Dental Care : Ask The Smile Expert
Q: I am a 44 year old patient who has bleeding gums and crowded front teeth in the upper jaw. I have been going to the dentist regularly for the cleaning of teeth. But within few weeks the bleeding starts once again causing me to stop brushing the area and the problem worsens. I am a bit worried about it so advise me on a permanent solution for the problem.
A: From the query I could understand three problems 1, recurrent gingival inflammation 2, crowded upper front teeth 3, bleeding gums. The major cause for all the problems is the crowded teeth which makes the brushing difficult and cause calculus to accumulate in the interdental spaces. There may be another reason for the gingival inflammation like trauma from occlusion where the lower front teeth contact the upper teeth with greater force causing irritation in the gingival area. The bleeding gum is an indication of gingival inflammation. The treatment for such a case is a comprehensive dental management with correction of crowding, relieving biting prematurity (if present) and deep cleaning of interdental spaces. The correction of crowding and biting prematurity could be done by aligning teeth with orthodontic treatment or by using veneers and crowns to alter the length and width of teeth. Once the teeth are well arranged it will facilitate proper brushing of the interdental spaces and the gum problems will resolve. If there are any permanent defects due to advanced periodontal diseases you may require bone grafting to reinforce the tooth support.
Q: I had met with an injury some years back causing broken upper front tooth. We had been to a dentist for repairing the tooth and fixed a crown. Now I am 25 years and there is a black line around the teeth near the gums which is very evident when I smile. The width of the line is increasing and I am losing confidence on smiling. Please tell me what to do.
A: Broken front tooth might need root canal therapy and crown. Metal reinforced porcelain or ceramic crowns when fixed in the front teeth might cause dark margins on the gums. But if you can replace them with all ceramic crowns like Procera, Emax or Cercon where there is no metal in the crown the dark margins will not develop. The other reason for dark margin is the reinfection of the tooth and subsequent discoloration of the toothstructure under the crown which could be corrected by doing root canal treatment.
Dr Thomas Nechupadam MDS
Dr Paulose’ Nechupadam Dental Spa
Ramada resorts Kumbalam Kochi