Why aren’t my gums healing after a crown?

It’s been two months since I had a crown done. The dental assistant kind of warned me that my gums were very angry during the placement of the permanent crown. She encouraged me to use saltwater rinses after the treatment for several days. I don’t think they have healed properly because they still are extremely tender and bleed when I brush in the area around the crown. Any idea what’s up?

-Paul in Wisconsin

Paul,

Any time there is pain or bleeding, infection is a possibility. But if you don’t have swelling or any abscess occurring, then it isn’t likely. Your gums should have healed by now. Do you have any other physical health issues? Most generally healthy individuals should have healed after a couple months.

Dental crowns can irritate the gums. Sometimes they are aggravated when an individual flosses around a new restoration. Bacteria can flourish in and around the crown if it is difficult to floss, which may cause some redness and inflammation which may cause bleeding. If this sounds like a possibility for you, try switching to a floss pick and brush a bit more carefully in the area that is bothering you.

The bleeding and redness should taper off in the coming weeks. Also, saltwater rinses will encourage healing. Keep this up until the tissue appears normal again.

If these steps do not improve your gum irritation, you need to be seen. It is possible that the margins on the porcelain crown may be bothering the soft tissue. The crown will likely need to be redone if this is indeed the issue. So, start with changing up your oral hygiene habits and if there is no improvement in a couple weeks, go back into your dentist to figure it out.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I need to replace a missing front tooth.

I haven’t been happy with my dentist, to say the least. Here’s the deal. I have a partial denture that contains five teeth. I’m missing one of the front teeth on it. It looks so bad. I complained and the dentist did it over multiple times. I still hate it. My insurance has already paid their part, so I don’t know if they will chip in anymore on the same procedure. Any ideas on how to help? Will porcelain veneers work to replace the missing tooth?

– Jason in Minnesota

Jason,

When a partial denture is done by a dentist that values aesthetics and is experienced in using a trusted dental laboratory, it can look beautiful. Unfortunately, it sounds like this is not the case for you. Not every dentist values the way a smile looks, they are mostly concerned with the function.

As you know, with a removable partial denture, there are clasps that attach the appliance to the surrounding teeth. The clasps are sometimes metal and are visible. Many people with partials, hate that part because they can be seen when the individual smiles. Valplast partial dentures are much more aesthetically pleasing. You may be interested in learning more about them. They are made from a plastic material that is transparent and much more natural-looking.

The good news is that you do have options to improve the look of your smile. But it’s all about choosing the right dentist. Be sure to ask about cases that are similar to yours and ask to see their portfolio of work. If the surrounding teeth are in good shape and you’re solely interested in replacing the front tooth, a dental implant may be the best choice. It is a permanent tooth replacement that looks, feels, and functions just like your natural teeth. Dental implants are expensive. And they are not fully covered by insurance. A partial denture is less expensive. When they are done by the right dentist, a partial can be made to look beautiful. So don’t completely rule them out if they are done by another dentist.

You may also require a combination of treatments. If you are looking for a smile makeover, than porcelain veneers incorporated with a dental implant, may work really nicely. It’s all about finding the best cosmetic dentist in your area. Because all of these treatment would need to blend in with one another.

Bottom line. It sounds like you’ve given your current dentist a fair chance and he has fallen short. Consult with a cosmetic dentist or an implant dentist with a heavy focus on aesthetics.

Hopefully this has provided some options you would like to consider.

This post is sponsored by Cleveland dentist Hylan Dental Care.

 

Of course I’m allergic to the Maryland bridge that was just put in…

I had to have one of my lower incisors extracted because my gums had deeply receded. The dentist placed a Maryland bridge to replace the tooth. Bad news. I’m allergic to it. I have been told that there is not enough room to place a dental implant. So, when I visited the periodontist, he was suggesting that the tooth next to the site be removed as well. Then, they will replace it with one tooth. I feel like this is an absurd solution. I’ll look ridiculous! Any other ideas?

