bother you cosmetically you can have them filled.

Jacqueline Demko, DDS, MSD
Chesterfield Orthodontist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.