Gums, orthodontics and rehabilitation: when treatments work together
Tooth position and periodontal health matter before restorations are selected.
On this page
Do all gaps have the same cause?
No. A gap may relate to tooth size, tooth position or changes in supporting tissues. A photograph alone cannot establish the cause. Assessment distinguishes a shape problem from one requiring periodontal or orthodontic care first.
What is pathological migration?
It is an unwanted change in tooth position, also seen with advanced periodontal disease. It differs from planned orthodontic movement. The EFP guideline addresses cases in which orthodontics can contribute to stage IV periodontitis care after periodontal treatment objectives have been achieved. [1]
What is assessed after braces?
Tooth position, contacts and remaining shape discrepancies. Monitoring may be sufficient, or additive restorations may be considered. Orthodontic retention and periodontal care remain part of the plan. A veneer does not automatically replace necessary orthodontic treatment.
What should you ask the team?
Why is the gap present? Which part can be addressed by moving a tooth and which by restoring its shape? How will the clinicians coordinate care and follow-up? Answers should relate to your own case.
Clinical sources
- EFP. Treatment of stage IV periodontitis — Case Type 2. Companion infographic to the 2022 guideline.
- Herrera D et al. Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline. 2022.
Further reading
- Aschheim KW (ed.). Esthetic Dentistry: A Clinical Approach to Techniques and Materials. 3rd ed. Mosby, 2015.
- Rosenstiel SF, Land MF, Walter R. Contemporary Fixed Prosthodontics. 6th ed. Elsevier, 2023.
Selected editions published from 2012 onwards. Books are recommended for further reading; clinical explanations reference the accessible sources above.
The information on this page is general and educational. It does not replace a medical consultation, and a treatment recommendation can only be made after examining each patient. Results differ from one case to another.
A plan for your situation
Book a consultationStart with a consultation and a plan
Every treatment begins with a diagnosis: clinical examination, photographs, radiographs and, where relevant, an occlusal analysis. Only then do we discuss options.