The need for orthodontic treatment: a periodontist's point of view

Data at hand suggests that occlusal traumatism is not causally related to gingival inflammation. Nor does occlusal traumatism affect the severity of existing inflammation. While an effect of occlusal traumatism on the spread of inflammation has been postulated, most observations seem to question such an interaction. Malposition of teeth has not been proven to be an etiologic factor in inflammatory periodontal disease nor could the degree of periodontal disease severity be consistently associated with improper tooth position. While malposed teeth may make plaque removal more difficult, specific oral hygiene measures should overcome this handicap. Orthodontic appliances may act as local gingival irritants, either directly or as plaque accumulants, and should be designed to minimize such irritations. Finally, orthodontic treatment, by properly aligning tilted or drifted teeth which also exhibit infraosseous lesions, may improve periodontal therapy at such sites.