Braces can give you the smile of your dreams and even improve your oral health post-treatment. But you might be worried about the pressure they place on the teeth causing other issues like tooth loss. While braces are unlikely to directly cause tooth loss, they can make your oral health more complicated.
In this guide, we will examine the causes of tooth loss and see how braces can affect this process.
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What Causes Tooth Loss?
Before we can understand how braces may play a role, let’s explore what causes tooth loss in the first place. Aside from oral injuries, tooth loss doesn’t happen overnight. It’s typically the result of untreated oral health problems — ones almost always caused by plaque.[ 1 ]
Plaque is a sticky film made up of bacteria and food particles.[ 1 ] When we give plaque the environment it needs to thrive, it leads to more serious complications. Two plaque-based conditions can lead to tooth loss if left untreated: periodontal (gum) disease and tooth decay.
Gum disease is the most common cause of tooth loss, and it’s typically the result of neglected oral health, beginning with plaque buildup at the gum line.[ 2 ] If you don’t clean plaque off your teeth, it hardens into a substance called tartar, which acts as a shield for bacteria, making it harder to clean away.
One cause of periodontal disease is gingivitis (gum inflammation).[ 2 ] Gingivitis is very common and most people will have it at one point or another in their lives. But don’t let its pervasiveness keep you from treating it right away. Once gingivitis has turned into periodontal disease, your gums may begin to recede, which can eventually result in tooth loss.
Plaque doesn’t just aggravate your gums; it can also cause cavities.[ 2 ] This kind of tooth decay, if left untreated, can also cause tooth loss. The acids in plaque can wear through your tooth’s enamel (its protective layer). Once plaque has worn through the enamel, it can create holes in your teeth called cavities.
If left untreated, cavities can progress further down into your tooth’s deeper layers — the dentin and the pulp.[ 2 ] The pulp is the deepest part of the tooth, and bacteria that reach it can form a pus-filled sack called an abscess. If your tooth decay escalates to the point of an abscess, you will need a root canal to remove the infection.[ 3 ]
Neither of these conditions happens because of one small lapse in oral hygiene. They come from the compounded effects of poor oral hygiene over a long period of time without intervention.
Can Braces Cause Me to Lose a Tooth?
In theory, yes, braces could cause tooth loss. However, the likelihood of this happening is quite slim. In fact, it is so slim that there is no documentation of it ever occurring.
So what is the theory behind tooth loss from braces? It comes down to something called root resorption.[ 4 ] Root resorption occurs when an extreme force traumatizes the tooth, causing the root to dissolve.
Like a tree without roots, the teeth are without their anchors, which then allows them to migrate upward in the gums and fall out. Luckily, even lengthy braces treatment is unlikely to result in the full dissolution of the root structure. Typically, it just results in shorter roots.
The more likely reason to lose a tooth or teeth during braces treatment is the same as when you have no appliance in place: poor or incomplete oral hygiene. And braces do make it harder to properly care for the teeth, which makes plaque buildup more likely, potentially leading to dental issues that eventually end in tooth loss.
The average braces treatment lasts 24 months. Two years is a long time, and it’s certainly enough time for a small problem to escalate if left unchecked. Since brackets are attached to your teeth, treatment can require a great deal of effort to ensure your mouth is free of plaque.
The good news: You have a great deal of control when it comes to your oral health. If you choose to prioritize your oral health during treatment and learn how to brush and floss correctly with braces in place, everything should go smoothly.
How Can I Prevent Tooth Loss From Braces Treatment?
Many causes of tooth loss come down to your own behavior. This is empowering — you can take control of your health to avoid tooth loss. Here are some tips to prevent tooth loss during braces treatment, and even afterward.
Use a Reputable Dentist or Orthodontist
If you’ve decided on braces, go to an experienced and licensed dentist or orthodontist. A good dentist will not administer braces without having a detailed medical/dental history and X-rays to make sure you are a good candidate. X-rays will show if you have any root issues that could present a risk for braces treatment. A detailed exam will show if you have cavities or gum problems to address, helping you avoid any issues during treatment and reduce the risk of tooth loss.
Maintain Great Oral Hygiene
Most of the problems we have mentioned so far are the result of plaque. If you clean plaque off of your teeth every day with proper brushing and flossing, you can avoid most oral health problems.
Braces make this routine a little more complicated, though. Brackets create many places for plaque to hide, and flossing in between the archwires can be a pain. You’ll need a new brushing technique to access all of your braces’ nooks and crannies. It may take longer than normal, but you need to prioritize your oral hygiene during your braces treatment.
You can buy inexpensive devices to help make your oral hygiene routine with braces a little simpler, such as small flossers that help thread your floss behind the archwire. Talk with your dentist or orthodontist to see if they have any recommendations. The easier you can make your oral care routine, the likelier you are to keep it up.
Make Regular Dentist Appointments
Twice-yearly dentist appointments are crucial for maintaining good oral health. Dental cleanings can remove plaque from hard-to-reach places, including tartar, which is difficult to remove with just a toothbrush.
Dentist appointments also provide you with important oral health oversight. Gum recession and tooth decay are both gradual processes that aren’t always easy to notice on your own. At your regular appointments, your dentist can identify tooth decay or gum issues before they escalate into something more serious. If you continue to have trouble keeping your mouth clean, your dentist may recommend three annual cleanings instead of two.
