Expert: Mark Bornfeld DDS - 2/18/2009

Question
My 13 year old has a signficantly receding gum on her lower incisor.  It seems to have developed rapidly after having gotten braces off.  She does wear the plastic, wireless type of retainer at night now. What might cause a receding gum in a person this young? Do I take her to her dentist or back to her orthodontist?

Answer
Dear Michelle,

Rapid recession of the gum on lower incisors is something that may occur when the teeth are moved forward-- essentially out beyond the contour of the gums. Some children develop this problem due to a pre-existing shortage of gum tissue on the facial surface of the tooth root.

Unfortunately, there are two conflicting objectives here-- the desire to position the tooth in a more functional and cosmetic position, and the fact that the position has unfavorable periodontal implications. There may also be the additional contributing factor that the new tooth position may be placing the tooth under excessive chewing stress.

Theoretically, orthodontists should take interest in any adverse consequences of their treatment. However, the importance that orthodontists place on "collateral damage" that occurs outside the scope of their specialty is variable. It would be best if you first took your daughter back to the orthodontist, because there's little doubt as to the fact that his treatment contributed to the current state of affairs. However, you may need to get the general dentist involved as well, because remedial action may include aspects of care that are not strictly orthodontic.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY