What to do about the gap between the crown and the gum. If the tooth under the crown is sick, it can be cured without removing the structure. Why does the gum move away from the tooth?

Most often, people who feel a bad odor coming from their mouth seek advice from a dentist. Indeed, in 90% of cases of registered visits, examination reveals diseases of the teeth and gums that require treatment. After solving the problem, the bad smell stops bothering you. But sometimes patients who have crowns installed on their teeth begin to worry about the smell of rot coming from their mouth, and the source is clearly the tooth under the prosthesis.

Causes of odor under the crown

If the prosthesis is made and installed correctly, and the tooth is pre-treated or properly depulped, then no extraneous irritating odors will arise while wearing the crown - of course, with proper oral hygiene and regular dental examinations.

But it happens that either a crown is installed on an already defective tooth, or decay begins after the installation of the prosthesis for various reasons. Here the only possible way out is to eliminate the consequences by contacting the clinic.

The most common reasons why a prosthetic tooth begins to smell bad:

• Loose fit of the crown to the gum. If there is a gap between the edge of the denture and the mucous membrane, food particles will certainly get there. It is not possible to clean them with traditional means - a toothbrush and rinsing - so the substrate accumulates daily. Pathogenic bacteria begin to multiply on this biomass, rotting processes develop, and a specific smell appears.
• Depressurization of the connection between the crown and the tooth. This happens if the prosthesis is initially installed incorrectly or the cement is destroyed, and pathogenic microbes penetrate into the resulting cavities. As a result, inflammation of the gums occurs and even the development of secondary caries. All this contributes to the appearance of a characteristic unpleasant aroma from under the crown.
• Violation of the sealed connection with the tooth of a metal-ceramic crown. If, in addition, the crown is made on a metal base, if the cement layer is broken, air containing oxygen and saliva penetrate under the crown. In a humid environment, taking into account the pH of the salivary secretion, the metal of the crown undergoes oxidation, causing a bad odor. In addition, oxidized metal can become a source of irritation and allergic reactions of the gums.
• Lack of tooth protection after grinding. After preparing teeth for crowns, the final fixation of the crown does not occur immediately. Therefore, during the waiting period, the dentist puts a temporary prosthesis on the tooth stump or treats it with medical cement, excluding the penetration of bacteria into the tooth tissues that lack protection. If these steps are skipped for some reason, bacteria invariably settle in the tooth stump and cause decay under the permanent crown.
• Violation of the technology for manufacturing and installing the prosthesis. For various reasons (lack of proper equipment in the laboratory, low qualifications of the dental technician, little experience in prosthetics by the dentist, etc.), the crown is fixed on a tooth with irregularities. Gradually, injury to the tooth stump or soft tissue occurs with suppuration and the development of infection.
• Installing a crown on a tooth that required removal. This doesn't happen very often. For example, it is necessary to install a bridge, and one of the supporting teeth must be removed. To save on implantation, the patient agrees to restore the defective tooth. As a result, after some time, the tooth is still destroyed, the tooth root is fractured, and the crown flies off. Therefore, if there is an indication for tooth extraction, then it should be removed and not used as a support for a crown.
• Lack of oral hygiene. Some dentures require careful care and cleaning of food debris. If simple steps are not taken, strains of pathogenic bacteria grow very quickly and putrefactive processes develop.
• Untreated caries and pulpitis at the stage of preparing the tooth for “crowning”. Hidden inside, diseases do not stop; on the contrary, they worsen. Therefore, it is first necessary to cure all dental caries.
• Poor quality depulpation. If the tooth canals are not completely filled, this causes the development of granuloma at the root apex. A granuloma, or cyst, is a cavity filled with pus. Also, the cause of the development of such inflammations is poor obturation of the root canals - with a loose arrangement of cement. Dr. Lopaeva’s clinic employs a professional dentist and endodontist who treats dental canals.
• Constant gum irritation. If the crown is poorly placed and regularly touches the gums, the mucous membrane responds with inflammation and swelling. The smell will also add severe pain. If there are no defects in the prosthesis, the doctor will trim the gum. If the defect is inherent in the product, you will have to install another crown.

