The question of whether braces can fix gum recession involves a complex interaction between orthodontic mechanics and periodontal health. Gum recession, or gingival recession, is the process where gum tissue pulls away from the tooth, exposing the root surface beneath. While orthodontic treatment is highly effective for correcting alignment, its relationship with existing recession is nuanced and requires careful management. Braces alone do not replace lost gum tissue, but the strategic repositioning of teeth can sometimes improve the environment around the gums. The outcome depends heavily on the underlying cause and the presence of healthy, thick supporting tissue.
What Causes Gum Recession
Gum recession is a common issue stemming from a variety of predisposing factors and direct causes. A person’s genetic makeup heavily influences the thickness of their gum tissue, known as the periodontal phenotype. Individuals with naturally thin gum tissue are inherently more susceptible to recession because this delicate tissue offers less resistance to external stress.
The most common direct cause is mechanical trauma from overly aggressive or improper tooth brushing techniques. Using a hard-bristled toothbrush or applying excessive force over time physically wears away the fragile gum margin. A more significant factor is periodontal disease, a bacterial infection that causes chronic inflammation and destroys supporting bone and gum tissue.
Anatomical issues also play a role, as misaligned teeth can put undue pressure on the surrounding bone and gum. If a tooth is positioned too far toward the cheek or tongue, its root may be covered by only a thin plate of bone, making the overlaying gum tissue highly vulnerable. Teeth grinding or clenching (bruxism) can also exert excessive force, contributing to the deterioration of the gum attachment.
How Braces Affect Gum Tissue
Orthodontic treatment applies continuous, controlled forces to move teeth through the alveolar bone via a natural biological process called bone remodeling. Specialized cells (osteoclasts) break down bone on one side of the tooth root, while osteoblasts rebuild new bone on the opposite side, allowing the tooth to shift. This process is generally safe, but it requires the tooth root to remain within the confines of the surrounding bone structure.
The primary risk is moving a tooth too far outside the bony housing, particularly in areas like the lower front teeth where the bone plate is naturally thin. When the root is pushed past the bone boundary, the overlying gum tissue loses support and is highly likely to recede. This effect is amplified in patients who already have a thin gum biotype.
Another factor is the difficulty of maintaining oral hygiene around orthodontic appliances. Poor brushing and flossing lead to a buildup of plaque and tartar, causing inflammation (gingivitis). This chronic inflammation weakens the gum tissue and can accelerate recession. Orthodontists mitigate these risks by using light, consistent forces and carefully monitoring the position of the roots throughout treatment.
Treatment Strategies When Recession is Present
Braces alone cannot regenerate lost gum tissue; the tissue that has receded will not grow back naturally. Treating existing gum recession requires a multidisciplinary approach involving both the orthodontist and a periodontist. The first step is always to stabilize the periodontal environment by eliminating any active disease.
If recession is caused or worsened by bacteria accumulation below the gumline, a deep cleaning procedure called scaling and root planing is performed. This non-surgical treatment removes tartar and smooths the root surface, allowing the gum tissue to potentially reattach and reduce inflammation. Once gum health is stable, the periodontist may recommend surgical intervention, especially for moderate to severe recession.
The most common surgical procedure is a gum graft, which involves transplanting tissue, often from the roof of the mouth, to the recession site. Techniques like the connective tissue graft cover the exposed root surface and thicken the gum tissue to protect against future loss. In some cases, the orthodontist may strategically move a tooth toward the tongue after a successful gum graft, improving the long-term stability of the newly grafted tissue. Coordinated timing ensures that orthodontic work is performed on a healthy, well-supported foundation.