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

[superjen]

AlwaysAnxious I seem to be having luck on calming down the gum over my crown brushing gently with only water, avoiding brushing that area on the gums at all, dabbling magic mouthwash on the sore gum (lidocaine, benedryl and maalox) and taking a benedryl at night. At this point I'm thinking I could be allergic to something I was using. The crown is porcelin only, and I have another crown which had not had this issue. I did take a steroid burst pack for a week, but the tooth really didn't feel better until I stopped hitting the gum with the brush.

My dentist has given me a host of other options to try- antibiotics, a chlorine dioxide gel called oxyfresh, vitamin supplements for gum health, but I think I'm going to pause without trying anything else to see if the stuff above continues to allow me to heal.

I hope your gum area is improving!

 

[AlwaysAnxious]

AlwaysAnxious I seem to be having luck on calming down the gum over my crown brushing gently with only water, avoiding brushing that area on the gums at all, dabbling magic mouthwash on the sore gum (lidocaine, benedryl and maalox) and taking a benedryl at night. At this point I'm thinking I could be allergic to something I was using. The crown is porcelin only, and I have another crown which had not had this issue. I did take a steroid burst pack for a week, but the tooth really didn't feel better until I stopped hitting the gum with the brush.

My dentist has given me a host of other options to try- antibiotics, a chlorine dioxide gel called oxyfresh, vitamin supplements for gum health, but I think I'm going to pause without trying anything else to see if the stuff above continues to allow me to heal.

I hope your gum area is improving!

Thank you so much! No improvement for me which is of course freaking me out. Im going to give what you’re doing a go. Although I don’t think I can find any of that magic mouthwash here .. Can I ask, are you flossing around that tooth?

 

[superjen]

I did not floss for a week. I just started again a few days ago. I am flossing gently.

The mouthwash is probably prescription only, but it seems common to use a mixture of the benedryl and maalox only.

 

[AlwaysAnxious]

Thank you! Did your dentist say what has caused the red gum?! I’m just so stumped. It appeared out of nowhere .. and now won’t go away.
I’ll try less attention in that area but I am worried and checking it several times a day ?

 

[superjen]

He's ruled out bacterial and fungal. His feeling is its viral or autoimmune like burning mouth syndrome, which does have an anxiety component. My feeling is it's either something infected deep in the tissues when the crown was put on, so antibotics may help, or I'm allergic to something that is hurting that area specifically because it was raw from the crown- like crown cement (he said he used bonding), toothpaste, chlorhexidine, food... Or maybe a side effect of anxiety medication that I started taking the week after the crown went on.

I go back next week. In the meantime I'm going to take benedryl meds nightly and put liquid benedryl on it. The magic mouthwash did reduce the pain by about 20%, and I wonder if it's the benedryl component that helped the most. If it doesn't go away completely then I'll try the antibotics. Then hopefully a gum specialist. Yours is more visually irritated than mine, so maybe a gum specialist would be a good idea. I also wonder if Gordon's Vaseline trick helped you at all.

I continue to brush with water only and use no pastes and that seems to make the biggest difference. I'm using a soft toddler brush and brushing gently as I read you are supposed to brush so gently that you would not take the skin off of a ripe tomato.

Good luck! I hope we both get this solved soon!

 

[AlwaysAnxious]

Hi Gordon just an update.
I tried to do gentle brushing with hardly any toothpaste and salt water rinse for 3 days. This made it worse?! It’s red all the time now.
The only thing that worked a tiny bit was chlorhexidine mouthwash but I only used this once or twice as I worried about it staining my teeth. Getting really anxious now ?

 

[Gordon]

Best guess: Since the chlorhexidine made a difference, there's some kind of bacterial involvement. I really think you need to see a periodontist to take this further.
If you get hold of Benzydamine Hydrochloride rinse, sold here as Difflam, then that's also an antiseptic like Chx but doesn't stain. Also tastes a lot better! You could give that a try? See if it also improves things?

 

[AlwaysAnxious]

Hi Gordon just an update. As you can see from photo, nothing has improved. It’s not going down at all and is consistently swollen (definitely slightly more red after a night). The chlorhexidine started to make the surrounding gums red? I stopped it. I haven’t gotten my hands on difflam. I’m in full panic mode. Nothing is working. I have a perio appt on Jan 28 but I’m worried an abscess will form any day now. I don’t know what to do and why I can fix it. My fear is the crown will have to come off, or im
Allergic to the cement used. the thought nearly sends me into a panic attack because if that’s the case I’ve got no hope … Something is clearly very wrong. I have noticed I have dry mouth. I wake up coughing/gagging because my mouth is so dry. I thought a lot of ppl just do this but apparently it’s dry mouth? Who knew. No matter how much water I drink my mouthy feels dry most of the time. I usually have some kind of mild mouth ulcer too. I still think my gum is a separate issue. Would antibiotics help? My dental hygiene is excellent, I just don’t know what is going on ?????

