Who This Article Is For

This guide is for UK adults who have noticed some degree of gum recession and are wondering whether clear aligners — sometimes called invisible braces — are still an option. You may have been told you have early-stage gum disease, or you may simply have noticed your gums sitting a little higher than they used to.

It is also relevant if you:

• Have been diagnosed with gingivitis or mild periodontitis and want straighter teeth
• Are concerned that moving teeth could make recession worse
• Had gum treatment in the past and want to know if orthodontics is now safe
• Were told by another provider that you are not suitable — and want a second perspective

Important: If you are currently experiencing bleeding, swollen, or painful gums, we would always recommend seeing a dentist or periodontist before exploring orthodontic treatment. This article is for information only and does not replace a clinical assessment.

Key Definitions in Plain English

What Causes Gum Recession?

Understanding why gums recede helps explain how a clinician decides whether orthodontic treatment is appropriate. Common drivers include:

Periodontal Disease

Bacterial plaque that is not removed effectively can cause the gums to become inflamed. Over time, this inflammation can destroy the attachment between the gum and tooth and erode the underlying bone — leading to recession. Periodontal disease is the most common cause of significant gum recession in adults.

Aggressive Brushing

Brushing too hard or with a stiff-bristled toothbrush can physically wear away gum tissue, especially along the gum line. This type of recession often affects the outer (buccal) surfaces of teeth and may be visible even when gum health is otherwise good.

Tooth Position

Teeth that sit outside the natural arch of the jawbone — particularly lower front teeth that are pushed forward — may have thinner bone and gum coverage. This makes them more vulnerable to recession, even without disease.

Genetics and Tissue Type

Some people naturally have thinner gum tissue (sometimes called a thin biotype), which is more prone to recession regardless of oral hygiene habits.

Other Factors

Smoking, teeth grinding (bruxism), lip or tongue piercings, hormonal changes, and previous dental or orthodontic treatment can all contribute to gum recession in varying degrees.

Why Gum Recession Matters for Tooth Movement

Orthodontic treatment works by applying gentle, sustained pressure to teeth, which triggers a biological remodelling process in the surrounding bone. For this to happen safely, there needs to be adequate bone and healthy gum tissue supporting each tooth.

When gums have receded, it can signal:

• Reduced bone support: If the bone has thinned alongside the gum, there is less anchorage for the tooth. Moving a tooth with poor bone support carries a higher risk of further bone loss or increased mobility.
• Active inflammation: Moving teeth through inflamed tissue can worsen the disease and accelerate attachment loss.
• Root exposure: Exposed roots are more sensitive and may be more susceptible to decay. Orthodontic forces could exacerbate sensitivity in some cases.

This does not mean treatment is impossible — it means the clinician needs to assess why the recession has occurred, how much bone remains, and whether the gums are currently stable. These factors determine what movements can be planned safely.

What Clear Aligners Can Do (and What They Cannot)

Clear aligners — including brands available in the UK and invisible braces in London — use a series of custom-made, removable trays to move teeth incrementally. Each tray is worn for one to two weeks before progressing to the next.

What Aligners Can Do

• Controlled, gentle movements: Modern aligner software allows clinicians to programme very precise, small movements — often 0.2 mm per tray. This level of control can be advantageous for patients with compromised gum support, because forces can be kept light.
• Improved hygiene access: Because aligners are removable, patients can brush and floss without navigating around brackets and wires. For someone with periodontal disease or a history of gum problems, this is a meaningful benefit.
• Targeted treatment: Clinicians can choose to move only certain teeth, avoiding areas where bone support is too thin for safe movement.
• Alignment that supports gum health: In some cases, correcting crowding or spacing can make oral hygiene easier and reduce plaque traps — potentially benefiting long-term gum health.

What Aligners Cannot Do

• Reverse gum recession: Orthodontics does not regrow lost gum tissue. If you have visible recession, the gum level may remain the same — or in some cases may change slightly — after treatment.
• Treat active periodontal disease: Aligners straighten teeth; they do not treat gum infections. Active periodontal disease must be managed (and ideally stabilised) before orthodontic forces are applied.
• Guarantee no further recession: While careful planning minimises risk, there is always some possibility that tooth movement could contribute to further recession, particularly in vulnerable areas. This risk should be discussed during your assessment.
• Replace surgical intervention: Severe recession sometimes requires gum grafting or other periodontal surgery. Aligners are not a substitute for these procedures.