Symptoms of tooth decay under the crown

The first and very obvious sign of irreversible changes occurring in the tooth is not pain, as many expect, but the smell. Sometimes pain is not felt at all, because the standard preparation of a tooth for prosthetics includes depulpation - removal of the neurovascular bundle. Therefore, the tooth loses sensitivity.

You should pay attention to the following points:

• First, an unpleasant taste appears in the oral cavity, and then a foul odor, which is noticed even by others. The smell cannot be masked for long with mouthwash or chewing gum.
• Dietary fiber gets clogged under the crown of the tooth and has to be removed from there. But if some large particles of food can be removed from the gap between the gum and the crown, then a large mass of them remains inside and begins to decompose.
• Darkening of the tooth under the crown.
• When you feel the prosthesis with your tongue, you feel a depression, a hole where food gets in.
• The gums become inflamed near the restored tooth and soft tissue swelling develops.
• If the tooth stump under the crown is alive, then there is noticeable pain.

All of these circumstances require an immediate visit to the clinic for treatment and indicate tooth decay with the formation of pus. Delay in this situation will lead to serious health consequences and considerable costs for medications and therapy. If you do not take quick action, the pus, accumulating inside under pressure, will cause the formation of a purulent cyst at the apex of the tooth root. Or it will break into soft tissues, turning into gumboil. To eliminate the abscess, you will have to endure a surgical procedure to open the abscess.

In addition, you should not think that pus in a tooth is a local nuisance. Together with the bloodstream, the infection spreads throughout the body, having a detrimental effect on the heart, lungs, joints, etc. It is no coincidence that in every dental clinic there will certainly be a poster warning that a rotten tooth is a source of constant inflammation of the ENT organs, osteomyelitis, blepharitis and other unpleasant diseases.

A neglected tooth left to rot under a crown is sometimes completely destroyed and has to be removed. Thus, a person gets a hole in his mouth that will need to be closed with expensive restorations: an implant or the installation of a bridge.

What to do to get rid of the smell

When an unpleasant odor occurs in the mouth, a person most often realizes that the cause is tooth decay, but tries to deal with the problem on his own: rinses the mouth with various pharmaceutical products or infusions made according to folk recipes, tries to kill the bad odor with mouth odorants or chewing gum. If the tooth responds with pain, the person takes painkillers. As a result, tissue decay continues. Then the pain goes away - because the nerve endings die, and the patient believes that a cure has occurred.

The result is tooth loss. It is especially unpleasant if the crown covered a gap in the front row. Now the patient will have to install an implant and crown to maintain the aesthetics of the smile. Therefore, no matter how great the temptation is to let things slide or attempt to cure yourself, remember: dental diseases, especially tooth decay under the crown, cannot be cured at home. All of them require the intervention of a medical professional.

Before visiting the clinic, you can rinse your mouth with tinctures of herbs that have anti-inflammatory properties: a decoction of chamomile, oak bark, calendula. In the hospital, the dentist will determine the stage of tooth decay and perform a series of appropriate procedures. A sick but strong tooth is cured, a damaged one is removed. If there is no inflammation, and the cause of the smell is plaque accumulated in the space between the tooth and the crown, the doctor will clean the tooth of dirt. The crown is then subjected to additional processing to adjust the size and ensure a tight fit to the stump. After this, the prosthesis is fixed with sealing cement.

To ensure hygiene in the oral cavity, if there are one or more dentures, a good solution seems to be the purchase of an irrigator - a device that removes dirt and plaque with a disinfectant solution supplied under pressure. Even hard-to-reach areas that no toothbrush can reach can be cleaned.

Dentists also recommend using dental floss and rinsing your mouth with clean water every time after eating. Various agents with an antibacterial effect are used to rinse the mouth. They are not able to clean plaque from microscopic cracks and gaps between the prosthesis and the tooth stump, but they successfully destroy pathogenic microbes, stopping their life cycle.

