Dental braces align teeth and correct bite issues using gentle, continuous forces. Many considering orthodontic treatment wonder about its effects on bone structure, specifically bone loss. This concern arises from visible tooth movement, which involves changes within the jawbone.
How Braces Reshape Bone
Tooth movement during orthodontic treatment relies on natural bone remodeling. When braces exert gentle, consistent pressure, this force transmits through the periodontal ligament (PDL), connecting the tooth root to the alveolar bone. The PDL responds, facilitating tooth movement.
On the side of pressure, specialized osteoclasts activate. These cells break down and resorb alveolar bone, creating space for the tooth to move. Simultaneously, on the opposite side where tension is created, osteoblasts build new bone. This coordinated resorption and formation allows the tooth to gradually shift while maintaining support.
Understanding Bone Changes with Braces
While bone remodeling is inherent to orthodontic tooth movement, significant, irreversible bone loss is not common in healthy individuals receiving proper care. Temporary bone density changes are necessary for teeth to reposition. Once treatment concludes, bone around the newly aligned teeth stabilizes.
Bone remodeling is a controlled physiological response. Pathological bone loss, a sustained reduction in bone volume, differs from normal temporary orthodontic changes. Localized alveolar bone height or thickness changes can occur, especially with specific tooth movements, but remain within biological limits and do not compromise tooth stability. Pathological bone loss is rare when treatment is managed correctly by a qualified orthodontist.
Factors Affecting Bone Health During Orthodontics
Several factors influence bone health during orthodontic treatment and may increase susceptibility to adverse bone changes. Pre-existing periodontal disease, or gum disease, is a concern; inflammation and infection can lead to bone deterioration. Active gum disease should be controlled before or during treatment.
Systemic medical conditions like uncontrolled diabetes or osteoporosis can affect bone density and remodeling efficiency. Certain medications, including bisphosphonates, corticosteroids, and NSAIDs, can interfere with bone remodeling, potentially slowing tooth movement or impacting bone health. Excessive orthodontic forces or poor oral hygiene leading to inflammation also contribute to bone changes.
Protecting Bone Health During Treatment
Protecting bone health throughout orthodontic treatment involves patient and orthodontist collaboration. The orthodontist conducts a thorough initial evaluation, assessing bone density and gum health to formulate a safe, effective plan. They select appropriate force levels and monitor progress to ensure healthy tooth movement and bone adaptation.
Patients must maintain excellent oral hygiene to prevent gum inflammation and bone issues. This includes consistent brushing and flossing, especially around braces. Regular check-ups with both the orthodontist and general dentist allow for early detection and management of concerns. Addressing pre-existing dental or medical conditions before or during treatment also minimizes risks and supports optimal bone health.