The connection between orthodontics and periodontal health has gained importance in current clinical practice, especially due to the evident increase in demand for orthodontic treatments in adults. This demographic often presents additional challenges, such as weakened gums or a history of periodontitis, which require extra care.
In this context, orthodontics can no longer be seen as an isolated procedure. It is increasingly evident that tooth movement must respect the biological limits imposed by the supporting tissues, making a thorough periodontal evaluation essential before and during treatment.
Thus, collaboration between orthodontists and periodontists allows for risk anticipation, approach adjustments, and ensures that the treatment proceeds safely. Recognizing this interdependence is essential to protect gum health and ensure stable and lasting results.
The Impact of Orthodontic Treatment on Periodontal Tissues
Orthodontic treatment, by moving teeth through the alveolar bone, induces physiological changes in periodontal tissues. In patients with healthy gums, this bone remodeling occurs in a controlled and reversible manner. However, in individuals with active periodontal disease or a history of periodontitis, the application of orthodontic forces can exacerbate gum inflammation and accelerate bone resorption. In this context, orthodontics is not contraindicated but requires careful planning, accompanied by a specific preventive protocol.
The presence of fixed appliances, in turn, promotes the accumulation of dental biofilm, complicating hygiene and increasing the risk of gingivitis. This plaque-induced gum inflammation, although often reversible, can progress to more severe stages if not properly controlled, jeopardizing the success of orthodontic treatment.
Gum Recession: A Silent Consequence
Among the possible complications associated with the imbalance between orthodontics and periodontal health, gum recession stands out for its frequency and aesthetic-functional impact. This phenomenon, characterized by the apical migration of the gum, exposes the root surfaces of the teeth, increasing dental sensitivity and compromising the harmony of the smile.
Gum recessions can result from several combined factors: poor brushing, thin gingival biotype, excessive or poorly directed orthodontic forces, and lack of adequate periodontal control. In susceptible patients, it is essential for the orthodontist to identify these weaknesses beforehand and, whenever necessary, involve the periodontist in the therapeutic plan, whether for prior stabilization of tissues or for regenerative or grafting interventions.
Importance of a Multidisciplinary Protocol
The effectiveness of orthodontic treatment is not solely about dental alignment but also depends on the stability and health of the periodontal tissues that support the teeth. Therefore, close collaboration between orthodontists and periodontists becomes imperative, especially in complex clinical cases or adult patients.
This collaboration should include the following steps:
- Initial and regular periodontal evaluation throughout the treatment;
- Motivation and personalized oral hygiene instruction;
- Prior periodontal interventions, such as scaling and root planing, when indicated;
- Adjustment of the magnitude and direction of orthodontic forces according to periodontal stability;
- Continuous monitoring of inflammatory signs, tooth mobility, and attachment levels.
In other words, in patients with a history of periodontal disease, orthodontics can even be an asset, allowing for the correction of malocclusions that favor plaque accumulation or hinder hygiene. However, this intervention will only be beneficial if the periodontal disease is previously stabilized and under active surveillance throughout the orthodontic process.
The Importance of Education and Prevention
In fact, patient education also plays a crucial role in preventing periodontal complications associated with orthodontics. Proper oral hygiene instruction, adapted, for example, to the type of appliance used, significantly reduces the risk of gum inflammation. Additionally, the continuous use of interdental brushes, oral irrigators, and antiseptic solutions can effectively complement conventional brushing.
It is equally important to make the patient aware of the need for regular periodontal maintenance visits, even in seemingly stable phases of orthodontic treatment. This preventive approach is the cornerstone of responsible and lasting orthodontics.
In conclusion, the relationship between orthodontics and periodontology is evidently interdependent and requires an integrated approach focused on prevention and individualized treatment.
Orthodontic success largely depends on the health of the supporting tissues, so controlling gum inflammation, monitoring gum recession, coordination between professionals, among others, are indispensable elements.
