Recently I had three crowns to be put on the three already root canaled teeth. My gum around the teeth is a bit in pain when i touch it and the side of my head which has crown feels numb. Please help. Lisa
Dr Marcarian I would start by going back to see the dentist who put the crowns in for you to check your gums. There could be many other reasons why your gums are painful, and your dentist should be able to help you.
Could you please explain to me what exactly Crown Lengthening involves and the reason for this procedure?
Debi, MO
Dr. Atcha: Often when a tooth fractures below the gum line or has a very large filling and your dentist has recommended a crown to restore the tooth to normal function a crown-lengthening procedure is often required to ensure adequate tooth structure is present for the retention and the longevity of the crown. This procedure involves the removal and re-contouring of the gum and bone surrounding the tooth. This provides your dentist with sufficient tooth to work with in order to place the crown so that it will have a better chance of being retained on the tooth and to allow the gum tissues to be healthy. Not all teeth that need crowns requires crown lengthening procedure.
My husband has been told that his gums are receeding. He's always had beautiful teeth. His alcohol intake has increased and I'm asking if this could contribute to gum and teeth health?
Dr Fields: Bonnie, your husband's receeding gums may be indirectly related to alcohol. Two things:
1. Alcohol, like tobacco, is a known irritant to gum tissue and will cause recession by itself.
2. Because alcohol is heavily carbohydrate, and carbbohydrate build-up causes dental problems, it may be causing this problem.
One of the biggest misconceptions concerning periodontal disease is that the dentist will control it. Bacteria is the culprit. Bacteria are present in everyone’s mouth and some bacteria are more aggressive than others. Unlike other infections, there is no antibiotic that is effective since there are multiple strains of bacteria that cause the disease. Periodontal disease is the most common disease in the world, and it is estimated that 70% of the population in this country have it.
The responsibility of controlling Periodontal Disease rests completely on the PATIENT! Treatment of gum disease by the doctor is important, but so often, patients do not understand the importance of and perform the diligent home care regimen they should to help control the disease.
What happens on a daily basis is that. plaque (or daily build-up on the teeth) and the toxins produced by the plaque must be controlled with careful daily brushing and flossing along with continuing care in the dental office. The plaque build –up hardens into tartar which harbors damaging bacteria in the gums and around your teeth. This results in massive bone loss and eventual loss of teeth.
The sad part is once a person has been diagnosed with gum disease, they will have it forever. There is no cure! The disease can only be controlled and should be evaluated at regular intervals so as not to progress to the point of loosing teeth.
So be diligent in taking care of your teeth and gums and see your dentist on a regular basis to avoid being in the 70% population that will have this disease for the rest of their lives. Again, the responsibility lies with an educated patient and a good dentist
If given a choice most people would say that they would rather be healthy than not, unfortunately, unlike general health, most people can’t tell if they are dentally healthy or not. This is because dental health rarely hurts. If you have the flu, you know that there is something wrong and you take the proper steps to treat yourself. This is not the case when it comes to your oral health. More than 80% of the entire population is living with a chronic oral infection, and most have absolutely no idea what is going on in their mouths right now. It’s not that they’ve never been to the dentist or that they don’t brush their teeth. So what’s going on here?
The cause of all these dental problems is well known and well understood! It’s just rarely well communicated to you, the patient. The cause is quite simply, an infection. A chronic, low grade, painless oral infection that over time destroys everything it comes into contact with—teeth, gums, and jawbone!
We’re well aware of the fact that we can have many serious health problems going on in our bodies at any given time. Generally people are unaware of these problems because they outwardly appear to be just fine. People rarely notice such things as; high blood pressure, clogged arteries, glaucoma, or the early stages of diseases like diabetes or cancer. The same thing is true of dental diseases, except that people are not nearly as well informed about dental health as they are about medical health. While the vast majority of us suffer from this chronic dental information to one degree or another, but the most of us are completely unaware of it! Fortunately, unlike many painless diseases, it’s easy to diagnose and responds well to treatment in nearly all cases.
I’m sure you’re familiar with the damage caused by this infectious disease; cavities and tooth decay, abscesses and toothaches, tender inflamed bleeding gums, gum pockets, gingivitis, loose or shifting teeth, periodontal disease, sensitive teeth, bad breath, and tartar buildup just too mention a few!
Oral infection is simply too many germs in all the wrong places—the pits, fissures, grooves, and the cracks and crevices of teeth; or underneath leaky unsealed fillings as well as in the cavities and gum pockets (gums form a turtleneck collar around each tooth, the space between the gum and tooth-where all the germs and popcorn kernels hide is call a “pocket”) and even inside our gums and bone. The germs start on the surfaces of our teeth and in our gum pocket spaces, and then (this is the part most people don’t realize) the germs infiltrate into the lining of our gum tissue itself! Unless the germs and the diseased layer of gum tissue they live in are removed, they will slowly wreak havoc in our mouths.
Dental disease is similar to what our bodies would be like without bathing. If we were to stop bathing, over time our skin would become more and more dirty, smelly, inflamed, raw, and even ulcerated and infected as the germs continued multiply and entrench themselves. The same thing happens in our mouths, only worse because there are so many more nooks, crannies, and recesses for the germs to hide in our mouths compared to our relatively smooth bodies. Thankfully, just as skin is easy to restore to health with proper hygiene, so are our mouths!
In medicine, we strive for prevention, but we know far less about preventing medical diseases then we know about preventing dental diseases. In dentistry, we know an infection is the cause of the problems, and we have proven ways to control the infection. As a result we’re quite successful in preventing the damage to out teeth, gums, and bone that the infection causes.
