Orthodontics and gingival recession

By Dr Sven Jensen

Background

Tooth recession is common in adults and can lead to sensitivity. When the gums (gingiva) recede, and the root of the tooth is exposed, sensitivity to hot and especially cold can occur. The root surface layer does not provide much insolation for the inner nerve. Crowded teeth can erupt into positions where the gingiva overlying the teeth is thin and at risk of receding. If the teeth are moved into a straight position through orthodontics, there is a chance that the gingiva can improve and decrease recession. The evidence for this is limited and mostly improvement of recession through orthodontics is anecdotal, something that we have all seen improve in our patients.

The role of orthodontics in the repair of gingival recessions. Laursen MG et al. 2020 American Journal of Orthodontics and Dentofacial Orthopedics

Research question

A team from Denmark and Germany looked at 12 consecutive adult patients (nine were female) with a mean age of 28 years of age and had one lower front tooth that had already had recession. Braces were used to move the teeth into a straight position. The recession at the start of the treatment and the end of the treatment was measured in terms of depth, width and area.

Results of the study

Improvement in all three characteristics was found. On average, the depth of recession decreased by 23%, the width by 38% and the area by 68% when compared to the baseline measurements. For one patient, the recession area decreased by 93%.

Summary

Recession can occur when the teeth are not situated within the bony housing of the jaws. This is more common when teeth are crowded and when the gingiva are already thin. This report of consecutive patients showed that improvement of gingival recession can occur with movement of teeth. The only other way to improve areas of recession is usually with gingival surgery, however, this is usually quite invasive.

It is humbling to think that straightening teeth can improve gingival health in the right situation. However, if orthodontists expand the dental arches and inclination of the teeth outside the limits of the bony housing of the jaws, recession can also occur. The pretreatment planning of orthodontic treatment is such an important step on the path to straight teeth. It is important for your orthodontist to reduce the chance of adverse outcomes such as gingival recession by planning each case individually and carefully.