If the destruction of cement, loosening of the crown or weakening of the pin occurs during the treatment guarantee, then all actions to restore the quality of the prosthesis are carried out free of charge. Therefore, it is important for the patient to monitor the crown and, if in doubt, contact the clinic where the restoration was made in time.

Treatment options for a tooth under a crown

When contacting the clinic, the dentist determines how great the changes are in the dental tissues, and based on the results of the examination, prescribes treatment.

• If the tooth stump has not undergone any changes and rot has not affected it, the doctor cleans out the accumulated food debris from under the crown. Then a new prosthesis or an old one, but corrected, is installed.
• If healthy roots remain, the crown is placed on the stump tab. This device is made in a dental laboratory from an impression and is a structure with peculiar “legs” that are designed to fix the inlay in the tooth canals. And a crown is attached on top.
• If both the upper and root parts of the tooth have rotted, the remains are removed from the mouth and periodontitis is treated. The patient then has to decide on how to restore the tooth. There are two options: implantation or installation of a bridge.

When contacting a clinic for initial prosthetics, it is important to find out at the stage of monitoring institutions whether the clinic provides a guarantee for the treatment provided. If there is a guarantee, then in case of medical errors, treatment and re-restoration are carried out free of charge for the patient.

How to care for a crown

Both the dentist and the patient are interested in the crown serving its intended purpose for a long time. To increase the period of good functioning of the prosthesis, a person will need additional care products, because a standard toothbrush is not able to clean the removable element:

• The beam brush is designed to clean the internal surfaces of the prosthesis;
• The interproximal brush on the head contains a special brush that easily reaches hard-to-reach places on the lateral surfaces of the prosthesis, cleans the areas between the crown and adjacent teeth;
• Floss is required for regular cleaning of interdental crevices;
• If the household has an irrigator, it will be a constantly in demand device, because only it can clean the areas in the cervical fastenings of crowns.

What to do if the tooth under the crown has completely rotted

It happens that a tooth rots because the crown was initially installed on a defective stump. And sometimes the person himself is to blame for this development of events, because he delayed contacting the doctor.

If the tooth has at least its roots preserved, it is possible to restore the tooth with a special device - a stump insert. The structure is made of ceramic or metal and has branches according to the number of roots. These processes are fixed in the root canals to a third of their depth. The top of the stump tab is intended to strengthen the crown on it.

Often gold or silver is used to cast the stump insert. The first material is preferable because it shines through the crown with a warm yellow color. This shade is similar to the color of natural enamel and is not perceived as foreign. The silver tab has antibacterial properties, but the cold shade affects the visual pigmentation of the gums. This will bother the patient, especially if the tooth is located in the front.

If the roots are rotten, the stump insert will not hold in them. The remaining tooth is removed and restored with an implant or prosthetics.

If the adjacent teeth, which will play the role of supporting teeth, are preserved, it is possible to install a fixed bridge prosthesis. Removable dentures are also common: nylon, acrylic. Here you will have to focus on the amount that the patient is able to pay for this or that method of dental restoration, and the aesthetics that he prefers. During the consultation, the doctor will offer to look at the options for finished products in the photo, and the person will choose the appropriate type of product.

What to do if a crown falls out

The crown sometimes flies off the tooth not only due to the complete destruction of the stump tissue. Sometimes the prosthesis comes off because it is poorly fixed to the cement: the material has collapsed or the adhesion to the crown material has been lost.

Often people do not attach importance to this, installing the crown in place on their own each time. However, such neglect is fraught with rotting of the tooth under the crown or accidental swallowing of the prosthesis. Therefore, you definitely need to contact the clinic to correct fixation deficiencies.

If the crown falls out along with the pin or stump, the conclusion is clear - the doctor did not properly strengthen the structure inside the tooth. Particular care must be taken to follow the technology when working with a stump insert: after it is placed in the root canals of the tooth, adjustment of the structure with a drill is possible only after 24 hours. This time is necessary for the cement to harden.

Inexperienced dentists often begin adjusting the inlay 10-15 minutes after installation. The cement breaks down before it has time to harden. Of course, soon the entire structure falls out into the oral cavity. If the crown is in satisfactory shape, a professional dentist can quickly return it to its place if you contact him without delay.

