scaling and root planning completed...but

[Guest]

I thought I'd wait until the whole procedure was finished to report back. The procedure wasn't bad, alittle soreness the next day but not a big deal really. My gums are still sore though and I went back for the follow-up today. The gums seem to be only sore around crowns that were put on within the last six monthes. I mentioned this to the periodontist who now is considering doing a "crown lengthening procedure" due to "violation of biologic width." I went back to the general dentist and told him the periodontist's suggestion, and he said that it wasn't a good idea because it might change the crown margins and therefore I might end up worse than I am now It now is hurting every time I chew on these teeth with the permanent crowns, but the dentist says it's the gums around them and to just keep flossing and using Listerine. I don't know if I should have the crown lengthening procedure done or not ??? I don't want to damage the crown margins, but they are hurting. Any imput would be greatly appreciated. I'm about ready to pull these things if I don't get some kind of help for them soon.

 

[Guest]

First off, it's kind of hard to comment without actually seeing what's going on but I'll try to give some general advice.
What kind of pain is going on here, is it short & stabbing or more long lasting? Does anything such as sweet food or cold provoke it? How long does it linger on for when it starts?

The periodontist is probably right about the crowns encroaching on the biologic width, this is his speciality after all and he should know what he's talking about. However, it's unusual for this to cause pain... inflammation and bleeding yeah, but not pain...
The general dentist is also correct in that crown lengthening surgery will spoil the appearance of the crowns in that the "margins" the edges between tooth and crown will show. How important that is would depend on where the crowns are in your mouth and whether the margins would show normally.
Sorry if this is more questions than answers.

 

[Guest]

Gordon, thanks for the reply. The pain is short and stabbing, lasts for only a minute or less, and is brought on by sweet foods and cold, but not heat. It's teeth numbers 5, 19 and especially 20 that are involved. The general dentist is concerned that if I have the crown lengthening done, the crowns won't fit properly and that I'll have to get new permanent crowns. Since the scaling was done, it feels like my teeth are loose and they are certainly longer then before the scaling. I don't want to go through the anxiety and expense of a crown lenghtening procedure and then need new crowns because the old ones won't fit properly afterwards. It seems that the scaling has made the sensitivity worse Thanks again for the reply.

 

[Guest]

Apologies for the delayed reply, I've been a bit busy.

Anyway... first off, although the discomfort you're having is bad, it's not altogether bad news.
Your general dentist is talking through his hat or else you've misinterpreted what he's said. Crown lengthening won't affect the fit of the crowns. What it will do is expose the join between crown and tooth, whether this is a problem aesthetically is another question, but it won't affect the fit of the crown one iota.

The scaling has reduced the swelling that was present from gingivitis, the teeth may look longer but this is a good thing really! Again the sensitivity will be worse because the swollen gums were covering some of the root surface, now that the swelling has gone down a bit more root surface is exposed. I've written a long reply about sensitivity someplace else on this board, go have a look for it...

I'd be back to your general dentist to ask him to treat the sensitivity, your symptoms sound like this problem could be very easily resolved with minimal trauma.

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Mike Gow