In many cases, orthodontics plays a valuable role in improving the long-term prognosis of teeth affected by periodontal disease — but only when undertaken with the right level of specialist oversight and careful timing.
Lusk Orthodontics, led by Dr Erfan Salloum, has extensive experience managing orthodontic treatment for adult patients with a history of periodontitis, bone loss, or reduced but healthy periodontium. Dr Salloum works in close collaboration with leading periodontists across Dublin to ensure that all such cases are planned jointly, sequenced appropriately, and delivered with the highest level of specialist oversight.
Periodontal disease damages the bone and soft tissue that support the teeth. When bone loss has occurred, the centre of resistance of each tooth shifts, which alters how teeth respond to orthodontic forces. This means that standard orthodontic force values and mechanics must be modified to account for the reduced periodontal support — if not, there is a risk of causing further bone loss rather than achieving the intended movement.
However, the relationship between orthodontics and periodontal health is not entirely one of risk. There is good evidence that correcting certain types of malocclusion can improve periodontal outcomes. For example:
If you have a history of gum disease or bone loss and are considering orthodontic treatment, book a consultation for a full assessment. Where appropriate, coordination with your periodontist will be established from the outset.
Before orthodontic treatment can begin in a patient with a history of periodontitis, the following conditions must be met:
Several adjustments are made to the way orthodontic treatment is planned and delivered in patients with periodontal disease or bone loss:
Dr Erfan Salloum is the founder and lead orthodontist at Lusk Orthodontics. Widely recognised as one of the most highly qualified orthodontists in Ireland, he specialises in complex orthodontic care, clear aligners,…
Read MORENot while the disease is active. The periodontitis must be treated, controlled, and stable before orthodontic treatment is considered. Once stability is confirmed by your periodontist, a specialist orthodontic assessment can be carried out.
If disease is active, yes — orthodontics should not be started. If disease is controlled and treatment is managed appropriately with modified forces, monitoring, and rigorous oral hygiene, orthodontic treatment can be completed safely and may in fact improve your periodontal status in specific areas.
Yes. Regular periodontal maintenance appointments must continue throughout orthodontic treatment. Both specialists remain in communication and share records where relevant.
In some cases, where bone loss is very severe, certain teeth may not be suitable for orthodontic movement. This is assessed individually at the planning stage, with reference to radiographs and periodontal probing depths.
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