-Cindy in Wisconsin

Cindy,

Sometimes dental professionals don’t think about aesthetics or what the patient really wants to live with. They are purely thinking about function. How about having one dental implant to support two teeth? This has been done before and works well under circumstances like yours. Discuss this option with your dentist. But if he or she doesn’t seem receptive, you may want to consult with another implant dentist that is more experienced.

Also, sorry to hear that you are allergic. The bonded porcelain tooth in a Maryland bridge is bonded to the metal framework. When the sides of the bridge are bonded to the surrounding teeth, there is metal in those portions. The metal must be etched for it to be successful. It is difficult to determine what you are allergic to within those metal components.

It is possible to create an etchable surface out of tin. The metal would be plated with tin. When that step is taken, a semi-precious alloy like palladium or silver can be used. Both of these materials are hypoallergenic. This could be a possibility for you.

Still another option for when you are missing one tooth would be to have a dental bridge made out of zirconia. This metal oxide is a compound of metal zirconium and oxygen. It is incredibly strongĀ  and looks similar to porcelain. It can be bonded successfully and the best news is that it looks beautiful. When the restoration is complete, the bridge will blend in naturally and appear lifelike. No one will know you’re missing a tooth.

Hopefully this provides you with some possible treatment options beyond having the space filled with one large tooth. Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

What do I do about this dental emergency while I’m pregnant?

I am pretty far along in my pregnancy, almost 34 weeks. I woke up with an absolutely horrendous toothache. I was trying to wait it out until after my baby is born, but I cannot take it anymore. So I went into an emergency dentist. He wants to do a root canal. But I am nervous it is not safe while I’m pregnant. He said it was safe, but I need to be sure even though I’m in pain! I could never live with myself if something happened to my baby because I made the wrong decision.

-Loretta in Texas

Loretta,

It is a good idea to put off any kind of cosmetic or elective dental treatment during pregnancy. But a dental emergency should not be put off! A root canal needs to be done as soon as possible because it is possible that the infection could spread. If that happens it could cause serious risk to you and your unborn child.

Generally speaking, the later you are in your pregnancy, it is better for invasive dental treatment. This is because the vital organs, etc. have already been developed. But since you are in your third trimester, you may have some issue with laying down on your back for extended periods of time. Discuss it further with your dentist to determine the urgency of your individual situation. It is possible some sort of temporary treatment may help if you cannot tolerate the root canal or you simply aren’t comfortable.

The biggest concern of having a root canal performed during pregnancy is that often times an antibiotic is prescribed to help eliminate the infection. That said, there are safe antibiotics like penicillin, amoxicillin, and clindamycin. Have your dentist and OB collaborate with one another to figure out the best medications, if they are required. Also, x-rays are not encouraged during pregnancy. In some cases an x-ray is advised when getting a root canal treatment. This will give the dentist a more complete picture of what is going on. You may find comfort in the fact that the American College of Radiology has endorsed that there is not enough radiation in a single x-ray to cause a fetus any harm.

The bottom line is that it is your call. If you are still unsure, it would be wise to discuss your options with your doctor before moving forward. But you need to get that pain under control or that alone may caused increased stress and cause issues. Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Confused about needing a crown after root canal?

My question is about one of my molar teeth. It had a root canal on it over five years ago. When the root canal treatment was completed, he put a filling on the tooth. Now, at my regular cleaning and exam, I was told I need a crown with posts. Is this really required? I would think a new filling would address the problem. Why wasn’t a crown done in the first place if he knew the filling wouldn’t last long?

– Silvia in Michigan

Silvia,

It is a bit unusual that the dental crown wasn’t originally placed when the root canal was done. Not every root canal requires a crown. Yet typically if the root canal was done on a molar tooth, a crown makes the most sense. Front tooth crowns may weaken the overall structure of the tooth after a root canal. So in those instances, a crown doesn’t always make sense. This is due to the fact that a root canal will make the tooth brittle and more susceptible to breaking. Since molar teeth are exposed to much more intense chewing force, a crown is appropriate.