 

[Gordon]

You absolutely won't get an abscess. Not a chance.

I've never heard of anyone being allergic to cements so that's pretty unlikely too. Even if you were allergic to the particular one used, there are literally dozens of alternatives.

Wait for the periodontist to check it properly, anything else at this stage is pure guesswork and not likely to be helpful.

Dry mouth is something else entirely, some meds can cause it, it's also sometimes caused by an autoimmune disorder linked to rheumatoid arthritis, have you ever had anything like that?
The simplest explanation could be that you're nose is a bit blocked up (allergies?) and you're mouth breathing more than usual.

 

[AlwaysAnxious]

Hi gordon
Thank you so much for putting me at ease. Everything I read just says red guns lead to abscesses and it’s seems to be an end-of-world situation. I realise I shouldn’t take anything seriously online - but you know us anxious types :/
I don’t have arthritis but I didn’t know what dry mouth was and I’ve realised it’s something I’ve had for years. I just thought it was normal! I also get an itchy tongue and lips. Nothing major. I am trying to work out what that is too!
Thank you so much for helping me keep my cool.

 

[Gordon]

I just can't fathom a link between red gums and abscesses. It isn't logical Captain

Whatever is going on with that crown it's not going to cause tooth loss or lasting damage. I'll be interested in hearing from the Periodontist when they see you.

Back to your dry mouth... the itchy/burning feeling is not unusual, quite often in ladies it's linked to low iron and or hormonal disturbances. Might be worth just bumping up the amount of folic acid and Vitamin B12 in your diet. (The usual suspects, green vegetables, especially legumes like broccoli and cauliflower, bizarrely Kellogg's Special K is a really excellent source of it).

Our old friend stress is very strongly linked with this too, it seems to come and go along with stressful periods like oh, Christmas for instance

However, bizarrely I once had a patient who suffered badly from burning mouth by not being stressed enough, she had been in a very high pressure job, then retired. The BMS (Burning Mouth Syndrome) started a few months after she retired. We went through a whole battery of tests and everything was normal. She noticed that it got better over Xmas and Easter... further questioning showed that she was suddenly very busy over those periods organising huge family get togethers.

We thought that her body had become so accustomed to high stress levels that she actually came round to needing them.

 

[letsconnect]

Just to add (I'm a bit of an anorak when it comes to nutrition)... it can actually quite difficult to meet the daily recommended amounts of many vitamins through diet alone. You'd have to eat over 600g of broccoli a day to meet the folic acid (B6) requirement for an adult under the age of 50 (of course, that does not take into account the B6 you get from other foods). Special K and some other cereals are very good for B6 and B12, as those vitamins have been added.

When it comes to B12, this is not actually found in plant-based foods. So if you are eating a vegan diet, it's really important to take a B12 supplement or consume enough fortified products such as cereals and plant milk and yoghurts (many, but not all of them, have Vitamin B12 added - so check the nutritional info on the packaging. Some foods high in B12 include clams, liver, trout, and salmon.

So if you're really low on folic acid/B12, a vitamin supplement may be the best way forward... just make sure they're not quacky ultra-high-dose B6 (folic acid) ones. With B12, it's virtually impossible to overdose.

I just can't fathom a link between red gums and abscesses. It isn't logical Captain

Me neither... Funnily enough, even the NHS website says: "Symptoms of an abscess in your tooth or gum may include: • shiny, red and swollen gums", but maybe what they actually mean is the redness and swelling when a collection of pus forms? Who knows! Totally off-topic, but this reminds me of an article I came across the other day (it's quite old, from May, but really interesting):

The 60-Year-Old Scientific Screwup That Helped Covid Kill

All pandemic long, scientists brawled over how the virus spreads. Droplets! No, aerosols! At the heart of the fight was a teensy error with huge consequences.

www.wired.com

 

[Gordon]

Thanks Lets. I was totally spoiled in my last job because I had a tame dietician who was very interested in dental matters and I used to just send patients round her way if they had any diet related issues.
I think they mean shiny red appearance as above the root of the tooth when an abscess is bursting out through the boney plate into the mucosa above it. Totally different thing from the issue here.

I enjoyed that article. Well done for finding it

 

[AlwaysAnxious]

Just to add (I'm a bit of an anorak when it comes to nutrition)... it can actually quite difficult to meet the daily recommended amounts of many vitamins through diet alone. You'd have to eat over 600g of broccoli a day to meet the folic acid (B6) requirement for an adult under the age of 50 (of course, that does not take into account the B6 you get from other foods). Special K and some other cereals are very good for B6 and B12, as those vitamins have been added.

When it comes to B12, this is not actually found in plant-based foods. So if you are eating a vegan diet, it's really important to take a B12 supplement or consume enough fortified products such as cereals and plant milk and yoghurts (many, but not all of them, have Vitamin B12 added - so check the nutritional info on the packaging. Some foods high in B12 include clams, liver, trout, and salmon.

So if you're really low on folic acid/B12, a vitamin supplement may be the best way forward... just make sure they're not quacky ultra-high-dose B6 (folic acid) ones. With B12, it's virtually impossible to overdose.



Me neither... Funnily enough, even the NHS website says: "Symptoms of an abscess in your tooth or gum may include: • shiny, red and swollen gums", but maybe what they actually mean is the redness and swelling when a collection of pus forms? Who knows! Totally off-topic, but this reminds me of an article I came across the other day (it's quite old, from May, but really interesting):

The 60-Year-Old Scientific Screwup That Helped Covid Kill

All pandemic long, scientists brawled over how the virus spreads. Droplets! No, aerosols! At the heart of the fight was a teensy error with huge consequences.

www.wired.com

Yes! That’s what I’ve been reading - ‘shiny red swollen gum’ means an abscess! It’s been stressing me out no end because that’s what I’ve got.
Thank you so much for clarifying.
I am definitely going to look into the vitamin B info you’ve provided. Thank you for that too.
I’ll let you know what the perio says at the end of Jan. *stress *

 

[superjen]

So sorry that you have to wait that long.

 

[letsconnect]

I'm not too sure how much scientific evidence there is for B vitamins and gum inflammation? Must look that up sometime... There does seem to be a fair amount of support for vitamin D deficiency impacting on gums though, so that might be worth checking out. Hardly anyone gets enough vit D over the winter months (actually I got quite a shock the other day being tested for Vitamin D levels because of another condition - I'd been taking quite high doses for a number of years and expected to be told off, but no - the vitamin D level was only just above the bare minimum ? - so now I've been prescribed a REALLY high dose supplement...). Might be worth checking out.

Let us know what transpires when you see the periodontist! Best of luck and a very Happy New Year to you!

 

[letsconnect]

I enjoyed that article. Well done for finding it

I didn't have to look too hard - someone sent me an iMessage with the link to the article... Glad you enjoyed it - I thought it was fascinating

 

[Gordon]

I didn't have to look too hard - someone sent me an iMessage with the link to the article... Glad you enjoyed it - I thought it was fascinating

 

[Gordon]

I'm not too sure how much scientific evidence there is for B vitamins and gum inflammation?

There isn't, we were talking about itching/burning mucosa in general, for which there is a lot of evidence linking to low serum folate and B12 levels.

Must look that up sometime... There does seem to be a fair amount of support for vitamin D deficiency impacting on gums though, so that might be worth checking out. Hardly anyone gets enough vit D over the winter months (actually I got quite a shock the other day being tested for Vitamin D levels because of another condition - I'd been taking quite high doses for a number of years and expected to be told off, but no - the vitamin D level was only just above the bare minimum ? - so now I've been prescribed a REALLY high dose supplement...). Might be worth checking out.

Vit C deficiency obviously is very strongly implicated in gum issues, Scurvy! I reckon D must be involved too, since we're talking about boney issues and Vit D is vital for bone health.
Not really relevant to AlwaysAnxious' issue since it's absolutely a gingival issue here and not related to bone as far as we can tell.

We've both been taking Vit D supplements for a few years now, I started on it as a way to control my psoriasis, Janice started after she broke her wrist a few years back. Oddly enough I have to cut back the supplement in summer, presumably because my body is making more of its own, there's a "correct" level for my skin health.

Let us know what transpires when you see the periodontist! Best of luck and a very Happy New Year to you!

Yes please do. Sorry for hijacking the thread a bit.