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Question:
I have had crowns on my two upper front teeth for about 17 years. They were replaced about 6 years ago and I had no problem. I then went to a new dentist who suggested redoing them because of a 'bad fit'.

The latest ones were therefore done 18 months ago. At the same time he filled the roots and did some gum curettage to lengthen the crown. Since this time I have had a chronic odour from around these crowns and an acidic taste from the area.

I am worried about the possibility of chronic infection, also the risk of bacteremia etc. What can i do? I have seen several dentists for an opinion with no answer. ...Visitor from Aldershot, United Kingdom

Answer:
Your situation does seem to raise some concerns. Please be advised that without a visual exam and appropriate radiographs an accurate diagnosis is impossible and the following is only a suggestion based upon the information given in your question.

There is an area in the mouth where the tooth and the gum tissue meets. This area is where the ligaments attach to the tooth. The distance from the top of the gums to the attachment of the ligaments is called the periodontal pocket. This pocket should have a distance of 3mm or less for optimum health.

When crowns are placed on the teeth the area where the crown meets the tooth is called a margin. This margin is usually placed just under the gum tissue so that the crown looks as if it is real and coming out of the gums. The margin should be placed at least 1.5 mm above the attachment of the ligaments to the tooth, (the area is called the Biological width). When the margin of the crown invades this Biological width the body responds with an inflammatory response. The gums become inflamed as the bone and ligaments are dissolving and making room for the new crown.

It is this chronic inflammation which may be causing the bad smell and taste. If this is the condition, than the remedy may be to either redo the crowns a little shorter or to have a crown lengthen procedure (a surgical procedure which lowers the bone and gum tissue) both of which will regain the 1.5 mm biological width which would stop the inflammation and restore the tooth, bone and gum tissue apparatus.

I hope that this helps.

Editorial Staff

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