A 50s Orthodontic Treatment Review｜Invisalign Improved Gum Recession and Crowded Teeth

Hello.

This is Yonsei Baro Dental Clinic, an orthodontic clinic in Apgujeong.

The key to orthodontic treatment in middle age is the gums, not just alignment

Today, I would like to introduce a case of orthodontic treatment for a patient in their 50s.

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The patient chose clear aligner treatment with Invisalign.

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The patient first visited us in October 2023 for Invisalign treatment.

From the front, gum recession is noticeable around the blue-arrow tooth, which is in an edge-to-edge bite.

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It was significantly out of alignment with the lower front teeth.

Teeth that have been pushed out of the alignment and are positioned forward in this way often experience gum recession.

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The two upper front teeth were rotated outward, commonly referred to as “butterfly teeth.”

At the initial consultation, the patient said the main thing they wanted to correct was the alignment.

The area of greatest concern was the black triangle.

If you are concerned about black triangles during middle-aged orthodontic treatment, please pay attention to this post.

When the lower front teeth are completely overlapping, removing one lower front tooth is also a treatment option.

Removing one lower front tooth makes the treatment much simpler.

The total treatment time was expected to be approximately nine months, and treatment with Invisalign Lite would also have been possible.

However, if one lower front tooth is removed and treatment is completed with three front teeth, a major disadvantage is that a large black triangle may remain.

Because the patient was most concerned about black triangles, we decided on non-extraction treatment to align the teeth evenly.

To bring a crowded tooth back into position without extraction, interproximal reduction is essential, as long as it is performed within reasonable limits for the surrounding teeth.

The patient began wearing the aligners in November 2023 and wore the first set through April 2024.

Rather than wearing the first set to the end, new aligners were ordered during the latter part of treatment, in the sixth month.

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Along the way, one tooth that had been significantly out of alignment did not fit properly with the attachment and aligner. However, we proceeded by changing the aligners as treatment progressed, leaving the attachment off that tooth while creating space.

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Once enough space had been created for one front tooth to be moved into position,

we determined that continuing to wear the aligners to the end would only waste time, so we immediately began making additional aligners.

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The patient wore the additional aligners for another four months, from August through November 2024, and treatment was finally completed.

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Let’s compare the before-and-after photos.

Total treatment time: 1 year and 2 months

Excluding the time required to make the initial and intermediate sets of aligners, the actual treatment time was about one year.

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The gum around the front tooth, which had receded because the tooth was severely out of alignment, had risen back to some extent, although not perfectly.

This was because the root, which had been pushed outside the jawbone, was moved back inside it.

This was possible because the patient’s gums were relatively healthy despite being in their 50s.

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The bite is satisfactory.

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The alignment, including the butterfly teeth in the upper arch and the crowded lower front teeth, has improved.

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The improved height and rotation of the front teeth make the smile look neater.

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Why does the gummy smile appear improved in the photos?

It is simply because the patient smiled less when the facial photos were taken.

The gummy smile was not actively improved by moving the front teeth upward through orthodontic treatment.

As people age, the lower teeth become increasingly more visible than the upper teeth due to aging of the muscles and skin around the mouth.

For middle-aged adults over 40, showing a moderate amount of gum when smiling is considered a youthful feature rather than a flaw, so it is not intentionally corrected.

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There was no root resorption, and root parallelism was also satisfactory.

Do not assume that it is too late in life to undergo orthodontic treatment.

Q. I am worried that black triangles may develop.

This is one of the most common concerns in middle-aged orthodontic treatment. The treatment plan should be established by comprehensively considering whether extractions are needed, whether interproximal reduction is needed, and the shape of the teeth. Depending on the case, the treatment plan can be adjusted to minimize black triangles.

Orthodontic treatment is not determined by age.

What matters is the current health of the teeth and gums, as well as the patient’s desired goals.

In particular, orthodontic treatment after middle age is not limited to simply straightening the teeth. To achieve a more satisfactory result, the health of the gums, black triangles, changes in the appearance of the mouth, and facial changes associated with aging must all be considered together.

If you have only been wondering, “Is it okay to get orthodontic treatment at my age?” many more patients in their 40s to 60s are actually receiving orthodontic treatment than you might think.

There is no age that is too late for orthodontic treatment. An accurate diagnosis comes first.