Can Periodontal Patients get Invisalign or Braces?
Yes, some periodontal patients can indeed get orthodontic treatment but it isn’t without risks.
My preference for these patients is always Invisalign over fixed braces for hygiene and also because the forces are slower and lower. This leads to less tissue breakdown over time during treatment.
Also, you need to differentiate between ACTIVE periodontal disease and past periodontal disease.
Patients with ACTIVE disease shouldn’t be treated until it’s resolved and you’ve finished the 1 month evaluation documentation and all pockets are <4mm without BOP. You also don’t want to treat patients who have more than half of their attachment gone. They should have at least 50% of crown to root ratio. Of course you need excellent, recent xrays as well.
I am also NOT a periodontist and neither are general dentists.
I punt every severe patient to perio and have them sign off in writing that they support and advise ortho Tx.
Without that signature, you’ll potentially be liable if something happens, even if you put that disclaimer in writing.
I also let them “baby sit” my patient during ortho Tx ( for PMTs) and let them put on the perio splint at the end for retention ( and I’ll do essix over)
It might be an additional out of pocket fee for the patient, but it’s standard-of-care and any patient who refuses and asks you to cut corners, shouldn’t be a patient you want in your practice.
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