Wearing braces can be a significant step toward achieving a straighter smile, but many individuals discover their gums appear swollen or begin to cover parts of their teeth during treatment. This common concern, known as gingival enlargement or gum overgrowth, can be uncomfortable. While braces themselves do not directly cause gums to swell, their presence can create an environment where such issues are more likely to develop. Understanding why this happens and how to address it can help maintain oral health throughout orthodontic treatment.
Understanding Gum Overgrowth with Braces
Gum overgrowth around braces primarily stems from inflammation triggered by plaque accumulation. Braces create areas where food particles and bacteria can easily become trapped, making thorough cleaning challenging. If plaque is not meticulously removed, it can irritate the gum tissues, leading to inflammation known as gingivitis. This inflammation manifests as redness, tenderness, and swelling of the gums, sometimes appearing to grow over the brackets or teeth.
Beyond bacterial plaque, mechanical irritation from the braces themselves can contribute to gum tissue changes. Brackets and wires rubbing against the gums can cause irritation and swelling. The pressure exerted by braces as teeth shift during orthodontic movement can also lead to gum inflammation. In some instances, a more pronounced overgrowth, termed gingival hyperplasia, occurs, which is an increase in gum cells. This condition is linked to poor oral hygiene, hormonal changes (such as puberty or pregnancy), or certain medications.
Managing Gum Swelling at Home
Home management of gum swelling with braces focuses on enhanced oral hygiene. Brushing thoroughly at least twice daily, and ideally after every meal, is important. Using a soft-bristled or specialized orthodontic toothbrush with a V-shaped head helps clean around brackets and wires without causing irritation. Angling the brush at 45 degrees towards the gum line and using gentle, circular motions ensures effective plaque removal from teeth and gum margins.
Flossing is equally important despite the challenges of braces. Orthodontic floss threaders or specialized floss can help navigate under wires and between teeth to remove trapped food and plaque. Daily flossing helps reduce inflammation by cleaning areas a toothbrush might miss. Rinsing with warm salt water several times a day can help soothe inflamed gums and reduce swelling due to its anti-inflammatory properties. Over-the-counter anti-inflammatory medications may offer temporary relief from discomfort and swelling.
Professional Treatment Options
If home care measures are insufficient to manage significant gum overgrowth or persistent inflammation, professional intervention from a dentist or orthodontist becomes necessary. A professional dental cleaning, known as scaling, can remove hardened plaque and tartar (calculus) that brushing and flossing cannot. This deeper cleaning helps reduce the bacterial load contributing to gum inflammation. In more severe cases, where deep pockets of bacteria have formed, root planing might be performed to smooth the tooth roots and remove bacterial toxins.
For substantial gum overgrowth, a procedure called a gingivectomy may be recommended. This surgical procedure involves the removal of excess gum tissue, either with traditional instruments or a laser, to restore a more balanced gum line and improve access for effective cleaning. While a gingivectomy can be performed while braces are still in place, it is typically considered after improved oral hygiene has been attempted. Your orthodontist can also adjust your braces if any components are directly causing mechanical irritation to the gums, reducing physical trauma. It is advisable to seek professional help if gum swelling persists, is accompanied by significant pain or bleeding, or if home care does not show improvement within a reasonable period.
Preventing Future Gum Issues
Preventing gum issues during orthodontic treatment requires consistent and proactive measures. A rigorous daily oral hygiene routine, including brushing after every meal and daily flossing, is important to prevent plaque buildup. Using interdental brushes can also assist in cleaning around brackets and wires.
Incorporating an antimicrobial mouthwash into your routine can provide an additional layer of protection by reducing bacteria in the mouth and flushing out debris. Regular dental check-ups and professional cleanings are also important, as dentists can remove hardened plaque and monitor gum health throughout your orthodontic journey. Choosing a diet that limits sugary and sticky foods can reduce the food sources for bacteria, further supporting gum health. Staying hydrated by drinking plenty of water helps wash away food particles and maintains a healthy oral environment.