Causes of blood taste in mouth

Sometimes, in addition to the unpleasant smell, the patient is also bothered by the taste of blood in the mouth. Possible reasons for such sensations:

• Gingivitis develops, inflammation of the gums around the crown. The mucous membrane can become inflamed for various reasons. For example, the prosthesis fits tightly to the soft tissues, constantly rubbing them.
• The crown scratches and injures the adjacent gum. Blood is released, infection enters the wound, the mucous membrane becomes inflamed and bleeds. This only happens if the crown is not fixed correctly or if its dimensions are violated. Needs a complete refurbishment.
• Bleeding can cause unsatisfactory treatment of the tooth before placing a prosthesis. Poor filling of canals or incomplete removal of the pulp invariably causes inflammation and accumulation of purulent masses. Tissues are destroyed with the release of blood.

The appearance of blood discharge in the oral cavity should not be ignored. Pathogens easily penetrate an open wound, causing great damage to human health.

Preventive crown care

In order not to provoke the accumulation of masses under the crown and cause tooth decay, it is necessary to maintain oral hygiene. A crown is an artificial structure and will require more care.

• Brush your teeth twice a day, including using special brushes for caring for dentures.
• Rinse your mouth after every meal.
• Floss regularly.
• Use toothpicks only when necessary. This is not at all a means of maintaining dental hygiene! Picking with a wooden stick, expanding cavities in teeth and crowns, is contraindicated.

If you have already had the sad experience of tooth decay under a denture, pay more attention to the alarm bells: pain under the crown, bad smell, taste of blood in your mouth. Make an appointment with a dentist; timely treatment will be shorter and cheaper than treatment for a neglected tooth.

If you realize that the tooth has begun to rot, remember that the process is irreversible. It will not be possible to cure inflammation with home methods. You should not wait until there is severe pain or the crown falls out in your sleep, with the risk of suffocation. A diagnosis from a doctor will help you cope with the problem.

If the gum has moved away from the dental crown, this is fraught for the patient with tooth loss, and then with bone tissue atrophy. Such complications exclude the possibility of effective prosthetics. Why this happens and how to deal with it - read on.

The minimum that can be expected with the development of pathology is tooth loss. In some cases, inflammatory processes lead to the formation of purulent tumors, when they rupture the exudate comes out. The consequence of such a complication can be blood poisoning, which is already life-threatening.

Why does the gum move away from the tooth?

Local reasons

Poor oral hygiene.

When pathogenic bacteria accumulate, gingivitis first appears - inflammation of the tissues surrounding the teeth. Gradually, gingivitis develops into periodontitis and inflammatory processes spread to the soft tissues that hold the tooth in the socket.

Mechanical gum injuries.

For example, hygienic cleaning with an overly hard brush, installing a filling that is too high, or an incorrectly selected denture: in all cases, irritation and injury to the soft gum tissue occurs. Over time, this leads to periodontitis.

Common reasons

Periodontitis can also manifest itself against the background of the following factors:

1. Diseases of the endocrine system (for example, diabetes).
2. Immunodeficiency conditions (caused by HIV and other diseases of the immune system).
3. Hormonal changes (pregnancy, menopause).

Types and stages of periodontitis

Depending on the lesion, the following types of periodontitis are distinguished:

• generalized (affects the tissue around each tooth);
• localized (spreads to one or two adjacent teeth, most often as a result of injury).

Stages of the disease:

The gums bleed after eating hard and hard foods, brushing, and tartar appears. Periodontal pockets (gaps between the edge of the gum and the crown) up to 4 millimeters deep are formed.

The gums bleed profusely and hurt, the crowns of the gums are exposed by 5-6 millimeters, and pathological mobility is not very pronounced.

Gingival bleeding is accompanied by suppuration, pockets deepen to 7-8 millimeters, and pathological mobility of teeth leads to their displacement.

What to do if the gum has moved away from the tooth

As trivial as it may seem, you will have to make an appointment with the dentist.

