Question:
My 12-year-old daughter has braces and suffers from puffy gums. She brushes regularly and has clean teeth. Why does she still have gingivitis?
Answer:
Your daughter probably does not have gingivitis. Instead, she most likely has gingival enlargement, also called “gingival hyperplasia.” Gingival enlargement is found in adolescent and teenage patients undergoing orthodontic treatment with braces. Patients with this problem have puffy gums, clean teeth and minimal to no bleeding around their teeth. Studies show that puberty related hormonal changes in conjunction with braces that might prevent cleaning with a toothbrush as the cause. I have found using a water pic or a water flosser works well for cleaning around the teeth. Saltwater rinses also work well to decrease the amount of gingival enlargement.