Often certain procedures are necessary either before, during or after orthodontic treatment. In all cases, a thorough periodontal examination is necessary prior to orthodontic treatment to either rule out periodontal disease or determine whether any type of soft tissue grafting is necessary. Periodontal disease must be treated prior to any orthodontic treatment, otherwise orthodontic treatment may exacerbate gum disease and bone loss. In addition, soft tissue grafting may be treated before, during or sometimes after orthodontic treatment. A thorough periodontal examination will determine what periodontal needs are necessary prior to beginning the orthodontic treatment.
In some cases, teeth are not able to make their way into the mouth and remain hidden under the gums and get stuck in the jaw bone. The only way to pull these teeth down is by performing a crown exposure. Your periodontist will evaluate the location of the hidden tooth, and expose it to place a little button (like a bracket in braces) that the orthodontist can use to pull the tooth into the correct position.
A frenectomy is a procedure where your periodontist will gently trim at the muscle tissue that attaches your lip to your gum either in the lower front or upper front area of your mouth. This muscle attachment sometimes is positioned too low and it interferes with closing the gap between your two front teeth. This procedure is quick and requires little to no recovery time.
A fibrotomy is can be done at the same time or after orthodontic treatment. Your orthodontist will work closely with your periodontist to determine when this is to be completed. If your teeth were severely rotated or malpositioned prior to the braces, there is concern that there will be relapse – meaning the teeth will want to move back to where they were before the braces. To prevent this from happening, a simple procedure called a fibrotomy will help to prevent this problem. The goal of this procedure is to gently loosen the fibers that attach your tooth to the jaw bone. This will help new fibers to form that don’t exert as much pressure to try and bring your teeth back to how they were positioned before.