People don’t typically go from perfect oral health to tooth loss overnight. It’s a gradual process, and dental appointments can help identify warning signs along the way.
If you avoid dental appointments because of the cost, try looking for dental schools in your area. Dental schools offer free or low-cost dental treatments supervised by licensed dentists.
Dietary Changes
Your diet has an enormous effect on your oral health. You’ve probably heard your dentist warn about sugar at some point, and that’s because plaque loves sugar. When you consume foods with a lot of added sugar, those sugars turn into the acids in plaque that eat away at your enamel.
Saliva is your greatest ally in the fight against plaque[ 5 ]. It washes plaque off of your teeth and keeps your mouth clean. A high-sugar diet generates more plaque, making it harder for your saliva to keep up.[ 6 ] This makes cavities more likely, as well as gingivitis and potential gum disease.
It’s important to avoid foods that will make your saliva’s job even harder, especially during braces treatment, when maintaining good oral hygiene is already challenging.
Whole, plant-based, fiber-rich foods are incredibly helpful in maintaining a healthy mouth. Chewing increases saliva production. Foods like leafy greens require more chewing, which, in turn, helps keep your mouth cleaner. Starchy, processed foods have the opposite effect.
To best serve your oral health, avoid processed foods and foods with added sugar. Sugar is one of your body’s biggest enemies.[ 6 ] Instead, opt for whole, plant-based foods to help keep your plaque in check.
Quit Smoking
Smoking can cause many health problems, and this includes plaque and tartar buildup.[ 7 ] As we have established, plaque and tartar cause tooth decay and periodontal disease, which can result in tooth loss.
Do All Teeth Straightening Options Present This Risk?
All teeth straightening treatments add more responsibility to your oral care routine. If you don’t rise to the occasion and keep your mouth healthy, problems can arise. That being said, some treatments require more personal responsibility than others.
Clear aligners are removable, which makes your oral hygiene routine much simpler. Clear aligners still require special oral hygiene care and attention but it’s easier to maintain without brackets and wires getting in the way.
Lingual braces, which are attached to the back of your teeth, present even more barriers to good oral hygiene than traditional braces. Cleaning out-of-sight brackets is complicated, and it’s challenging to thread floss through a wire you cannot see. This doesn’t mean that periodontal disease or tooth loss is inevitable; you’ll just need to invest more time into your oral hygiene routine.
Final Thoughts
Braces are unlikely to cause tooth loss. However, improper oral hygiene during braces treatment can lead to issues that, if allowed to progress, can eventually result in tooth loss.
None of these outcomes are inevitable since you have a great deal of control over your oral health. Taking the time to prioritize your oral hygiene during braces treatment can be the difference between healthy or unhealthy teeth and gums when your braces are removed.
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Frequently Asked Questions
Can tooth loss be sudden?
Tooth loss is usually only sudden when it’s due to an injury. Typically, tooth loss is the result of another untreated oral health problem like periodontal disease or tooth decay. It’s important to stay on top of your oral hygiene, as well as your trips to the dentist, so they can detect issues in their early stages.
Why do my teeth feel loose during braces treatment?
Braces gradually move your teeth into new positions, which can make your teeth feel a little loose since braces need to loosen the ligaments holding the teeth in place and remodel the jawbone to move them. Loose teeth can be a little jarring, but this is a very normal part of the process.
Can gingivitis be treated?
Gingivitis can absolutely be treated. It’s important to treat it early before it escalates into more severe gum disease. If your gingivitis is due to poor oral hygiene, it will often go away if you start to adhere to good oral hygiene practices. Gingivitis can disappear in a few days or a week or two, depending on its severity. Talk to your dentist about the best treatment for your gingivitis.
Can gum disease be reversed?
Once gingivitis progresses to the next stage of periodontal disease, it cannot be reversed. However, there are plenty of treatment options — both surgical and nonsurgical, depending on the severity.
If I have periodontal disease, can I still get braces?
This depends on the severity of your periodontal disease. If your dentist and/or periodontist can stabilize your condition, then braces may be a possibility for you. You’ll just need to be extremely vigilant with your oral hygiene during treatment.
Am I more likely to lose a tooth with braces or clear aligners?
Neither braces or clear aligners are likely to end in tooth loss. However, it’s easier to keep teeth clean during clear aligner treatment since clear aligners are removable. This doesn’t necessarily mean you’d be doomed with braces, or completely in the clear with aligners. Both of these treatments require you to maintain excellent oral hygiene.
Do genetics have anything to do with gum disease?
If gum disease runs in your family, you are more likely to experience it yourself. However, you can still take preventative measures like diligent oral hygiene. Predisposed to gum disease or not, plaque is still the main culprit. Maintaining a healthy mouth is still important even if genetically you’re more likely to get gum disease.
Are there other teeth straightening treatments that allow smoking during treatment?
You are technically allowed to remove your aligners to smoke (just brush and floss before putting them back in). However, it would benefit your health to quit smoking altogether instead of looking for a treatment that can accommodate it.
Can you pass gum disease to someone else?
The bacteria can be spread to other people, but it is rare and doesn’t usually result in them developing periodontal disease if their mouth is healthy.
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