Invisalign and gum disease: can the two go together?

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Severe gum disease can cause tooth loss and movement. This can lead to gaps, a misaligned bite, and crooked teeth. Not to mention a smile that’s no longer as straight as it once was.


So, it’s little surprise to hear that a question I often get asked is ‘can you get Invisalign with gum disease’.


The answer is yes. Provided that you have your gum condition under control before starting any form of teeth straightening.


Read on to learn about the risks of orthodontic treatment in patients with untreated gum disease. We’ll also look at the benefits of straighter teeth. Plus, find out how Invisalign compares with braces for people with gum disease.


The risks of orthodontic treatment with gum disease


People with gum disease (periodontitis) are at higher risk of several oral health issues. This includes gum recession, tooth mobility (drifting, rotating, and shifting), and tooth loss. These conditions increase the likelihood of orthodontic treatment failure. 


Both braces and Invisalign move the teeth through continuous pressure. But if there’s bone loss and tissue damage to the gums, this physical movement can make things worse. It can further damage the supporting structure for the teeth (periodontium).

Even when orthodontic treatment is successful, there may not be enough bone or healthy gum tissue to keep the teeth in place. In this case, the hard work and patience that went into adhering to treatment is wasted. Your newly straightened smile is lost.

Woman putting on her Invisalign aligner.
It is extremely important that you have your gum disease under control before starting any form of orthodontic treatment.

In other instances, Invisalign aligners or braces may aggravate or intensify an underlying issue. Let’s take gum recession for example. This is a condition where the gums pull back (recede) from the teeth. The roots of the teeth become exposed, causing sensitivity. It is possible that the movement of teeth may increase the risk of further gum recession.


Gum disease can damage the soft tissue, leading to swelling. Wearing aligners when you have existing inflammation can cause serious discomfort. It may also result in bleeding gums.


There’s also the risk that orthodontic treatment may cause your periodontitis to progress. Fixing orthodontic appliances, like braces, to the teeth can make them harder to clean. Food and plaque can become trapped in and behind the brackets and wires. This can lead to a build-up of plaque, inflammation, and infection.  


No one wants to fork out thousands of dollars, only to have their hopes of a dream smile dashed. It doesn’t matter if you choose traditional braces or Invisalign aligners. Resolving existing oral health problems before orthodontic treatment begins is essential.


How straighter teeth can prevent gum disease


Having straight teeth not only improves your smile. It can make managing and preventing periodontitis easier. How, exactly? 

Dr Ed Ohlrich x-rays patient’s teeth to further assess their gum health.
Straight teeth are much simpler to clean. Good oral hygiene limits bacteria overgrowth and plaque buildup. This reduces the risk of gum disease. 

Crooked and missing teeth create gaps and pockets in which food and bacteria can get stuck. Proper bushing and interdental cleaning become more difficult. Making sure you get into every nook and cranny is no easy feat. 


Straight teeth are much simpler to clean. Good oral hygiene limits bacteria overgrowth and plaque buildup. This reduces the risk of gum disease. 


Crowded and crooked teeth can also lead to bite misalignment. This can affect the way you eat and chew, causing wear and tear to tooth enamel. Dental erosion makes teeth more vulnerable to cavities and decay. If left untreated, bacteria may get into the gums. This can be the basis for gum disease.


Misaligned teeth can also result in uneven pressure on different teeth. Teeth with gum disease and reduced bone support can more easily be overloaded or traumatised. 


Braces vs Invisalign: which is better when you have gum disease?


Choosing between braces and Invisalign can be difficult. If you’ve had or have gum disease, the decision can be even harder. 


The first step is to talk to your dentist or orthodontist. They will assess your stage of gum disease and the health of your jawbone. In cases of moderate to severe gum disease, you’ll likely be referred to a periodontist. This is to treat your gum disease and get your oral health under control. 


A periodontist will examine your gums, teeth, and surrounding bones to ensure they are healthy enough for safe orthodontic treatment. They can also help you decide which orthodontic treatment is best for you.

Choosing between braces and Invisalign can be difficult.
Invisalign aligners are removable, so maintaining good oral hygiene is less challenging. In fact, studies show that compared to braces, there’s less plaque build-up and better oral health with Invisalign.


Final thoughts…


Orthodontic treatment in patients with untreated gum disease can be disastrous. Tooth mobility and unstable gums are a very real problem for people with periodontitis. Ensuring your gum disease is under control must be your first priority.


For those with stable gum disease, straight teeth can do more than enhance your smile. It can help with periodontitis too, by making it easier to maintain good oral hygiene.

Notice blood every time you brush?

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Receding gum treatment: How to stop gum recession from worsening