Gum health during treatment

What is normal

Some tenderness and mild puffiness in the first few weeks after bonding, as the tissue adapts to appliances at the gum margin. It settles as the cleaning routine becomes established.

What is not

• Gums that bleed every time you brush, months into treatment.
• Tissue overgrowing the brackets, particularly around the upper front teeth.
• Persistent bad taste or odour.
• Gum receding away from one tooth, exposing root surface.
• A single area that is swollen, tender and different from the rest.

None of these are caused by braces as such. They are caused by plaque that braces make easier to accumulate, and they are reversible if addressed early.

Why it affects treatment

Teeth move through bone, and inflamed tissue changes how that bone responds — movement becomes less predictable and often slower. In an adult with reduced bone support from previous periodontal disease, moving teeth through actively inflamed tissue can cause real and permanent attachment loss. This is why active gum disease is treated and stabilised before orthodontics begins, in adults of any age.

Gingival overgrowth

Some patients develop tissue that swells over the brackets, most often around the upper front teeth. It is usually a hygiene response and improves with better cleaning within weeks. Where it does not, or where it is medication-related, a referral for a minor procedure to reshape the tissue may be appropriate — often best done near the end of treatment when the teeth are in their final positions.

The routine that prevents all of this

Twice-daily brushing with attention to the gum margin, interdental brushes under the wire daily, flossing with threaders, and cleanings with your general dentist through treatment. Tell us at your adjustment visit if your gums are bleeding — it is a fixable problem at six months and a bigger one at eighteen.