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Gum around front crown reddens and swells overnight but calms down during day

A

AlwaysAnxious

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Hi, I’m not sure what’s going on. I have some gum redness and swelling around a 3year old front crown. When I wake up in the mornings it’s red & swollen. During the day it seems to go down and almost looks normal. Then overnight it returns again. It’s causing me so much anxiety. It’s been going on 6 months. Dentist not concerned but she is very blasé …
I floss, I use Colgate total with the antibacterial, I use listerine mouthwash, I’ve tried savacol … when I press on the crown there is more feeling than other crowns but nothing painful.
I’ve had several X-rays - nothing detected.
Why is my gum doing this?!
 
Gordon

Gordon

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Any chance of a photo when it's red and swollen. Otherwise there's not much to go on with I'm afraid. What kind of crown is it?
 
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I’ll take a photo tomorrow morning in the light!
 
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Here’s a photo. Margins have all been checked several times - there’s no rogue cement from the crown. Could this frown be interfering with the ‘biological width’?
 

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AlwaysAnxious

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Another photo
 

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A

AlwaysAnxious

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Further info:
My mouth is always very dry in the morning and I clench my teeth. But I can’t work out why any of that would affect just one area of gum? Sorry I am very anxious. Can’t afford a perio this side of Xmas ?
 
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AlwaysAnxious

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Update: the more I read from dental journals the more it sounds like the biological width has been violated. I only noticed the red/swollen gum 6 months ago because I was going through a severe period of anxiety (health anxieties are my worst) so it could have been there the whole time… There’s no other rhyme or reason for the gum. I get regular dental cleans, I clean 2-3 times a day, use mouthwash, and floss.
If it IS biological width violation what will happen? ??
 
Gordon

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If it was a biologic width issue (which is controversial amongst dentists) then I'd expect it to be swollen and red all the time, not just waking in the morning...
What kind of crown is it? All porcelain, porcelain fused to metal? Could be some kind of weird reaction to the metal base but why during the night??
Sometimes front teeth dehydrate overnight, well the gums do. Happens if somebody has a slightly short upper lip and mouth breath in their sleep, this can cause a bit of inflammation but again I'd kind of expect that to affect more than just one tooth!
Whatever is going on, you're absolutely NOT going to lose any teeth over it, if that's any consolation.
 
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superjen

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I actually just saw a dentist on this issue today on a new crown. He suggested to stop all dental products and brush gently with water only for a few days. He feels some newer toothpastes have products in them to make their good effects stick on the teeth longer, but sometimes it's too much for some people's gums to handle.
I hope you feel better soon.
 
A

AlwaysAnxious

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I actually just saw a dentist on this issue today on a new crown. He suggested to stop all dental products and brush gently with water only for a few days. He feels some newer toothpastes have products in them to make their good effects stick on the teeth longer, but sometimes it's too much for some people's gums to handle.
I hope you feel better soon.
Wow really? Can you keep me updated on how it all goes? I’ve had it for 6 red/swollen for 6 months now ?
 
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If it was a biologic width issue (which is controversial amongst dentists) then I'd expect it to be swollen and red all the time, not just waking in the morning...
What kind of crown is it? All porcelain, porcelain fused to metal? Could be some kind of weird reaction to the metal base but why during the night??
Sometimes front teeth dehydrate overnight, well the gums do. Happens if somebody has a slightly short upper lip and mouth breath in their sleep, this can cause a bit of inflammation but again I'd kind of expect that to affect more than just one tooth!
Whatever is going on, you're absolutely NOT going to lose any teeth over it, if that's any consolation.
Thank you Gordon! It’s still swollen/red during the day, just a bit less so. It makes me wonder - could it be the fact that I am upright during the day and so helping the swelling subside?!
And you say the biological width violation thought is not something all dentists agree on?
 
Gordon

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Yes, the biologic width stuff is quite controversial amongst dentists.

I doubt if your vertical alignment has much effect :)

WHAT KIND OF CROWN IS IT? for the 3rd time!!!

How long has it been there for?

Reading back over this, I'd stop the Listerine and change from the Colgate paste, I don't like Listerine at all, far too much alcohol in it and it's a waste of time anyway, some people are sensitive to the higher level of SLS in Colgate pastes, so try something blander like Sensodyne.
 
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AlwaysAnxious

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Shoot sorry! It’s porcelain, no metal.

Happy to try sensodyne! Fingers crossed
 
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And I’ll drop the mouthwash for a bit!

Haha well it was worth asking the question about vertical v horizontal. I guess ?‍♀️?
 
Gordon

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Good to know. All porcelain would rule out some kind of allergic reaction, porcelain is completely inert biologically.

The other thing I'd maybe try is change from floss to something like a TePe brush, just in case you're irritating something with the floss when you use it at night time (assuming you do floss before bedtime? Some folks don't (the current Mrs Gordon for example) :)
 
A

AlwaysAnxious

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Thanks Gordon! It’s pretty tight bw my crowns and I often end up stabbing my gums. My natural teeth are much easier to use the Tepe brushes (piksters here). Should I be concerned that there’s more sensation in that tooth with the inflamed gum? It doesn’t hurt but if I press on it there’s pressure
 
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AlwaysAnxious

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I mean obviously there’s pressure but just more sensation than any other teeth.
It is worrying me.
 
Gordon

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No, I wouldn't worry about that right now. Has the dentist taken any x-rays of it since you noticed it?
 
A

AlwaysAnxious

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Yep nothing is showing on them! I feel like something sinister us lurking and about to happen. I am obsessing. Thanks for your communication, it helps a lot!
 
Gordon

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Nope, it's nothing sinister and nothing bad is about to happen.
 
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