[porcelain1001]

I had 2 anterior porcelain crowns put in in 2006 and was told by 2 periodontists that I had a biological width problem with one tooth and that crown lengthening would solve it.
A few months ago I had the crown lengthening procedure but continue to have the same redness over the gum I had before.
The periodontist is now advising to try provisional crowns for an indefinite time (1 month or more) before replacing the crowns and states that there is no guarantee this will work.
When I asked him why the crown lengthening didn't work he said the biological width wasn't the problem after all but has no idea what is causing the irritation... just that I am "unique".
I couldn't be the only person with this issue... do you have any idea what might be going on?
It seems like a periodontist would at least have some good theories on what the source of the irritation it (I supposedly have pure porcelain veneers in two front teeth, not porcelain to metal). Do you think it's a good idea to invest more money and take the risk on provisional crowns with no guarantee?

[tickle]

I wouldn't do it with this periodontist if he is not offering a guarantee, although it is hard to guarantee crown work because everyone has different issues and medical problems, some unstated at the time.

I don't think he should be so oblique though. I suggest you get a second opinion because that is what you are entitled to do with dental issues.

Discuss this with your regular dentist, tell him your problem, and ask him to refer you to another specialist.

Your mouth is something not to be fooled around with and procedures are so costly. I hope you will hear from our resident expert Ms. Flossie, as always, she will offer some good advice.

Good luck procelain


Ms tickle

[Amir1981]

Hmm.. well if it is only 1 tooth then it's probably not an allergy to the crown/cement. Assuming the crown is made properly (no gaps hiding bacteria) then it is possible that it is still biological width (everyone has different one). If it is not that bad, I'd keep it clean and try to live with it. If not, then you'll hve to try to provisional crown

[flossie]

Hello porcelain1001,

A couple of questions... are you experiencing the irritation on the gums of both teeth that have the crowns or just the one that had the crown lengthening procedure done?
Are you sure that the crowns are all porcelain and not porcelain fused to metal?

If the irritation is over both of the crowns then an allergy may be the cause and you should find out exactly what was used in making the crowns and cementing them in and go to an allergist to be tested.

There could be a ledge under the gum where bacteria is collecting. To check if this is the case all you have to do is take your fingernail, place it at the gumline of the crown and feel under the gum. You will be able to feel a ledge if there is one.
If this is the case you will have to keep it really clean. Use a soft toothbrush at a 45degree angle pointed toward the gumline. Gently press the bristle tips so they slide between the tooth and gum and then wiggle the bristles and swipe the brush down the tooth. Don't scrub back and forth or bang your brush up against the gums. When you floss make sure you get the floss in a "C" shape around the tooth so the floss actually goes up and under the crown. You can also get yourself some good quality tea tree oil and gently massage a small amount on the gums using your fingertip.

A couple of things you can try before deciding whether to go with provisional crowns. I would also have a dentist who does a lot of cosmetic dentistry take a look if the above suggestions don't help.

Good luck.