Step-by-Step: How Treatment Typically Works

If you have some degree of gum recession and are considering clear aligners, here is what the process usually looks like:

How Clinicians Manage Risk

Treating patients with gum recession requires extra care. Here is how experienced clinicians typically reduce risk:

Suitability Checklist

This is a general guide — not a diagnostic tool. Only a clinical assessment can confirm whether clear aligners are appropriate for you.

If any of the caution signs apply, it does not necessarily mean aligners are off the table — it means the clinician will need to weigh the risks carefully and may recommend preparatory treatment first.

Risks, Side Effects, and Limitations

Transparency about risks is important. Here is what patients with gum recession should be aware of:

• Further recession: There is a possibility that tooth movement could contribute to additional gum recession, particularly in areas where tissue is already thin. Careful planning reduces but does not eliminate this risk.
• Bone loss progression: If periodontal disease is not properly managed before or during treatment, bone loss could worsen. This is why stabilisation before starting aligners is essential.
• Root resorption: A small degree of root shortening can occur with any orthodontic treatment. For patients with reduced bone support, this is a more significant consideration.
• Sensitivity: Exposed roots can be more sensitive to temperature changes, and wearing aligners may occasionally increase awareness of this.
• Treatment limitations: The degree of tooth movement that can be safely achieved may be less than for a patient with healthy gums. The clinician may recommend a compromise result that prioritises gum health over a cosmetically "perfect" alignment.
• Longer treatment time: Slower, more conservative movements may extend the overall treatment duration.
• Need for periodontal maintenance: Ongoing gum care appointments (typically every three to four months) may be recommended during and after aligner treatment.

How Long Treatment May Take

Treatment time for clear aligners varies depending on the complexity of tooth movement and individual response. For patients with gum recession, additional factors come into play:

As a rough guide, many mild-to-moderate aligner cases in the UK take between 6 and 18 months — but your clinician will provide a more accurate estimate based on your specific situation.

Costs in the UK

Clear aligner treatment in the UK typically ranges from around £1,500 for simpler cases to £5,500 or more for complex full-arch treatment. Several factors can influence where your case falls within that range:

• Complexity of tooth movement: More aligners and longer treatment generally cost more.
• Preparatory periodontal treatment: If gum treatment is needed before aligners can begin, this is usually carried out by your dentist, hygienist, or a periodontist — and will involve separate costs.
• Refinement stages: Some plans include refinements; others may charge separately.
• Retention: Retainers are an additional cost at most practices — and they are essential.
• Clinic location: London and other major cities tend to have higher fees than rural areas.

For a more detailed breakdown, visit our clear aligner cost guide. Many clinics, including ours, offer interest-free payment plans to help spread the cost.

Note: We cannot quote a specific price without assessing your case. The figures above are indicative ranges and vary by provider and complexity.

Keeping Your Results: Retention and Aftercare

Retention is a non-negotiable part of orthodontic treatment — teeth have a natural tendency to drift back toward their original positions, especially in the first year after active treatment.

For patients with a history of gum recession or periodontal disease, aftercare is even more important:

• Retainers: You will typically be given removable retainers to wear nightly (and sometimes a fixed bonded retainer on the lower teeth). Follow the schedule your clinician prescribes.
• Periodontal maintenance: Regular hygiene appointments — often every three to four months — help keep gums healthy and catch any early signs of disease returning.
• Home hygiene: Interdental brushes, a soft-bristled electric toothbrush, and possibly a chlorhexidine rinse (if recommended) form the core of a good routine.
• Avoid risk factors: Smoking is one of the biggest drivers of gum disease and recession. Reducing or stopping smoking will significantly support your long-term results.
• Monitor changes: If you notice new recession, increased sensitivity, or bleeding gums after treatment, contact your clinician promptly.

When to Seek Advice

If you are unsure whether your gums are healthy enough for aligners, these signs suggest it is worth getting a professional opinion sooner rather than later:

• Gums that bleed regularly when brushing or flossing
• Visible recession — teeth appearing longer than they used to
• Persistent bad breath that does not improve with brushing
• Teeth that feel loose or have shifted position
• Sensitivity along the gum line, especially to cold

None of these signs necessarily means you cannot have aligners — but they do mean a clinician should assess your gum health before any orthodontic treatment begins. Early intervention for gum problems generally leads to better outcomes.

Frequently Asked Questions

Disclaimer: This article is for general information only and does not constitute dental or medical advice. Gum recession and periodontal disease vary significantly between individuals, and treatment suitability can only be determined through an in-person assessment by a GDC-registered dental professional. If you are experiencing gum pain, bleeding, or other symptoms, please contact your dentist promptly.