Risk Factors In Orthodontry: Periodontal Complications

Continuing our discussion of the possible risks and complications during orthodontic treatment, it has become necessary for us to mention the possible side effects that wearing orthodontic braces can have on your periodontal tissue. So far we have talked of the complications these devices may cause to teeth and to tooth surfaces, but orthodontic devices may also very rarely damage or inflame the gums as well. This happens more often with patients who have lurking or hidden periodontal diseases, as even a slight inflammation can cause changes in the periodontal tissue that can complicate treatment.

Enlargement And Recession Of The Gingiva

Orthodontic appliances achieve their aim through causing minor, agentless inflammation of the periodontal tissue. This makes it easier for the teeth to move around and for the device to align them to the prescribed position. This inflammation though,is not entirely without risk. The gums can become swollen, and this condition is known as gingival enlargement. It is much more common in patients who have periodontal infection. To read a detailed, in depth analysis of the possible risks of gingival enlargement, click here.

This enlargement of the gingiva is problematic, as it may cause the teeth to shift in direction that the device is not pushing them in, as the periodontal tissue willé become softer when inflamed. The treatment may also become painful, as sensitivity increases in swollen or enlarged tissue. The enlarged gingiva may also become entangled or caught in the brackets of the device itself, and may press upon the device, which may complicate or alter the course of treatment.


Alternatively, since orthodontic braces cause an increased dryness of the mouth, gingival recession, or a disappearance of the gum may also happen. In these cases, the gums will recede and the may become sensitive. An increased risk of bleeding may also come with the recession of gums, as the capillaries will become closer to the surface of the gums, and intercapillary action may break through to the surface, in the form of a little bit of blood. Teeth may also become sensitive, as there is less gingival tissue covering the nerves, and thee nerves may start to react to more impulses than previously.   

Interdental fold

What To Do To Minimize RisksThe interdental papilla is a small bit of gum located in between any given two teeth. This piece of gum can also recede when gums recede, exposing more of the tooth than just its surface, which can be problematic, and also painful. A bigger issue in the case of orthodontics is when this papilla increases in size due to an inflammation or infection of the periodontal tissue.

When the papilla becomes enlarged enough that it actually starts to cover the tooth surface, the condition is known as an interdental fold. This fold can change the tension and direction of the archwire, can loosen or remove brackets, can be damaged by brackets leading to bleeding and infection, and can also inhibit the work of orthodontic elastics (rubber bands).  

More often than not, swelling and recession of the gums, and all of the negative aspects and side effects associated with this condition come from the patient having some sort of periodontal disease or infection prior to starting the treatment. It is absolutely important that you have any dental work that needs to be done, such as root canals, hygiene sessions, filings, or anything at all, be finished by the time you start orthodontic treatment. This way the risks of periodontal complications are minimized, and besides, during orthodontry, you will be experiencing inflamed gums, and if your gums are already inflamed due to an infection, the possibility of complications rises exponentially. So just make sure that no infections or half finished dental work is present, and you should avoid all of these nasty complications altogether!

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