So, at this point, it would be in your best interest to move forward with the crown. Also, a post may be required if there isn’t much natural tooth structure remaining. If there is sufficient tooth structure, you may not require a post.

Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is a CT scan required before dental implants?

I am just starting the dental implants process. My dentist told me that the next steps are some x-rays and then a CT scan. I recently had x-rays done at my regular dentist. I am trying to limit my exposure to radiation since I just had another set done earlier this year for another health issue. I would think the recent ones at my dentist would suffice. When I asked the implant dentist if they CT scan and x-rays were a requirement, I felt like the office gal tried to put me off with a generic response.

– Jeff in Indiana

Jeff,

A CT scan is a very valuable tool to an implant dentist. So technically it’s not a requirement. But most successful implant dentists highly recommend them. A 3D scan will provide the implant dentist and oral surgeon with highly sophisticated images of the anatomy of your jaw, teeth, sinus and naval cavity. Also, the imaging will reveal the areas where your bone density is greatest. This innovative technology will ensure the dentist to select the proper dental implant placement based on your unique case.

If you opt to skip the CT scan, the risk for dental implant failure is much higher. There is no shortage of horror stories where implants have pierced the sinus cavity or impinged upon nerve endings that may have been otherwise revealed. Wouldn’t you want your dentist to use all the “tools in the toolbox” when it comes to your treatment?

You also may not realize that when x-rays are administered by a dentist or other health care professionals, every effort is taken to minimize your exposure. Newer technology in x-rays also minimizes your direct exposure. So it is quite possible you have received far less exposure than you imagine. That said, you have a valid concern. Discuss it with your doctor. He or she will likely explain that your recent x-rays were taken to show decay and may not reveal the anatomy that is required for successful dental implant placement.

It’s up to you, of course. You may regret the potential for additional expense and complications that you may encounter if you skip it. Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Is low price a red flag with dental implants?

I have been on the search for dental implants that I can actually afford. I understand that they are expensive for a reason. So I’m not looking to cut corners and end up with a bunch of problems. Trust me, I’ve seen plenty of dental implant horror stories in my research. I’m just looking for the best, most affordable fees for quality implants. I just received a cost estimate from a local implant dentist that is coming in at about half of what other dentists in my area have offered. Is this a red flag? This new dentist has said the other dentists in our area are over-priced. I’m not sure what to do?

-Leslie in Oregon

Leslie,

Something isn’t adding up and it sounds like you are skeptical for a reason. Dental implants are expensive. There are multiple phases, appointments, and doctors involved. An implant dentist requires extensive training to be successful. It sounds like quality is important to you. So, you need to be very careful when price shopping for cheap dental implants. Some dentists will not only cut corners, but will obtain cheap components from third world countries to keep costs down. Implant dentistry is all about trust. Shift your mindset to researching a dentist’s credentials, experience, and cases he or she has done that are similar to yours. If you end up going with the lesser expensive treatment, you may end up paying for it in the long run and they will end up more expensive.

Skill and experience level, as well as the staff involved with the procedure also come into play with the final fees. So when a dentist comes in at half price, something is fishy.

Are you sure you’re comparing apples to apples? Is it possible the new dentist’s estimate was for mini implants? You could also inquire about the billing codes that were used to come up with the fees. Then you will have a direct comparison to your other quotes. If the codes differ, they are not offering the same treatments. Obtaining the codes may also help you to determine if the products and components are from a reputable, FDA-compliant company in the US or if they are from overseas.

You are smart to be doing this research upfront.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Why can’t my teenage daughter get a dental implant?

My daughter has grown up with a missing tooth. She is a teenager now and you can definitely see it when she laughs or smiles. It breaks my heart that she is self conscious about it. It wasn’t knocked out or anything, her permanent tooth never came in. She desperately wants to get it fixed with a false tooth. When we talked about it with our dentist, he told her no. He said she may not be done growing. I want to do what’s right and best for her. But I cannot seem to help her move past this. She is devastated and embarrassed and won’t take no for an answer. Can I try a different dentist?

