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Generally speaking, whether orthodontic treatment leads to gingival recession depends on oral hygiene practices and the appropriateness of the orthodontic plan. If proper oral hygiene is maintained during orthodontic treatment, the orthodontic forces are moderate, and the treatment plan is reasonable, gingival recession typically does not occur. However, if oral hygiene is poor, orthodontic forces are excessive, or pre-existing periodontal problems are present, gingival recession may develop.

If thorough brushing twice daily, flossing, or using interdental brushes and water flossers to clean the spaces between braces and teeth are consistently practiced during orthodontic treatment, along with regular periodontal check-ups and professional cleanings, and if the orthodontist designs a scientifically sound treatment plan with gentle and appropriate corrective forces that follow physiological tooth movement principles, the gums can remain healthy and recession generally will not occur.

However, inadequate oral hygiene during orthodontic treatment can lead to accumulation of food debris and plaque around the teeth and braces, triggering gingivitis or worsening existing periodontal conditions. Additionally, excessive orthodontic force may cause teeth to move too quickly or uneven stress on periodontal tissues, potentially damaging the gum attachment and leading to progressive gum recession. In severe cases, this may even compromise tooth stability.

Extra attention to oral hygiene is essential during orthodontic treatment. It is recommended to use specialized orthodontic toothbrushes along with interdental brushes, water flossers, and other tools to thoroughly remove food debris and dental plaque.