Category Archives: Dental Crown

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.

My crown keeps coming off.

I have had to get my dental crown re-cemented three times. It keeps coming off after about a week. My dentist has decided there is really nothing left to do to fix it. He asked me to think about getting a dental implant. But will I just have the same problem with the implant crown falling off? Do you know if there is a different kind of crown that will do the trick?

– Gordon in Iowa

Gordon,

What you have described is very rare. If a dental crown is properly placed it will not fall off. It may be time to begin seeking another opinion from a different dentist. And if you decide to go that route, than it may be in your best interest to research and find an experienced cosmetic dentist. As far as your question about the dental implant, I would again seek another opinion. If this current dentist can’t place a crown properly, you really don’t want to take your chances with a dental implant. Dental implant failure is all too common from dentists that attempt to cut corners or save on costs.

A well placed crown is highly dependent on quality tooth preparation. If the shape of the tooth is too tapered than the crown will have difficulty staying in place. So that could be what happened in your situation. Again, a cosmetic dentist will be familiar with the technology required to properly bond the crown to the tooth, whether it is metal, porcelain, or some other material.

Good  luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Do I really need a root canal?

I just went to the dentist for my first filling. I’m not going to lie, I was a little bit anxious because he told me the filling was deep. When the drilling was going on I felt a sharp “zing” several times so he decided to give me another shot. That means I had a total of three shots. Although, the pain wasn’t really bad it just made me anticipate more pain. The dentist ended up leaving some of the decay and putting in a temporary filling and told me that I need a root canal. Do you think I really need to get a root canal or maybe they are over treating me because I felt some sharp pain?

– Jerry in Louisiana

Jerry,

Having to be told you need a root canal when you are only expecting a filling is a bit unnerving. The typical treatment plan when you need to have a filling is to get x-rays because the dentist can usually tell a lot from the x-ray. There is always a possibility that the x-ray may not reveal the need for a root canal and it can be discovered during the drilling. This is because the dentist may have had to do more drilling than what was first anticipated on the x-ray. What has likely happened to you is that during the drilling process the dentist realized that the decay has reached the pulp or nerve center of the tooth. This section is called the pulp chamber and it is also possible that you required more numbing shots because an infection may have already been starting. It is sometimes more difficult to numb the tooth when this happens.

Try not to stress about the root canal treatment. It is more complex than a filling and takes longer but is a routine treatment. There is nothing to be concerned about. Pretty much what is going to happen is that the decay will be removed and they will also remove the nerves inside the tooth root. Then the roots are sanitized and filled with some dental material. This process seals off the root section of the tooth. Then you will likely be prescribed an antibiotic to take care of the tooth infection. After the root canal treatment has been completed, you will need a dental crown. This will protect the tooth from any future breaking because there is no longer a blood flow to the tooth since the roots have been removed. The crown provides extra strength and protection.

If you are extremely anxious or nervous, you can ask your dentist about sedation dentistry. Oral sedation simply involves taking a pill before your appointment. Or if you want something stronger than Novocain but don’t want to be knocked out, you may be a candidate for nitrous oxide.

This post is sponsored by Cleveland dentist Hylan Dental Care.

I really think my dentist gave me a lousy crown. What can I do?

My dentist placed a filling in one of back molars about a year ago, but afterward I would get pieces of food stuck between that tooth and the on in front of it because for some reason there was more of a gap. I oftentimes could get floss in between the teeth to get the food out but sometimes food would not come out.

My dentist recommended a crown which I just had the crown prep done on the 15th of August. During that crown prep the hygienist had me bite down, but because she didn’t tell me to hold the bite, the mold got messed up so she had to redo that one. On the next, I made sure to keep my bite down this time, but she told me to open too soon because the mold was not set yet and immediately i had to bite back down. She said let me see if Dr. ____ thinks this is okay.

I am concerned that the original mold was done incorrectly because now that the permanent crown is in my mouth, I have a pretty much flat tooth with no real cusps on the tooth and it feels incorrect when I bite down. There is also a bulge on the inside of my tooth by my gums like a bubble was formed from the rebite. I really don’t think that the dentist is willing to do much about it, but I am going to speak with him today again. Can this be fixed and is he liable to make it correct?
– Crystal from Wisconsin

Crystal,
It does indeed sound like there is a real problem with this crown, and that you need to get a second opinion.

Keep in mind that we haven’t seen the situation in your mouth ourselves and so I am relying entirely on what you are telling me, but what you are telling me makes sense, and it seems like something that can easily happen in a dental office.

What you are describing to me with the mold you were biting on sounds like the impression that the dentist takes in order to make the dental crown. This impression has to be absolutely accurate, because the crown has to fit the tooth precisely. If there is the slightest gap between the final crown and the tooth, that provides an opening where decay can enter, and it can also provide an irritant to the gum tissue. So if, when you opened your mouth the second time, if that was while the impression material was partially set, that impression would be distorted to one degree or another, and I’m confident Dr. Hylan would have discarded it and done it over.

The features of the crown that you are describing – the bulge on the inside by the gum, and the flat chewing surface, also do not sound healthy. I would need to look at this myself to make a correct judgment of the situation, but it is cause for me to question your treatment.

Also, the history that you are describing with this tooth – the filling a year ago that sounds like it didn’t make proper contact with the adjacent tooth, so it collected food between the teeth – that doesn’t give me much confidence in your dentist. And it makes me wonder if you really needed the crown. Maybe you did need the crown, but all these questions add up.

So yes, I would recommend getting a second opinion. I also would like to give you a piece of advice about getting a second opinion. The most accurate second opinions are what we would call “blind,” meaning that the dentist has no other information other than what he or she can perceive. So it’s best if the second dentist doesn’t know who did the work in the first place, and I would say as little as possible about the history. So I would get a recommendation of a good dentist and ask the dentist to look at this crown and give you an opinion about it. If the dentist presses you with questions about what happened, you can tell him or her that I told you not to give any history, but the dentist should just evaluate what he or she sees.

This blog is sponsored by Cleveland implant dentist Dr. Brad Hylan.
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