What does it mean when your gums are inflamed around your crown? Is it dangerous? How soon should you get it fixed?
If the gums are inflamed, then possibly the one choice a patient would have would be getting a replacement crown. Some patients don’t like to hear the word “replacement,” however because of accumulated plaque, contour of the crown itself, margin integrity or location and even metal sensitivity would almost determine that a replacement would be needed.
If you have swollen gums around crown, then it is a good indication that the location of your crown is causing the problem. What can be done about this? There are such things as “biologic width,” and “crown margin.” Just ask Dr. John Kois, periodontist and restorative specialist. All your problems with swollen gums around the crown boil down to “location.”
So let’s examine what else contributes to swollen gums around the crown:
• Accumulation of plaque –This is what causes the irritation to your gums. The best way to determine if this is the cause is by knowing your brush techniques. Do you need to brush differently? Maybe power brush? Maybe you should irrigate with an antimicrobial (an agent which kills microorganisms and prevents growth) or water. This should clear up the problem. If the tissue is still inflamed after you do this, then the problem is something else.
• Contour – There are artificial and natural crowns. The contour of an artificial should resemble that of a natural. Artificial crowns are more often associated with larger more lingual facial structures than natural crowns are. Gingival health will be compromised with slight deviations in contour if the tooth roots are too close together. The periodontists general rule of thumb is no more than one-half millimeter for the bulge in the gum and tooth area. There should always be a little room between crowns.
• Integrity of the margin – gum pain around the crown can be because margins are off. Well known dentists strive to get the perfect margins when setting a crown. But in reality no margins are perfect. Even though margins are open, if they are off too much, it allows enough room for bacteria to fully enter in.
• Location of the margin – The biologic width should not be violated by the crown’s margin. But because individuals are esthetically made different, it is important to note how far below the gingival margin that the crown margin goes. Ultimately, the margin of the crown should be at least 2.5 millimeters from the bone. If it is too close to the bone, inflammation around the bone forms in the gums.
• Metal Sensitivity – Watch out for some metals that will leach themselves out of alloys! You may be one of the 10 percent of the U.S. population that is sensitive to nickel.
What if the problem of inflammation persists after a dental cleaning? If the inflammation is localized close to the crown, sometimes the dentist will remove the crown and look at the tooth underneath. Any decay in the tooth itself can then be removed and a refitting of a proper crown will go in effect. Then you should be ready to go.
So what is the best solution to seeing red and puffy gums around the crown in your mouth? The inflammation you have could be due to bad dental hygiene, a crown poorly fitted, a crown that is loose, a cracked root, recurring decay or periodontal disease. The only and best way to know would be to contact a dentist. Your dentist can look at and examine the crown and surrounding gingiva and determine for you the reason for the inflammation. Your dentist can also recommend the necessary treatment.
In various dental practices, there is a radiograph that can be used, along with a periodontal probe which can help your dentist determine your inflammation cause. For example, if the crown is attached well and the tooth doesn’t have an intrinsic problem, your dentist might suggest getting a good dental cleaning and maintaining your dental hygiene after. Because it is after a thorough dental cleaning that patients will start to notice less general inflammation. Remember, see your dentist for regular cleaninings every six months!