At home, you can only temporarily minimize the unpleasant manifestations of the disease in the following ways:

• antiseptic rinses (potassium permanganate solution, Chlorhexidine);
• cold compresses (you can apply cold to the inflamed area to relieve pain);
• taking painkillers (for severe pain, Tempalgin, Sedalgin, Ketanov, Solpadein, etc. will help).

What not to do:

• warm and hot rinses (in a warm environment, microbes will multiply even more intensely);
• warming compresses.

Whenever possible, hygiene procedures should be continued to prevent bacterial growth. If brushing your teeth is not possible, it is recommended to rinse your mouth with a paste diluted in water.

Treatment

First, the doctor conducts diagnostic tests to determine how far the gum has moved away from the tooth. For a complete picture of the course of the disease, a visual examination and radiography are necessary.

Therapeutic treatment

Treatment of mild and moderate stages of periodontitis includes the following steps:

Removing solid deposits.

Ultrasonic cleaning and Air Flow sandblasting help get rid of soft and hard deposits, and closed curettage of periodontal pockets makes it possible to thoroughly remove subgingival plaque.

Anti-inflammatory therapy.

After removing the stone, the gums are thoroughly treated with anti-inflammatory solutions and gels (Chlorhexidine, Stomatidine, Miramistin, Rivanol, etc.).

Antimicrobial therapy.

For acute inflammatory processes, antibiotics are prescribed - Metronidazole in combination with Lincomycin, Clindomycin. For patients with diabetes mellitus or resistance to other antibiotics, drugs with active ingredients such as Norfloxacin, Ciprofloxain or Ofloxacin are indicated.

Surgery

In severe cases of periodontitis, therapeutic methods alone cannot be used. Affected gum tissue is treated with the following surgical methods:

Open curettage.

The gum is cut 1-1.5 mm from its edge, damaged tissue is removed. The dentist peels the gums from the roots, polishes them and treats them with an antiseptic, clearing them of plaque and pus. Next, sutures are placed and, if possible, the gum is sutured to the tooth.

Flap surgery.

The doctor makes two incisions on the gum and removes the flap formed after the incisions. Exposed areas are cleared of sediment. After this, the flap is returned to its place and sutured.

In the surgical treatment of periodontitis, drugs that promote osteosynthesis (bone tissue growth) are widely used.

Exposed tooth during pregnancy

The teeth and gums often suffer from hormonal changes in the body of the expectant mother. The difficulty lies in the fact that radiography and surgical treatment of periodontitis are not recommended for pregnant women. Therefore, if a woman notices that her gums have been exposed literally a millimeter or two, she should immediately contact a dentist for gentle and safe therapy for the baby.

How to strengthen your gums

Oral hygiene

Cleaning is needed at least twice a day. The procedure should last at least three minutes. After each meal you should rinse your mouth with water.

The spaces between your teeth should be cleaned with special floss every time after eating. Do not neglect mouth rinses.

Rules for using dental floss

Diet

To keep your gums healthy and strong, it is advisable to include the following in your daily diet:

• foods rich in vitamin C (lemons, oranges, kiwi, pineapples, strawberries, onions, etc.);
• fermented milk products (calcium is useful not only for dentin, but also for gums);
• solid vegetables (chewing apples and carrots is an excellent massage for the gums);
• nuts (prevent the appearance of tartar).

Have you noticed the listed symptoms of exposed teeth? Sign up for a consultation at one of the clinics below.

Overhanging edge of denture. An overhang occurs when excess crown material protrudes beyond the edge of the core. This error is often observed in the clinic, which is surprising given how easy it is to recognize and correct before fixing the prosthesis. Fortunately, it can be adjusted later without damaging the restoration.

Insufficient edge of the denture. With this defect, the edge of the crown does not reach the edge of the stump, leaving it open, but without a significant gap between the crown and the surface of the tooth. The error is again quite common, especially with a metal edge, but is difficult or impossible to correct during fitting.
She often arises from insufficiently precise marking of the gingival edge of the stump, as a result of which the blank is prepared too high and the retainer comes out short.

