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Treatment for braces or aligners in patients with gum disease requires a meticulous interdisciplinary strategy to ensure tooth positioning and periodontal stability are simultaneously optimized. Gum disease, which affects the gums and supporting structures of the teeth, can increase risk of treatment failure if inadequately managed. Before any braces or aligners are placed, a thorough evaluation by a periodontist or gum specialist is non-negotiable. This includes evaluating radiographic bone levels, bleeding on probing, and tissue resilience.

Patients with active periodontal disease should delay orthodontic intervention until their condition is clinically stabilized. This typically involves scaling and root planing, enhanced brushing. Once the gums are healthy and stable, orthodontic treatment can be initiated with modified protocols. The orthodontist must design a treatment plan that minimizes stress on already compromised tissues. This may include applying gentle biologically compatible forces, extending adjustment periods, and limiting intrusive or distal movements that could accelerate tissue destruction.

Ongoing collaborative surveillance during orthodontic intervention is vital. Patients must commit to rigorous daily sanitation, as orthodontic hardware impedes effective biofilm removal. Recommended devices including soft-bristle brushes, pulsating irrigators, and prescription mouthwashes may be prescribed. Notable gingival erythema, increased mobility, or persistent discomfort should be addressed immediately.

Once active tooth movement has ended, ้˜ใƒถๆทต ็Ÿฏๆญฃๆญฏ็ง‘ retention is just as important as the movement phase. A well-fitted retainer helps maintain the new tooth positions while protecting the gums. Lifelong periodontal maintenance is indispensable to prevent recurrence of gum disease and protect the investment in cosmetic and functional alignment.

Interdisciplinary synergy between specialists, along with the consistent personal responsibility for gum care, is the key to successful outcomes. With the right care, patients with compromised periodontal status can achieve straighter teeth and a healthier smile without jeopardizing tissue stability.