Bone loss is a common concern among adults who want dental braces—and rightly so. But in many cases, it doesn’t stand in the way of a healthier, more aligned smile.
With the right evaluation and a carefully managed plan, it’s entirely possible to move forward with braces safely—even if you’ve had gum issues in the past.
In this article, we’ll guide you through how treatment is adjusted in these cases, what your provider will look for, and how to know if you’re a good candidate.
Can You Get Braces with Bone Loss?
Orthodontic treatment is still possible in cases of bone loss, but it requires careful case selection and coordination. The health and stability of the periodontium—the bone and gum tissue around the teeth—are key factors in determining if braces are appropriate.
Before moving forward, most orthodontists will consult with a periodontist to assess bone density, check for inflammation, and ensure the teeth can be moved safely without worsening existing conditions. Candidacy typically includes:
- Stable periodontal health (no active inflammation)
- Controlled or resolved bone loss
- A bite pattern that allows for low-stress movement
Risks and Considerations Before Getting Braces
Getting braces on a weakened foundation is like building a house on soft soil—it might look fine at first, but problems can show up down the road.
Gum Health Comes First
Moving teeth without healthy gums and bone is like pulling on a loose fence post—it won’t hold up the way it should. That’s why your dentist checks for stability first. Treating any underlying gum issues helps make sure everything stays strong as your smile shifts.
Bone Loss Can Limit Movement
Sometimes, it’s not about moving every tooth—it’s about making the right movements. With bone loss, your orthodontist may prioritize subtle adjustments that still improve your bite and smile without overloading your teeth.
There’s a Slightly Higher Risk of Complications
If braces are too aggressive, they can put stress on areas where bone is already thin—but that’s exactly why planning matters.A personalized treatment plan allows your orthodontist to work around those weaker spots, moving teeth in ways that are both safe and effective.
And in many cases, you’ll end up with a bite that’s easier to clean and maintain—which actually helps protect your bone moving forward.
How Orthodontists Manage Bone Loss During Treatment
Orthodontic treatment doesn’t follow a one-size-fits-all model—especially when periodontal support is limited. In cases with bone loss, these key adaptations help reduce risk and ensure safe outcomes:
- Gentle, Gradual Tooth Movement: Instead of moving teeth quickly, orthodontists apply lighter forces over a longer period of time. This reduces stress on the bone and helps avoid damaging already sensitive areas.
- Customized Treatment Plans: Every case is different, especially when bone loss is involved. Your orthodontist may use different brackets, wires, or even clear aligners to guide your teeth more safely. In some cases, they may avoid moving certain teeth altogether if the bone support is too weak.
- More Frequent Monitoring: Patients with bone loss may need more regular checkups during orthodontic treatment. This helps catch any issues early and allows the treatment plan to be adjusted if needed.
- Collaboration with a Periodontist: You might also see a periodontist during treatment to ensure your gums stay healthy. Think of it as a team effort—your dentist, orthodontist, and periodontist working together to keep your mouth stable while improving your smile.
Bone Loss After Orthodontic Treatment—Is It Normal?
Some patients worry that braces might actually cause bone loss—but here’s the good news: in most cases, they don’t. In fact, when managed properly, orthodontic treatment can improve overall oral health.
What Actually Happens to Bone During Braces?
Braces work by applying gentle pressure to your teeth, which causes the surrounding bone to remodel. This is a normal and healthy part of the process. As teeth move, bone breaks down slightly on one side and rebuilds on the other to support the new position. That’s not bone loss—it’s bone adaptation.
When Bone Loss Can Happen
Problems can arise if the patient has untreated gum disease during treatment, braces are applied with too much force, and oral hygiene is neglected during the process. These situations can lead to bone loss after orthodontic treatment, especially in patients who already had compromised gum and bone health before starting. You can prevent these issues by:
- Keep up with cleanings and at-home hygiene
- Follow your orthodontist’s instructions closely
- Address any gum concerns early
- Get regular check-ins throughout treatment
With proper care and monitoring, significant bone loss after braces is rare—especially when treatment is done with your individual needs in mind.
Final Thoughts: Getting Braces with Bone Loss Is Possible—with the Right Care
Bone loss doesn’t automatically disqualify you from getting braces. With the right planning, monitoring, and support from a knowledgeable team, you can still straighten your teeth safely—even if you’ve had gum issues in the past.
The key is working with specialists who take your oral health history seriously and create a treatment plan tailored to your needs—including how long you may need to wear dental braces to move your teeth safely and effectively.
Every case is different, but with careful pacing and regular checkups, great results are still within reach. At the end of the day, it’s not just about straighter teeth—it’s about a healthier, more confident smile that lasts.
Thinking About Braces? We Got You Covered!
At Washington Orthodontics in Bellevue, WA, we understand that no two smiles are the same. That’s why we start every treatment with a Comprehensive Smile Assessment—so we can learn about your goals, evaluate your bone and gum health, and guide you through a plan that works for you.
Whether you’re dealing with mild bone loss or just haven’t had a checkup in a while, our team is here to help you feel confident every step of the way. From your first consultation to the day your braces come off, we’ll walk with you through a process designed to be clear, comfortable, and customized. Schedule a free appointment with us today!
