Gum disease is common in adults, and many people considering clear aligners have been told at some point that they have gingivitis, pockets or some bone loss. The good news: a history of gum disease doesn't automatically rule out orthodontic treatment. The key is the order in which things happen.
Gingivitis vs. periodontitis
| Gingivitis | Periodontitis | |
|---|---|---|
| What it is | Inflammation of the gums | Infection that damages the bone and tissue holding teeth |
| Signs | Red, puffy gums that bleed when brushing | Deep pockets, receding gums, loose or shifting teeth |
| Reversible? | Yes, with better hygiene and cleanings | Bone loss is permanent, but the disease can be controlled |
Why gum health comes first
Teeth move through bone. If that bone is actively being lost to infection, moving teeth can accelerate the damage. That's why your provider will evaluate your gums and take X-rays before planning treatment, and may refer you to a periodontist for deep cleaning or other care first.
Can you have aligners after periodontal treatment?
Yes, once the disease is under control and stable. Many patients with reduced bone support are treated successfully, often with gentler movements and closer monitoring. Your dentist, periodontist and orthodontic provider will coordinate, and you'll likely continue periodontal maintenance cleanings during treatment.
Why aligners suit gum-conscious patients
- You remove the trays to brush and floss normally, so plaque control is simpler than with brackets.
- There are no wires or brackets for plaque to collect around at the gumline.
- Straighter teeth are easier to keep clean for the rest of your life.
About black triangles
When crowded teeth are straightened in adults who have lost some bone, small triangular gaps can appear near the gumline between teeth. They were there before, hidden by the overlap. Your provider can often reduce them by reshaping the contact points slightly, and bonding can fill them if needed. Ask about this before you start so you know what to expect.
Your role during treatment
- Keep every periodontal maintenance appointment.
- Brush and floss before putting trays back in after every meal.
- Report gum bleeding, swelling or a tooth that feels looser than expected.
If you've been told you have gum disease and want straighter teeth, start with an honest evaluation. An Infinity Aligner certified provider will check your gum health and coordinate with your periodontist when needed.
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