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Question:
Space in between crown and gum: Is it normal for there to be a space in between a newly-placed
crown and the gum-line?
The scenario: my dentist had recommended I crown (no root canal needed) this back molar, since the filling was very large and very old. I am now experiencing some fairly uncomfortable sensitivity to hot and cold, as well as problems with the bite (feels like the crown is too long, even though he shortened it a great deal and the crown no longer has natural-looking and feeling indentation along its surface, it's almost completely flat).
It upsets the tooth to chew on nuts, seeds, crunchy foods, soft foods are okay. The space in between the gum and the top of the crown is visible, about one millimeter or so. At the permanent fitting, the dentist encouraged me to rub the gum to bring it down to cover the space, but didn't say much else.
I hesitate to go back because the permanent crown placement was unpleaseant (felt as if the nerves were being stimulated and jangled as he kept poking into that empty space with metal prong). Does this sound normal? ...Visitor from IL
Answer:
There is not necessarily any right or wrong answer. ANYWHERE a dentist can leave a margin (end of the crown or cap and the beginning of the untouched tooth - or in other words, the end of man's work and the beginning of God's work) above the gum line it is to the advantage of the patients oral health.
The reason for this is rather than burying the margin under the gum line and leaving it "exposed" or above the gum line, the margin can be easily cleaned. Therefore the crown or cap will last a great deal longer and the gum tissue will be much happier. This is especially true with a gold crown which is a functional and not a cosmetic restoration.
Please remember when God's work (your original equipment), does not last a lifetime, everything a dentist does is a compromise and the more easily cleaned the restoration the greater the longevity and therefore your return on investment.
Obviously, if it is front tooth, we want to "bury" the margin under the gum line for maximum esthetics. This frequently and unpredictably backfires as the gum tissue and porcelain are poor neighbors, not very biocompatible and you frequently see the gum tissue recede from this insult and a black line or the natural tooth exposed which compromises the intended esthetic effect.
If the crown is in the back of your mouth the esthetic requirement is not so great. Additionally the wearing of a temporary may make the tissue recede. This was not intended but just how the patient's individual tissue responded. The sensivitity around the neck of the tooth normally diminishes with time after a crown procedure. A tooth paste for sensitive teeth may be one solution. Another is a good, healthy, non-confrontational conversation with your dentist.
Editorial Staff
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