Why do black spaces at the gums appear during braces treatment, and what can be done to treat it and maintain healthy gums?

Doctor's Answers (1)

Black spaces that appear at the gums during braces treatment are termed black triangles. It appears black as you can see the darkness of the mouth behind the teeth through these gaps. It occurs as a consequence of straightening the previously crooked teeth. When teeth are crooked, they often overlap each other. With braces treatment, the crowding is resolved and the teeth no longer overlap. However the gums, unfortunately, do not grow with the teeth into a new position hence it is the lack of gum coverage in between the teeth that results in the black spaces. 

There are a few ways to manage these black spaces. 

  1. Interproximal reduction. These black spaces are most obvious if the teeth are triangular in shape, broader at the biting edge and narrower closer to the gums. By changing the shape of the teeth to be more rectangular through judicious re-contouring of the teeth (aka interproximal reduction) it helps to reduce the size of these black spaces.
  2. Tooth coloured filling material can be added on the adjacent teeth to fill in the black spaces. Tooth coloured or composite restorations can be bonded on the adjacent teeth at the black spaces to fill in the spaces and improve the appearance. However these fillings need to be done well, if not it poses an oral hygiene hindrance due to the extra bulbosity at the gum level it will trap plaque more easily. Your dentist will advise that flossing or interdental cleaning around these fillings are very important.
  3. Porcelain Veneers or crowns to change the shape of the teeth. This is the most drastic and invasive way to manage black spaces. If the black spaces are also associated with teeth that are heavily restored or discoloured, a veneer or porcelain crown will not only help to cover the space it can also improve the appearance of the teeth. However, this involves cutting the teeth down to accommodate the porcelain veneer or crown and would be the most destructive, a consultation with your restorative dentist will be needed to ascertain if this is suitable for you. 

Hope this helps and all the very best,

Dr Priscilla Lu

Orthodontist at the Orthodontic Clinic

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