-Karen in Wisconsin

Karen,

I don’t have to tell you how tough teenagers can be. Especially, one that is having a cosmetic issue they are convinced is the solution to her problem. Your dentist diagnosed the situation properly. It is important that your daughter’s jaw is completely done growing for the dental implant to be successful. If the dental implant is placed too early, it will not expand as the jaw grows. Then, your daughter may potentially have serious problems down the road.

A dental implant is indeed the best treatment to replace a missing tooth. It just sounds like the timing isn’t quite right yet. She does have other options in the meantime. Have you discussed any other treatments with your dentist? A partial denture or dental bridge are possibilities for the short term. But a dental bridge will require preparing the two adjacent teeth and may not be best in the long run.

Ask your dentist for a consultation to see what he recommends for the time being. He is the most familiar with your child’s case and specific issues.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Will a sedation dentist do all the work at once?

My teeth are deteriorating and I have no one to blame but myself. I can say I’d blame it on having no extra money. But in reality, that’s only part of the story. I hate the dentist. At my last appointment, he gave me a list of things that needed to be done urgently, then things that can wait a bit. Let’s see, a couple teeth need to be extracted and others need crowns. Also, I’m supposed to get a root canal to hopefully save a tooth. I saw an ad for pain-free sedation dentistry. Now that is what I’m talking about! Do you think a sedation dentist will do all this work during one appointment?

– Carrie in Nevada

Carrie,

Based on what you have described, you could be an ideal candidate for sedation dentistry. Who wouldn’t be anxious if they were told they needed that much dental work done? Don’t talk yourself out of the care you need. A sedation dentist can help you work through it and get you back on track with regular dental care. There is also a good chance that a lot of the treatment can be done in the same appointment.

Scheduling a consultation with the sedation dentist you are interested in is the first thing that you need to do. During that time the dentist will take a look and make sure they agree with the recommendations of your previous dentist. They will also review your medical history. Or, have you asked your dentist if they provide sedation dentistry? With as much work as you require, you may consider having consultations with a few dentists to see how their recommendations and cost estimates compare.

Then, when you give consent and select the right dentist, all treatment will involve is to take a prescribed medication prior to the appointment. You won’t be able to drive to and from the appointment. But the good news is you will likely remember nothing of the procedures. It will feel like no time has passed, kind of like you fell asleep. Oral sedation is a safe and effective. Hopefully, after you have completed this work, you will be able to keep up with preventative care to avoid costly and nerve racking experiences in the future.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Sensitivity after a tooth was pulled.

I had a tooth extraction done to remove a wisdom tooth. All went well, I didn’t think it was really that big a deal. Well, at least as big of deal as my wife was building it up to be. Anyway, a couple weeks have passed and the other day I noticed it was kind of achy near the extraction site. I had just exerted a lot of energy from starting out my workout for the first time since the procedure. Now, it seems that anytime warm food or drink comes near the area, it is very sensitive. Do I need to be concerned?

-Paul in Illinois

Paul,

It is not uncommon for their to be some aches after physical exertion. But you should not be experiencing discomfort or sensitivity to heat.

Usually, when a patient complains of sensitivity to temperature near the tooth extraction site, it is nine times out of ten, the tooth right next to it that is reacting. Sometimes, the root of the tooth near the site will become exposed and you may begin to notice it. Sensitivity to cold, as long as it’s mild, isn’t usually anything to be concerned about. All that to be said, it’s always a good idea to contact the dentist and explain what is happening. It could be a minor irritation from the recent procedure.

But if the tooth is having trouble tolerating heat, the pulp inside of the tooth could be dying. Usually, a toothache will be the outcome and eventually a root canal may be required to save the tooth. Your dentist will be able to check things out and see if there is cause for concern. Thank you for your question. Hopefully it turns out to be nothing serious.

This post is sponsored by Cleveland dentist Hylan Dental Care.