About the word prevention, it’s probably the most misunderstood and misused word in dentistry. Many patients come to me with a full-blown infection silently destroying their mouths, thinking everything is fine, and mainly interested in “prevention”. Think about that for a minute! Isn’t it a little late for “prevention” if you already have something? The problem is, they’re unaware they have something because nothing hurts and nothing’s broken. The patient wants to prevent needing filling, root canals, etc. Getting rid of the infection would indeed prevent these things but they first need to realize that an infection causes these problems. They must also realize that they have this infection, that they need treatment to get rid of the infection, and that they need to prevent the infection from coming back. This is where I come in.
Am I more likely to get Periodontal Disease now that I am over 55?
Dr. Pasch: Statistically,
Most patients are diagnosed with periodontal disease after 35 years of age.
The rates are approximately, 15% at 10 years of age, 38% at 20 years of age, 46% at 35 years of age and 54% at age fifty.
Males are more affected than females and the severity of disease is usually worse.
However, your dentist will encourage you to maintain preventative measures mentioned previously, that will help you manage and potentially prevent progression or recurrence of gum disease if you remain diligent.
Dr. Pasch: The most important factor of Periodontal Disease is improper oral hygiene, however, there are other factors that may also contribute to the disease. These factors include hereditary predisposition and hormonal imbalances of different types, diabetes, pregnancy, emotional stress and tension, thyroid problems, impacted food particles, smoking or chewing tobacco, poorly aligned teeth, poorly fitting caps (crowns), bridges or partial dentures, grinding of teeth, poor nutrition, anti-epilepsy drugs, steroids or anti-cancer drugs.
Dr. Pash: A good oral hygiene routine practices for a few minutes twice a day can help reduce your risk of developing periodontal diseases and tooth decay.
Brush your teeth twice a day with a fluoride toothpaste. With thorough brushing, you can remove plaque from the inner, outer and chewing surfaces of each tooth. Your dentist or dental hygienist can show you a proper brushing technique.
Clean between teeth once a day with dental floss or another interdental cleaner to remove plaque and debris from areas your toothbrush can’t reach. Daily cleaning helps keep the plaque under control and reduces tartar formation, but it won’t completely prevent it.
If you need extra help controlling gingivitis and plaque that forms above the gum line, your dentist may recommend using an antimicrobial mouthrinse as an addition to your daily oral care routine.
Eat a balanced and health diet.
Visit your dentist at regular intervals and see the hygienist for cleanings at regular intervals as well. Having your teeth cleaned regularly at the dental office to reduce plaque and remove calculus from places your toothbrush and floss may have missed is essential. Professional cleanings are the only way to remove tartar, which traps bacteria along the gum line. Your dentist may also recommend more frequent checkups.
If you use tobacco, it is important to understand that tobacco contains chemicals that can slow the healing process and make the treatment results less predictable. People who smoke or chew tobacco are more likely to have periodontal diseases.
Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or from recurring. It just takes a few minutes twice a day to care for your teeth and gums.
You don’t have to lose teeth to periodontal diseases. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for optimal results and healthy smiles.
"Will my Dentist be able to treat my Periodontal Disease?"
Dr. Pasch: Periodontal treatment methods depend upon the type and severity of the disease. If the disease is caught very early (gingivitis), and no damage has been done, you may simply be given instructions on improving your daily oral hygiene.
The first non-surgical step usually involves a special cleaning, called scaling and root planning, to remove plaque and tartar deposits on the tooth and root surfaces. This procedure helps gum tissue to heal and pockets to shrink. This is sometimes referred to as "periodontal" or "deep cleaning" and may take more than one visit.
Your dentist also may recommend medications to help control infection and pain, or to aid healing. These medications could include a pill, a mouthrinse, or a substance that the dentist places directly in the periodontal pocket after scaling and root planing. Your dentist may also stress the need to control any related systemic disease, like diabetes.
At the next visit, the dentist checks the pocket depth to determine the effect of the scaling and root planning. If the disease has advanced to the point where the periodontal pockets are deep and the supporting bone is lost, surgery may be necessary.
More specifically, when the sulcus (groove or furrow), develops deep pockets, it is difficult to completely remove plaque and tarter even with thorough daily oral hygiene. If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce the pocket depth and make teeth easier to deep clean. Surgery allows the dentist to access hard-to-reach areas that require the removal of tartar and plaque. The gums are sutured back into place or into a new position to make tissue snug around the tooth.
Bone surgery, including bone grafts, may be used to rebuild or reshape bone destroyed by periodontal disease. Splints, bite guards or other appliances may be used to stabilize loose teeth and to aid the regeneration of tissue during healing. If excessive gum tissue has been lost, a gum graft may be performed.
After surgery, the dentist may apply a protective dressing over teeth and gums and a special mouthrinse may be recommended or prescribed. An antibiotic and mild pain reliever also may be prescribed.
Dr. Pasch: The word periodontal literally means “around the tooth Healthy gum tissue fits like a cuff around each tooth. Where the gum line meets the tooth, it forms a slight v-shaped crevice called a sulcus. In healthy teeth, this space is usually three millimeters or less.
Periodontal diseases are infections that affect the tissues and bone that support teeth. As the tissues are damaged, the sulcus develops into a pocket that is greater than three millimeters. Generally, the more severe the disease, the greater the pocket depth and bone loss. The enlarged pockets allow harmful bacteria to grow and make it difficult to effectively clean. Left untreated, periodontal diseases may eventually lead to tooth loss.
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Recently I had three crowns to be put on the three already root canaled teeth. My gum around the teeth is a bit in pain when i touch it and the side of my head which has crown feels numb. Please help.