If the edge crowns does not go under the gum, sometimes it is possible to prepare and polish the surface of the tooth. In the case where the edge is located under the gum and there is local inflammation, you can still try to correct the edge using a narrow stone or bur, although this can cause damage to the gums. Most often, however, the prosthesis must be removed for correction.

Marginal gap of denture. Marginal gap is the gap between the crown and the edge of the stump. There are 4 main reasons for its occurrence:
Crown or another retainer does not match the tooth surface, a gap already exists at the fitting stage.
When trying on, it fits well, but at the time of cementing, the hydrostatic pressure of the cement (especially if it had already begun to harden) prevented it from being put on completely.
Under pressure cement the moving abutment tooth has sunk into the socket lower than the other teeth, leaving a gap.
At the moment cementing there was no gap, but it appeared later due to loss of cementum through a combination of erosion and abrasion, and possibly caries.

In any of these cases there is 2 options for further action: remove the prosthesis and fill the gap with a suitable restorative material, or leave everything as is, subject to dynamic observation.

Traditionalists It may be argued that any defective fastener should be removed and replaced. However, this is not always in the best interests of the patient, and skillful correction of the gingival margin can extend the life of the restoration for many years.

Occlusion problems. In addition to mobility of abutment teeth, problems with occlusion can cause damage to retainers and artificial teeth through excessive wear or breakage.

Occlusion can change as a result of tooth extraction, installation of new restorations, or wear of occlusal surfaces.

Depending on the degree of tooth decay, its treatment may require different approaches. If part of the tooth or root is still preserved, they resort to installing crowns. When several teeth are missing at once, a bridge is often used.

Regardless of the material used (metal, plastic, metal-plastic, metal-ceramics, metal-free ceramics), the installation of crowns and bridges is carried out in accordance with orthopedic standards in dentistry. Proper dental prosthetics reduces the risk of complications, one of which may be the gap between the gum and the prosthesis. Is it always a flaw?

Why does a gap appear between the gum and the denture? Is it normal?

After dental prosthetics, there should be no gap between the crown and the gum (see also: how to eliminate the gap between the tooth and the gum?). Its detection requires immediate medical attention.

If we are talking about a bridge, then between its intermediate part, on which the artificial teeth are located, and the gum, the presence of a small gap is normal. The fact is that a tight, hermetically sealed fit of the edges of the prosthesis to the gum can cause traumatic reactions.

In addition, when chewing food, its smallest particles fall under the artificial tooth. If they are not evacuated from there, they will begin to decompose, which will lead to gum inflammation. For this reason, doctors leave a rinsing space between the gum and the denture, which allows you to easily remove pieces of food. At the same time, too wide a gap can lead to unpleasant consequences.

In general, a small gap between the bridge and the gum is necessary. The photo shows what its normal sizes look like. To independently determine compliance with standards, a small study is carried out. If everything is in order, then:

1. The gap is not visible. Its width is a fraction of a millimeter.
2. There is no pain. The tongue, when touching the bottom of the prosthesis, does not feel the hole and does not feel its edge.

Why is the gap sometimes too wide?

So, too wide a gap under the bridge, as well as its absence, are fraught with unpleasant consequences. The gap is too wide for the following reasons:

What complications can arise if the rinsing space is too wide?

A flush space that is too wide can cause the product to quickly fail, but this is not the worst thing. A wide gap can cause difficulty in eating and even make breathing difficult.

If hygiene is improper, food fragments will become lodged in the gap, which can lead to a number of dental diseases and complications.

What do we have to do?

Before treating complications, you should start with hygiene procedures. To do this, use a soft brush to clean the surface of the teeth and rinse after meals. A hard toothbrush can provoke traumatic reactions of the tissues surrounding the neck of the tooth. Do not use hard, hard tools (matches, needles, slivers and brushes) to clean the rinsing space.

If pain and discomfort not only does not disappear, but also increases, you need to immediately visit your dentist or orthodontist. Timely measures taken can reduce unpleasant consequences or prevent them altogether. In serious cases, repeated prosthetics will be required.