Old crown hurting gums

Conrad3000

Hi all. Got a pretty old crown from a few years ago. It's on top of one of the front teeth. Gap of 4mm has also formed over time, and the gums are beginning to hurt.

I remember going to the dentist a year or two ago and he said as long as the crown is doing what it's supposed to do (i.e no issues with biting), then there's not much he can do, even though it looks unsightly.

I didn't mention the gum issue at the time. If I do, is it incumbent for him to replace it or can he give me the same response as last time?

Thanks in advance.

brook2jack2

If the gums are hurting it is because plaque is building up around the gum and you need to clean better in this area. This is not necessarily a reason to replace the crown on the NHS and neither is the crown being unsightly. 

If the tooth is becoming sensitive ie to hot and cold this may be because root is exposed and again this would be treated by cleaning better and the use of eg sensitive toothpaste applied on the root at night , left on and not rinsed out. Again it does not necessarily mean the crown should be replaced on the NHS. 

However the only person who can answer over whether the crown should be replaced is the dentist who can see you, your crown and your x rays and if it's been a year or two and you have gum problems you should be contacting your dentist for a check up anyway. 

Toothsmith

I would agree with Brook.

When a crown is put on a tooth, the dentist will try to get the edge near to, or slightly below the gum - as this looks nice. But a crown is a 'foreign object', and the gum won't like it. So over time, and especially if toothbrushing is too vigorous and/or not very effective around it, the gum will creep away from the crown edge. Technically, as your dentist said, this isn't an issue.

Changing it could cause more problems. For one, the tooth would need a drill taken to it again - and that is never a risk-free procedure, and secondly, if the new crown edge is tucked nicely down at gum level again - then exactly the same thing is likely to happen over the next few years, and you'll end up with a long looking tooth with another dark edge at the bottom of it.

Be guided by your dentist, and try to improve the way you clean around the crown.

Conrad3000

Thanks for the info.

So I saw the dentist today and he prescribed me some Metronidazole. Not sure why because the crown's causing the issue, not some sort of infection.

Anyway we'll see what happens with that medicine.

I also asked him the next step if the pain's not going away, and he basically said he'll have to take the tooth out; the one where the crown sits on.

If he did, what would the space be filled with? An implant? Denture? Or anything else?

brook2jack2

You need to discuss this with your dentist. Implants are not available on the NHS and beside which if you have gum disease then implants can be lost easier than your own tooth. 

A bridge may be suitable if the other teeth are healthy and you have no active gum disease or decay , otherwise a denture may be the only option. 

The only person who can advise is your dentist who can see you, your teeth and x rays . 

Conrad3000

Thanks brook. I'll go back in a couple of weeks time if the pain doesn't subside.

Btw if it's a partial denture, will it have clips on it? If yes, will they show when I talk or smile?