Swollen gums with braces and bleeding gums with braces are two very common problems and complaints that patients have. After they have had braces for sometime, patients may experience these issues and realize that it’s not normal. Of course, young patients with braces may not report this problem. It may only be discovered when the young patients visit their orthodontist for follow-up appointments.
As a parent, you do your best to ensure healthy teeth and gums for your children. However, children with braces can become lax in their own oral hygiene for various reasons. As such, they can develop swollen or bleeding gum tissue and then a major decision has to be made. Understanding the causes of this problem and its possible treatment options for adults as well as children is important.
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How Gum Disease with Braces Develops
When a patient doesn’t have braces and brushes regularly, he/she removes the plaque that can cause gum disease. When he/she flosses as well as brushes, then there is very little chance that plaque can build up and create the perfect breeding ground for bacteria in the gums. However, it is much more difficult to keep a regular flossing and brushing routine with braces.
Braces prevent regular flossing. Special orthodontic flossers have to be used to get in between teeth, near the gums and above the brace wires. Flossing takes several minutes longer to do. Kids as well as adults are less inclined to take the time to floss when they have to individually thread floss through the teeth this way. As a result, not enough plaque or bacteria is removed from the gums to prevent gum disease.
When patients with braces also skip brushing their teeth, then none of the food that gets trapped in braces is removed. Food is trapped in the braces and in the teeth. Brushing could at least remove some of it, but failing to brush leaves it trapped. Food particles break down in saliva and rot. Rotting food particles in braces and teeth infect the gums. Swollen gums with braces is the first indication that a problem is developing.
Symptoms of Gum Disease
Whether you have braces or not, symptoms of gum disease are the same. It starts with swollen gums. The swelling may be minor, so minor that you may not even notice it initially. Then they swell to the point where it is obvious and you can see it and feel it. If the patient is your child, you will be able to see inside his/her mouth and notice the large, lumpy gum tissue.
IF not addressed at this point (and it is reversible), the next step is a little bleeding. The minor bleeding stops, but results in “pink in the sink” if you do brush. Patients should not stop brushing at this point, but continue to brush to reverse the issue.
Then the gums really start to bleed. As the teeth look worse and worse, the gums look like they belong to someone decades older than the patient. If not treated, the teeth will begin to loosen.
If the patient still refuses to floss and/or brush, the gums will advance to the point where the teeth become loose. The loose teeth will fall out and the only thing holding them in place at that point are the braces. If the braces are removed, the loose teeth will come with the wires and brackets. All your hard work to straighten teeth is lost on the poor hygiene and missing teeth.
Treatment Options
Treatment options begin with better oral hygiene. Gum disease with braces is reversible if caught and treated early and brushing and flossing are essential. Brushing bleeding gums with braces removes food particles and bacteria that are at the heart of this issue. The more you brush, the faster this issue reverses course.
Your orthodontist may also suggest or prescribe a medicated mouth rinse to destroy bacteria your toothbrush can’t reach. When used in conjunction with better brushing and flossing the rinse can help heal your gums. Pain will begin to dissipate to make it easier to brush and floss.
If the oral hygiene of the patient is so bad, the orthodontist may decide to remove the braces after some time to encourage better brushing habits. Without the braces, the patient may resume brushing and flossing without the hindrance of the brackets and wires. If oral hygiene improves significantly, the orthodontist may revisit an orthodontic plan to straighten the patient’s teeth at a later date. An option to straighten with clear orthodontics may be possible if hygiene improves enough.
Another approach is to remove the orthodontic appliances and perform a full mouth debridement. Debriding the teeth and gums involves removing all of the thick plaque both above and below the gum line. It is a painful process because the gum disease is usually extreme at this point.
However, the dentist or orthodontist can numb the patient’s whole mouth to do this procedure. It is much more than a typical dental cleaning and goes much deeper. After a debridement has been completed, regular brushing and flossing must resume to avoid another debridement procedure in the future. As for orthodontics, the patient may resume orthodontic treatment, but hygiene habits must improve.
A Word on Tooth Replacement When Teeth Are Lost
A patient with orthodontia whose oral hygiene has led to tooth loss may either have to live without the teeth or consider dental implants. Patients under the age of 18 have to wait until they are 18. Cosmetic dentists will not perform this surgery on minors who are still growing and developing.
Adult patients who have lost teeth to poor hygiene while wearing orthodontia may get implants for each tooth lost. The cost of dental implants in Houston is not covered by health insurance. The full cost lands squarely on the patient’s shoulders.
Tips for Preventing Gum Disease When Wearing Orthodontia
Without a doubt this condition can be avoided. It can be prevented and it can be reversed if you start the treatment process early. It cannot be stressed enough that flossing and brushing will prevent it. Avoiding sweets and sugary foods as well as all of the foods your orthodontist tells you to avoid helps too. Your orthodontic treatment plan often includes special mouthwashes, flossing samples, toothbrushes and sample toothpastes, etc., for the care of your teeth at this time.
If you know that you or your child is going to have a problem with oral hygiene when wearing traditional wires and brackets, consider the clear plastic pop-out orthodontic appliances. These allow you to fix crooked teeth while still maintaining a regular dental hygiene routine at home. It also helps you clean the clear appliances with a toothbrush and toothpaste before popping them back into your mouth. These appliances should be cleaned whenever you brush and floss your teeth after meals.
Cleaning the plastic appliances and clearing out the food bits is a lot easier than cleaning the metal brackets and wires. Many patients who struggle with oral hygiene routines find that these plastic appliances make correcting their teeth and preventing gum disease more manageable. Talk to your orthodontist to see which orthodontic appliance option is best when oral hygiene practices are at their worst.