Is there ever a situation in which straighter teeth are not preferable? Yes. This article explores what you need to know when it comes to orthodontic treatment and gingival embrasures (AKA “black triangles”).
The most common compliant we treat is crowding of the lower front teeth. Resolving this crowding involves an outward expansion to create enough space for all of the teeth to fit into the archform. The animated GIF below represents four lower front teeth that are being expanded in this way to resolve crowding:
As the teeth become less crowded, the triangular spaces between the teeth appear larger. The clinical term for these black triangular spaces is gingival embrasures. There are three primary contributing factors that will make gingival embrasures larger and more noticeable:
- The shape of the teeth. Teeth that are more triangular will be narrower at the gumline than at the crown of the tooth. This creates more space between the teeth at the gumline.
- The amount of overlap/crowding present before the orthodontic treatment.
- The presence of gum recession. As gums recede, more of the narrower part of the tooth is exposed. This will exaggerate the appearance of black triangles. To demonstrate this principle, the GIF below represents the exact same teeth and movements as in the GIF above, but with the gumline moved a slightly lower. Note that the black triangles appear larger:
For the majority of patients – even those with lower teeth crowding – gingival embrasures are not an issue. However, some patients are a “perfect storm” of 2 or 3 of the factors listed above. If our doctors anticipate that black triangles may become conspicuous, we’ll let you know and discuss options with you to mitigate the appearance of black triangles. These options may include one or more of the following:
- A treatment plan that does not fully resolve tooth crowding so as to avoid excessively large gingival embrasures
- A treatment plan that includes to IPR (shaping of the teeth) to make them more rectangular and less triangular
- Cosmetic dental and periodontal solutions
As with any medical or dental procedure, knowledge is power. It is important to know what questions to ask and what things to look for. When evaluating an orthodontic treatment plan, be sure to look at how tooth movements might affect the appearance of gingival embrasures.
