Can I Wear Braces if I Have Periodontal Disease?

Braces with Gum Disease

When talking about oral health, an informing and recurrent term often used to describe teeth damage is tooth decay. The main reason for tooth decay is an accumulation of sugar from sugary added or starchy foods over teeth and gummy tissue.

Sugar itself causes no harm, but bacteria is everywhere, including the mouth, and bacteria feed from sugar. Fed bacteria reproduce rapidly. As they grow in number, they form a protective shield named biofilm, allowing them to stick to teeth.

Biofilm produces acids that form plaque that erodes the protective outer layer of teeth named enamel. As the enamel becomes vulnerable, biofilm penetrates further layers of teeth, causing tooth decay, sometimes reaching the core known as the pulp.

At this stage, bacteria advanced a long road, and treatment might require making a root canal to reach the nerve or losing a denture piece. Unfortunately, plaque can also affect soft tissue (gums) and the bone in which teeth sit.

Despite tooth decay and gum disease being fully preventable, approximately 65 million Americans suffer from gum disease. Therefore, a major concern arises when a patient requires orthodontic treatment but has been simultaneously diagnosed with gum disease.

This article addresses some major questions patients have before entering into orthodontic treatment, especially those referring to dealing with gum disease before and during orthodontic treatment.

What Causes Gum Disease?

There is a tendency to state the cause of Gum Disease is eating too many sugary added or starchy foods. This statement is partially true. But Tooth Decay and Gum Disease are caused by a combination of causes.

As we have described, plaque erodes enamel and irritates a patient’s gums. So, brushing and flossing after meals eliminates sugary residues from which bacteria breed. Consequently, the main factor contributing to Gum Disease is poor oral hygiene.

Unfortunately, poor oral hygiene favors the accumulation of acidic plaque, activating a gums defense mechanism in which gums try to get rid of plaque by receding. However, heavily receding gums might produce teeth to fall out.

Can Braces Cause Gum Disease?

Braces themselves do not cause gum disease. However, braces make it a little hard to practice good oral hygiene. Therefore, orthodontists recommend patients who wear braces take additional oral hygiene measures.

Good oral hygiene measures for patients wearing braces include brushing teeth with a soft-bristled toothbrush and flossing with a waxed self-threading or interdental flosser after meals.

Food might get stuck between brackets and wires. Patients can opt to include complementary measures that include using a water irrigator that shoots pressurized water to unclog stuck dirt and rinsing with a mouthwash.

Consequently, gum disease is a preventable condition that requires enhanced oral hygiene habits. In fact, gingival disorders are medical conditions known as gingivitis or periodontal disease (periodontitis) that occur in levels ranging from mild to severe.

Sometimes, braces-wearing patients experience swollen gums during braces treatment, which might indicate a mild case of gingivitis. Practicing good oral hygiene habits and scheduling dental maintenance visits at least twice a year can help reverse the mild and moderate early stages of gingivitis.

Why Should You See a Periodontist Before Getting Braces?

The orthodontic treatment produces a positive impact on patients. The main advantage is that aligned teeth are easier to clean, decreasing the possibility of costly treatments to fix a deep cavity or save a denture piece.

Therefore, correcting malocclusion with orthodontic treatment is an investment that improves patients’ long-term oral health. Yet, before getting braces, it is crucial to have a thorough evaluation of your gums with a periodontal specialist.

Gingivitis negatively impacts orthodontic treatment. Brace’s function is to exert controlled strain to move teeth. During an inflammatory and infectious process of the gums (gingivitis), teeth displacement stagnates or turns slower.

Untreated gingivitis might lead to a more severe condition named periodontitis. In such circumstances, gums might recede, and there might be a higher possibility of losing a denture piece.

If an orthodontic process is underway and a patient has not had a timely treatment, periodontitis might advance to the bone that is the base on which the tooth sits. At this stage, the tooth might get loose. In addition, added braces strain might cause teeth to fall off.

Consequently, orthodontists work hand-by-hand with periodontists to smooth the braces installation process and obtain the best treatment results. A periodontal evaluation includes checking your gums, bone structure, teeth, and bite, including age and health risk factors.

As previously indicated, mild to moderate gingivitis is reversible by practicing good oral habits for several weeks. After that, your gums will switch from red and swollen to pink and healthy.

Once conditions improve, a periodontist gives clearance to start orthodontic treatment with braces. Don’t forget that braces treatment lasts from 18 to 24 months, so orthodontists must reassure gums and teeth are healthy enough to start the journey to a beautiful and healthy smile.

Can I Get Braces with Gum Disease?

The recommendation is not to have your braces installed if a periodontist has detected gum disease. This statement becomes more important if a patient suffers from periodontitis.

However, some specialists consider that patients can start orthodontic treatment if they have a mild gum disease case that is under control. A major concern arises when patients fail to practice good oral hygiene during braces treatment.

Conversely, orthodontic treatment contributes to getting teeth straight and facilitating oral hygiene. Consequently, as treatment advances, plaque stops getting caught in intricate spaces formed by crooked teeth.

Again, we recommend getting a partnered evaluation that includes an orthodontist and a periodontist, as patients’ needs vary depending on a malocclusion and gum disease case.

Before starting with orthodontic treatment, a periodontist must first control a patient’s gum disease. Also, “an orthodontist should inform the patient that non-adherence to the oral hygiene protocol will result in discontinuation of the orthodontic treatment.”

In short, to summarize our approach to the problem, a study concluded that “Specialists should perform a clinical periodontal evaluation that includes periodontal probing every six months during orthodontic treatment.”

How to Clean My Teeth with Braces?

In detail, wearing braces requires patients’ compliance with orthodontist recommendations, including dietary recommendations, proper oral hygiene measures, attending follow-ups, and adjusting visits.

Oral hygiene encompasses adherence to two general recommendations, dietary restrictions and practicing excellent oral hygiene habits.

Dietary Restrictions

The first part of this article, incidentally, included facts related to the harmful consequences of ingesting foods with sugar. Accordingly, some other foods like nuts, by their nature or texture, are pervasive, leaving small residues that are hard to clean with conventional methods.

Consequently, orthodontic patients must refrain from eating sugary foods or at least reduce their consumption to the least possible. Solid advice is to brush and floss after eating any sugary product.

Practicing Enhanced Oral Hygiene Habits

During orthodontic treatment, practicing good oral hygiene is not sufficient enough. Therefore, orthodontists recommend patients work a little harder on their hygiene. We include a short list of recommendations to have your mouth clean to the fullest while wearing braces.


  • Brush after meals using a soft-bristled toothbrush.
  • Brush your teeth, spending an extra thirty seconds per quarter of your denture.
  • Use little toothpaste to identify stuck food particles.


  • Use a self-thread flosser, inserting the thread in the interdental space and between the wire and gum space, making up and down movements on each tooth.
  • Repeat this procedure in the interdental space from the wire above the wire on the lower jaw teeth and below the wire on the maxillary teeth.
  • Alternatively, you can use a handy interdental flosser with bristles that contribute to the mechanical remotion of debris.
  • Complementary, use a water irrigator directing the water splash to the portion where you identify a stuck particle.


  • Add mouthwash to perfect your cleaning routine. The antibacterial properties of a mouthwash contribute to reducing the number of bacteria in your mouth.

Visit A Specialist

Visit a dentist or a Dental Hygienist at least twice a year for plaque buildup controls. You should also get in touch with our team for a proper evaluation and review if you can start your treatment with braces as soon as possible.

Set an appointment with us.

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