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Black triangles are triangular empty spaces between teeth that come together. You may notice them forming between your teeth as they’re getting straighter, so it’s only natural to ask yourself – are braces causing this?
While braces won’t cause black triangles, they may help reveal them by aligning triangular teeth, or crooked teeth with gum resorption. Triangular teeth are the most common cause of black triangles because of how they come in contact. We can fix black triangles with IPR, bonding, and gum surgery.
Black triangles are annoying. They may cause a lisp, or even whistling or spitting when you talk. But aside from their unsightly appearance, black triangles can be an early warning sign of gum disease. So before focusing on aesthetics, talk to a periodontist to make sure your gums are in good shape.
In this article, I’m going to explain why you may end up with black triangles after braces, and the many options you have for correcting them.
How do braces cause black triangles?
Braces aren’t to blame for black triangles, but they can certainly put a spotlight on them once your teeth are aligned and leveled.
When braces align teeth, they enable them to contact each other at certain points, rather than entire surfaces. These contact points are a normal and desired part of dental anatomy.
Believe it or not, triangles between teeth are a good thing. They protect your teeth from getting interproximal cavities, and your gums from being impacted by hard food. It’s only when these triangles are empty, or “black”, that it becomes a problem.
The main cause of black triangles is the teeth’s shape. Triangular teeth only come in contact at the very edge, which is quite far from the gums and the bone crest. According to specialists, any distance bigger than 5 mm from the bone crest to the tooth contact can create a black triangle because the gum papilla can’t fill up the entire space.
Another cause for small black triangles forming as you wear your braces is improper bracket placement. A misplaced bracket can cause a tooth to become tilted, which affects the way it contacts its neighbors. Repositioning the bracket and getting the roots to be parallel is a sure way to correct this.
Lastly, you may be showing black triangles because of gum disease that’s been attacking your papillae, causing the gum contour to be flat in between teeth. We see this often in our adult patients, especially in their bottom teeth.
Gum trauma can also cause this, although it’s not that common. Excessive use of toothpicks or flossing too hard can damage the delicate tissue between teeth. It’s best to avoid these tools and use a good water flosser instead.
Can misaligned teeth cause black triangles?
If you’re young and healthy, aligning crooked teeth shouldn’t cause black triangles to appear. It’s true that a lifetime of crooked teeth pressing on the papillae can cause them to diminish, but I’ve noticed that they often grow back to fill up the space during or after orthodontic treatment.
If your misaligned teeth have a square or barrel shape, you’re less likely to get black triangles, unless you have moderate to severe gum disease.
Do black triangles go away on their own?
As I mentioned, if your gums are healthy, they can eventually grow back to fill up the black triangles after orthodontic treatment. Gums can take a while to recover and reorganize their tissue, so give it a year before you take any drastic measures.
However, if your teeth are very triangular, I doubt your gums will come back on their own, and even if they did, they would look weird. It’s better to address the cause – the shape of your teeth – and then wait for the gum to fill up the rest of its space.
If the gum doesn’t come back, you still have options, and we’ll discuss them all below.
How will your orthodontist fix your black triangles?
Ideally, your orthodontist will notice and treat black triangles while you still have your braces on. Most orthodontists have a trained eye and will notice black triangles forming long before it becomes a problem for the patient.
Your doctor will probably suggest IPR (interproximal reduction) to slenderize your teeth and create a surface contact, instead of your old contact point that was causing the issue.
We can perform IPR using special fine burs, disks, abrasive strips and saws. This method is also called stripping, and while it removes a small part of the enamel, we will polish it back and your teeth will recover. Studies have shown that moderate stripping won’t harm teeth.
After IPR, you’ll notice a gap between your teeth. That’s a good thing, and your orthodontist will soon close it. Enjoy watching your black triangle shrink in less than a month.
Downsides of IPR while treating black triangles
Stripping isn’t suited for all cases. If your teeth are very triangular, IPR may cause them to become too narrow and unattractive. Tooth bonding or veneers may be a better option instead.
Bottom front teeth can be particularly triangular, and their shape, combined with gum resorption, won’t make you a good candidate for dental stripping. In this case, it’s best to resort to gum surgery and/or aesthetic procedures like bonding, crowns, and veneers.
Lastly, for small black triangles during orthodontic treatment, bracket repositioning can often do the trick. Your doctor will notice the tilt of your tooth on an X-ray and correct it before taking your braces off.
How will your periodontist fix black triangles?
If bone and gum resorption are at fault for your black triangles, no amount of dental bonding or IPR will fix this issue. In your particular case, it’s best to go see a skilled periodontist to help you rejuvenate your gums or at least keep them from getting worse.
There are two main ways of correcting gums and reconstructing papillae:
For both techniques, your gums should be free of gum disease, because the inflammation caused by bacteria will seriously hinder your results.
How do dentists correct black triangles?
If all else fails, the best thing we can do is hide the black triangles with either composite or porcelain.
Dental bonding is a procedure that adds discreet layers of composite to your teeth, correcting their shape and filling in the gaps. Both your orthodontist and dentist can bond your teeth as a quick chairside procedure.
The next option is composite veneers. Composite veneers are better suited for misshapen or stained teeth. Your doctor will use a mould to inject resin and create the desired shape. After polishing, your teeth will look unrecognizable.
Lastly, we have porcelain veneers. Porcelain veneers are highly aesthetic ceramic shells that cover the entire tooth. Some veneers require tooth preparation, so I don’t suggest you get them unless you really need them.
How much does it cost to fix black triangles?
While the cost of braces and gum surgery varies greatly, it’s easier to estimate the cost of bonding and veneers. Bonding is the cheapest option, but you’ll need to have your composite replaced every 3 to 5 years or so.
Porcelain veneers are stunning, but they can cost more than braces, and you still need to replace them every 10 to 15 years. If you’re young and you want veneers, keep in mind that they may need a lot of upkeep during your lifetime.
Here’s an approximation of what you can expect:
For every black triangle correction, you’ll need veneers or bonding on two teeth, and if you have multiple black triangles, it can get quite pricy.
In the end, it’s up to you if you want to correct your black triangles. If you’re dealing with black triangles in your bottom teeth and your lower lip is hiding them, there’s no point in correcting them. Maintaining the health of your teeth and gums should be enough.
The same goes for your upper lip – some patients resort to Botox to relax their lips and cover their black triangles. However, I don’t recommend it, since hiding your teeth will make you look older.
Hopefully, you already have a rough idea about how you want to treat your black triangles after reading this article. Good luck with finding the best professional for your needs!
Whether you’re new to braces or a braces veteran, taking care of your teeth (and your health) during orthodontic treatment is crucial. That’s why I’ve put together a list of orthodontist-recommended tools that will make caring for your braces a breeze: