Inflamed gum above crown - I can’t sleep from anxiety

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AlwaysAnxious

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hi, I am hoping for some professional guidance as I’m losing my mind to anxiety. Firstly I made a horrible mistake to get my 6 front teeth crowned in my early 20s due to poor body image. I wanted veneers but the dentist said with my rotated canines that the only way to get a neat smile was to cap all the teeth as veneers would fail. I sure wish Invisalign was accessible 15 years ago. :(
I have had a lot of gum problems and a root canal on one front incisor since the crowns. I am now extremely anxious about this red gum above the other incisor. My dentist has cleaned twice & removed plaque and said she’s not concerned but it’s been weeks and no improvement.
Can I get an opinion? I’ve had this set of crowns for around 3 years so they aren’t new!
I can’t sleep thinking about my gum.7460A10A-1469-4AFB-9A08-2D0F401FD556.jpeg
 
Gordon

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Ask for a referral to a periodontist. Can't really diagnose from a photo but if it's worrying you that much get a specialist to look at it.
 
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Thank you so much for taking the time to reply!
 
Gordon

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No worries. Has the inflammation always been there since the crowns were fitted or is this a new thing?
 
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It’s a new thing. Crowns fitted 3 years ago .. this gum has been like this for about 5 weeks. I keep getting mixed advice on how go care for it. Some say use saline solution, others say don’t. I’ve swapped from using a salt water solution to kids toothpaste just on the gum. I’m a bit lost
 
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Thanks. That rules out a bit of excess cement causing the problem :)

Let's start with basic stuff:
1: Make sure that you're cleaning the area as well as you possibly can. Use your non-brushing hand to lift your ip up out of the way so you can see what you're doing.
2: Use a good electric brush, Braun Oral B is the best available.
3: Use any adult toothpaste with Fluoride. Whatever you like the taste of
4: If you notice bleeding when you're brushing or immediately after, do NOT panic, do NOT assume you're brushing too hard or whatever. Bleeding at the moment is a good sign, it means you're getting the gums cleaned out.
5: Get hold of some TePe brushes (Amazon sell them) and carefully work them in between the teeth at the gum level. Keep the brush at 90 degrees to the tooth don't dig them up into the gum!

Lastly and this sounds a bit odd, would you be able to put up a photo of your mouth at rest, it looks like you might have a slightly short upper lip.

This can allow the gums around the front teeth to dry out a bit, which can lead to mild inflammation like you've got. Don't know why this is suddenly happening but maybe something else has changed :)

When I was a student, we used to call this "incompetent lips", it always went down well when you told a young lady that one. These days we call it "Lip Apart Posture" which is more accurate and won't get you a slap :)
 
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I think that’s just the photo! But here’s another one. Although I do find I really have go lift my top lip to get right up the top of the gum.
 

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Thank you so much. I am going to follow all of your instructions.
I am very paranoid it’s a sign of something sinister like an impending root canal which means I could have to replace my crown. (All x6 front teeth are crowns).
 
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I sometimes rest with mouth open but usually close it as i clench my jaw a lot being anxious
 

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Gordon

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No, it's not an impending root canal. Something is causing that gingival margin (the bit of gum above the edge of the crown) to be inflamed.
Since it's relatively new then it's not something fundamentally wrong with the crown I don't think, so I don't see why the crown needs replacing.

From the bottom photo, if that's your "relaxed" face, then the front teeth are slightly exposed, this can sometimes let the gum dry out a bit around the front teeth which can lead to some mild inflammation... hence why I was asking for a relaxed photo. (In case you thought I was some kind of weirdo. I mean I am a bit weird but not that way.)

Try the cleaning regime I suggested for a few days and then we'll see how it goes?
 
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Haha aren’t we all a bit weird! As a kid I used to rest with my front teeth out like a rabbit, without realising.
Thank you so much, I am following your instructions but I do need to get the Tepes (we’ve got something here called Piksters which are similar) but I’m flossing and brushing well (already used the oral b electric toothbrush) after breakfast & dinner. I guess I was a bit confused/worried as I look after my teeth so don’t know where this has come from. But I’ve been changing up how I’ve been looking after this particular gum so may have just exacerbated the issue. Also I’ve noticed that it looks more red when I wake up in the morning and then looks a little improved as the day goes on. But back to square one in the morning?!
 
Gordon

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If it's related to your short upper lip then I'd expect the gums to dry out overnight, which would lead to them looking a bit worse in the morning. We can work on that but let's see how the improved hygiene routine works out first. TePe is just a brand, I'm sure there are others on the market just as good.
 
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Hi Gordon, still no improvement. The gum doesn’t hurt and there’s no bleeding, but it just won’t get better. Still swollen and red. I am panicking every morning now. Not sure if my stress is making it worse. Is it because of my crowns that this is happening?
 
Gordon

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Stress is never great but I doubt it's having much impact. What kind of crowns are they? All porcelain or porcelain fused to metal?

You could try this to see if the gums drying out is an issue. Get hold of some vaseline petroleum gel and put a very, very little smear of it across the inflamed area when you're going to bed. Last ditch stuff but if it helps it'll give you a diagnosis.

I must stress again, you're at no danger of losing your teeth or anything due to this, it's a mild gingivitis at worst!
 
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Thanks Gordon. Straight porcelain I believe. I haven’t yet tried the vaseline yet but my dentist has said maybe it’s due to bruxism? I had a splint made a while ago but never wear it as it’s very tight and im afraid it will rip out my x6 front crowns!! Also since paying more attention to cleaning my teeth I am noticing sensitivity in my crowned teeth. Why would this be? 😩
 
Gordon

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Thanks. Sometimes you can get an allergic reaction to the metal used in porcelain fused to metal crowns, which can look a wee bit like in the photo, but you can't be allergic to porcelain.
ask the dentist to adjust the splint then, it's silly having it and not being able to use it. I don't think that's the cause of your issue though.
Sensitivity could well be because your gums have been a little bit swollen due to the gingivitis and they're shrinking back a bit now with the improved OH, this will expose a small area of root surface which can be slightly sensitive for a while.
 
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Thanks so much Gordon, you are really helping me through this.
I’m going to get the splint adjusted. My dentist is now saying she will refer me to a periodontist as she can see the inflamed gum is distressing me. Separately , a friend of mine has put me in touch with a prosthodontist and I feel that would give me a bigger picture of everything and maybe I could become a long term patient, thinking about the future crown replacements I am going to need. It makes me panic knowing I have to replace these every 10 years, or sooner if things go wrong. Anyway my appt with the prosth. is next week so I’ll let you know the outcome :((
 
Gordon

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Good idea re. the periodontist.
There's no absolute rule that crowns need replaced every 10 years. I've seen some that have gone on for much much longer. Heck my wife has 3 gold inlays that I did as a student dentist back in 1980 which are still perfectly serviceable.
 
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Lucky wife! Also brave if you were student dentist 😂
So I visited my friends friend who is a prosthodontist. He took X-rays, couldn’t see anything wrong with the tooth. He couldn’t explain the gum inflammation. He said to contact him in a month if it hadn’t resolved. It’s a week later and there’s no improvement. Im at a complete loss and still completely anxious.
On another note, can I extend the life of my front top crowns if:
- I don’t use those teeth for eating (rarely do)
- don’t snack or graze
- don’t eat very hard foods
- brush after every meal
- floss daily
- dental appts every 6 months (should I make these more regular)
Anything else?
 
Gordon

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1) Doesn't matter, they're perfectly able to stand up to regular chewing forces. Just don't do what we call parafunction, open hair clips, bottle tops, etc etc
2) Never a bad idea in general for your dental health but doesn't really matter for your crowns
3) See 1
4) Not necessary, three times a day is the most you need to do
5) Absolutely yes, or use TePe brushes daily
6) Not necessary for a lot of people, varies from 4 monthly to every other year...

As before, you have a gum issue, you need to see a periodontist rather than pros.
 
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