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Advice PLEASE!! Gum recession and braces.

Posted: Wed Jan 16, 2019 1:48 pm
by cbraces678
Hi everyone,

A slight follow up to a previous post of mine. Just to recap, I had posted a couple weeks ago about my gum being sore and white around 1 tooth (bottom front tooth). I went to the orthodontist to follow up about the concern and he said he thinks it was just because of the adjustment. However, he pulled up my before pictures and you can tell the gums on my 4 front bottom teeth have recessed. He said he wasn't concerned about it though.

Now that 2 weeks have passed, the gum is still white, but the pain is less (still there sometimes, but not as bad). I am totally paranoid about the gum recession though. I took some pictures of where this gum is white and you can clearly see that in the last 2 weeks it has recessed even more. I am wondering what you guys think should be done. Even though he felt it was just because of the adjustment, should I call again and say I am still concerned because it's not better and it appears to be recessing more? Or would this be better to get a second opinion from my dentist about it, and maybe go to a periodontist? Has anyone else had pretty bad gum recession during orthodontics?? So many questions lol.I knew to expect some recession, but I feel like this one tooth doesn't have all that much more room to continue recessing, so then what happens??

I am too far in to treatment to just quit now, but I am worried about gum health. Anyway, any advice for next steps you would take, or what you have went through would be helpful. I will attach a photo. I am fairly embarrassed about the recession. I have really bad gum genetics unfortunately. It is still white (hard to see in the photos), and I really don't want it getting worse. It is already pretty bad I think. Give me your opinions. Thanks!

Re: Advice PLEASE!! Gum recession and braces.

Posted: Wed Jan 16, 2019 1:58 pm
by cbraces678
Ok photos...

The first photo shows my front bottom teeth. The one to the left of the “issue tooth” seems be where my gums all used to be on those 4 teeth prior to braces. It’s the only one that hasn’t recessed.

The second photo I mirrored the image to show the change in 2 weeks.

Thanks for your help!!

Re: Advice PLEASE!! Gum recession and braces.

Posted: Wed Jan 16, 2019 2:53 pm
by bbsadmin
Well, here is my story. My bottom teeth were extremely crowded before I got braces (a couple were overlapping slightly). Six month into getting braces, my orthodontist saw the exact same thing that is happening to you, but with me it was both bottom middle teeth.

I went into the treatment knowing that I might need some teeth pulled due to the extreme bottom crowding, but my orthodontist wanted to try to fix things without extractions. Six months into treatment, it was evident that I needed the extractions. I got them done (4 second bicuspids) and my treatment continued successfully.

However, about 10 years after getting my braces off, I began to see more gum recession on the bottom. I don't know if it was because of my age (early 50s at the time) or as a slow result of the orthodontic work. I wound up needing two rounds of gum grafts, all done to various bottom teeth. I also had a Frenectomy (cutting of the little connection between the mouth and lip on the bottom). It was expensive and uncomfortable, but totally worth it.

My advice would be to stay on top of this situation. You may want to consult with a periodontist. Gum recession isn't the end of the world as long as you don't let it get too bad. I nipped it in the bud long before it could threaten my teeth badly. The goal of gum grafting is to thicken the tissue at the base of the tooth, and I have achieved that.

Re: Advice PLEASE!! Gum recession and braces.

Posted: Wed Jan 16, 2019 3:11 pm
by cbraces678
Hi.

Thanks very much for sharing your story. I am glad it all worked out for you in the end. I was thinking if it continues this way that a gum graft would be something I’d look into. I just don’t want it to get too bad during treatment. I’ve still got more than half my treatment to go.

Did the recession stop once you had the extractions? I had a couple ortho recommendations that wanted to do extractions, but the ortho I went with said extractions weren’t necessary. My teeth are nearly all in alignment now. These bottom teeth were quite crowded. They still have some movement to do for sure, but they have come a long way. Perhaps consulting with a periodontist like you mentioned would be worth it to make sure it’s within normal limits for now. Thanks again for your reply.

Re: Advice PLEASE!! Gum recession and braces.

Posted: Wed Jan 16, 2019 3:19 pm
by cbraces678
Here is a photo for reference. They’ve come quite far, and the recession is on the tooth that was originally the most rotated so I guess it makes sense. Still a bit more movement to go. Hopefully the gum can get through it lol.

Re: Advice PLEASE!! Gum recession and braces.

Posted: Wed Jan 16, 2019 5:49 pm
by wendydong
I also had recession around the lower incisors. I went to a periodontist, and he said it's perfectly fine to wait until after braces

my gumline was kind of similar to your bad tooth gumline.

i also bought a lot of "gingigel" from amazon.. It doesn't really re-grow gums, but it kinda calmed down my inflamed gums at the time...

Re: Advice PLEASE!! Gum recession and braces.

Posted: Thu Jan 17, 2019 1:35 am
by bbsadmin
The gum recession on my bottom two teeth did stop after the extractions. I didn't have any further recession until about 10 years after I got my braces off.

Re: Advice PLEASE!! Gum recession and braces.

Posted: Thu Jan 17, 2019 6:32 am
by cbraces678
wendydong wrote:
Wed Jan 16, 2019 5:49 pm
I also had recession around the lower incisors. I went to a periodontist, and he said it's perfectly fine to wait until after braces

my gumline was kind of similar to your bad tooth gumline.

i also bought a lot of "gingigel" from amazon.. It doesn't really re-grow gums, but it kinda calmed down my inflamed gums at the time...
Thanks for the reply. It’s comforting to know they said it was fine to wait until after braces. I will look into this product as well.

Re: Advice PLEASE!! Gum recession and braces.

Posted: Thu Jan 17, 2019 6:33 am
by cbraces678
bbsadmin wrote:
Thu Jan 17, 2019 1:35 am
The gum recession on my bottom two teeth did stop after the extractions. I didn't have any further recession until about 10 years after I got my braces off.
Good to know. Thanks again!!

Re: Advice PLEASE!! Gum recession and braces.

Posted: Fri Jan 18, 2019 6:08 am
by cbraces678
Thanks for bringing up the frenectomy bbsadmin.

I was looking around more about it because as you can see the attachment is close to the gum that is receding in the photos. So that could be part of the cause of this issue. It actually looks similar to other pictures and would explain the “white gum” that I can’t seem to find any other info on. Apparently if the gums weaken (which they have thanks to my braces), the frenum can begin to pull on the weak gums and cause them to recede where the attachment is. Sort of seems like what’s happening here. I feel slight relief that their may be a solution (although unpleasant I’m sure) to the recession on this tooth if this is actually the case.

I have an appointment with a periodontist next Thursday to take a look at everything. It seems like a frenectomy is doable with braces on. I would just have to postpone any adjustment to the lower arch until it heals. I am looking forward to getting the periodontist’s recommendations (I won’t tell her about my self diagnosis :lol:). Thanks all for the replies!

Re: Advice PLEASE!! Gum recession and braces.

Posted: Thu Jan 24, 2019 12:22 pm
by cbraces678
Updating the issue. I find that helpful in case anyone else has similar concerns.

I saw the periodontist and I need a frenectomy and gum graft on the one tooth. I have my adjustment with the ortho next Tuesday, and then the frenectomy and graft
will happen the Monday after. She’s doing the gum graft to strengthen the gum, not raise the gum line for now since orthodontics can affect that. Once the braces are off we will see if we need to do more to raise the gumline. No real downtime in terms of ortho progression. I will go for my next adjustment 4 weeks after the frenectomy/graft which is basically on track with when my adjustment would be scheduled anyway. I am not looking forward to it, but knowing there is a solution is comforting. Overall she said there is no concern in the recession right now anywhere else. She said to keep an eye on a few prominent roots where the gum is thin, but she hopes as my teeth continue to move that that will actually get better since it looks like my teeth need to be moved back a bit which would in turn make the roots less prominent.

Thanks again to everyone for the replies.

Re: Advice PLEASE!! Gum recession and braces.

Posted: Fri Jan 25, 2019 1:24 pm
by Meowmeowbeans2
I had two gum grafts to thicken the tissue before braces - it’s really not too bad! Avoid talking for a day or two and eat soft foods the first week and you’ll be fine!