Hi..I'm having constant (daily, but moderate) gum pain that I believe is
coming from a permanent crown on #14 (done 4 months ago). (15 and 16
were also crowned to fix bad CERECs at about the same time).

The crown appears much larger than my other teeth, and I'm wondering if
the size of it is the cause of the problem. (Can the crown "push" on my
gums oddly if it is too big and cause this discomfort?)

Dentist has adjusted the bite over 6 times now on this tooth, and it
still seems a bit "off" - so could bad bite be the cause of feeling pain
in the gums? He is also making me a guard to wear at night as he thinks
it's "my fault" and that I'm grinding at night (I'm not - teeth actually
feel best in the AM right when I get up..it's only after I've been up
for a while, after I eat, etc that the pain comes back).

The tooth itself seems pain free - it's the gum area that's bothering me.

Dental rinses (Clorhexidine Gluconate) and "extreme" care - brushing
with SonicCare, flossing constantly - seems to help relieve the symptoms
- but they come back a short while later.

I also have some Perio issues - diagnosed with Periodontal disease, but
the hygenist says my gums look "good" at my last cleaning (about a month
ago) and that I've done a great job at keeping them healthy.

Would an appointment with a Periodontist be my best course of action
here? (Wondering if it's gum infection, bad margin, etc). Dentist
seems to not be getting anywhere and wasn't overly receptive to my idea
of re-doing the crown..

Thanks for any/all help.

- J

Jim S wrote:

Hi..I'm having constant (daily, but moderate) gum pain that I believe
is coming from a permanent crown on #14 (done 4 months ago). (15 and
16 were also crowned to fix bad CERECs at about the same time).

The crown appears much larger than my other teeth, and I'm wondering
if the size of it is the cause of the problem. (Can the crown "push"
on my gums oddly if it is too big and cause this discomfort?)

Dentist has adjusted the bite over 6 times now on this tooth, and it
still seems a bit "off" - so could bad bite be the cause of feeling
pain in the gums? He is also making me a guard to wear at night as he
thinks it's "my fault" and that I'm grinding at night (I'm not - teeth
actually feel best in the AM right when I get up..it's only after I've
been up for a while, after I eat, etc that the pain comes back).

The tooth itself seems pain free - it's the gum area that's bothering me.

Dental rinses (Clorhexidine Gluconate) and "extreme" care - brushing
with SonicCare, flossing constantly - seems to help relieve the
symptoms - but they come back a short while later.

I also have some Perio issues - diagnosed with Periodontal disease,
but the hygenist says my gums look "good" at my last cleaning (about a
month ago) and that I've done a great job at keeping them healthy.

Would an appointment with a Periodontist be my best course of action
here? (Wondering if it's gum infection, bad margin, etc). Dentist
seems to not be getting anywhere and wasn't overly receptive to my
idea of re-doing the crown..

Thanks for any/all help.

- J


If you have doubts about your restorative dentist, checking with
your periodontist couldn't hurt.

Steve

Thanks, Steve.

Do you feel that the gum pain is more likely due to the crown being "too
large"/installed wrong (eg: too far under the gum, too wide for the
space it's in, etc), or from bad bite/occlusion?

Jim

Mark & Steven Bornfeld wrote:

Jim S wrote:

Hi..I'm having constant (daily, but moderate) gum pain that I believe
is coming from a permanent crown on #14 (done 4 months ago). (15 and
16 were also crowned to fix bad CERECs at about the same time).

The crown appears much larger than my other teeth, and I'm wondering
if the size of it is the cause of the problem. (Can the crown "push"
on my gums oddly if it is too big and cause this discomfort?)

Dentist has adjusted the bite over 6 times now on this tooth, and it
still seems a bit "off" - so could bad bite be the cause of feeling
pain in the gums? He is also making me a guard to wear at night as
he thinks it's "my fault" and that I'm grinding at night (I'm not -
teeth actually feel best in the AM right when I get up..it's only
after I've been up for a while, after I eat, etc that the pain comes
back).

The tooth itself seems pain free - it's the gum area that's bothering
me.

Dental rinses (Clorhexidine Gluconate) and "extreme" care - brushing
with SonicCare, flossing constantly - seems to help relieve the
symptoms - but they come back a short while later.

I also have some Perio issues - diagnosed with Periodontal disease,
but the hygenist says my gums look "good" at my last cleaning (about
a month ago) and that I've done a great job at keeping them healthy.

Would an appointment with a Periodontist be my best course of action
here? (Wondering if it's gum infection, bad margin, etc). Dentist
seems to not be getting anywhere and wasn't overly receptive to my
idea of re-doing the crown..

Thanks for any/all help.

- J



If you have doubts about your restorative dentist, checking with
your periodontist couldn't hurt.

Steve

Jim S wrote:

Thanks, Steve.

Do you feel that the gum pain is more likely due to the crown being
"too large"/installed wrong (eg: too far under the gum, too wide for
the space it's in, etc), or from bad bite/occlusion?

Jim

Almost anything I say without looking at you would be pure
speculation. Bad bite would not irritate the gum directly, but
certainly could make the tooth sore. Bad margin, margin too far
subgingival, open margin--could all be possibilities, and I wouldn't
rank them. Have it looked at.

Steve

Mark & Steven Bornfeld wrote:

Jim S wrote:

Thanks, Steve.

Do you feel that the gum pain is more likely due to the crown being
"too large"/installed wrong (eg: too far under the gum, too wide for
the space it's in, etc), or from bad bite/occlusion?

Jim


Almost anything I say without looking at you would be pure
speculation. Bad bite would not irritate the gum directly, but
certainly could make the tooth sore. Bad margin, margin too far
subgingival, open margin--could all be possibilities, and I wouldn't
rank them. Have it looked at.

Steve




Interesting! Last time I was at the Dentist, he really keyed on the sore
gums - said in his opinion that this was being caused by bite still
being wrong. So, should I be concerned that his diagnosis apparently
wasn't right and question the level of care I'm getting there?

I've been back to this Dentist over 6 times now for the same problem.
And he's the second Dentist over the past 3 years, as the first one's
work (CERECs on 14, 15 and 16) is what started the whole problem in the
first place. Logic would say to try YET ANOTHER Dentist [since this one
isn't making me any better], but I'm out of people to try - unless you
can recommend a great Dentist in the Detroit area (NE suburbs). I
really don't trust ANYONE at this point after two bad experiences and a
total of 3 years of constant, daily dental pain as a result..

How in the world can I find a "good" Dentist at this point that can FIX
the problem vs. this ongoing nightmare that I've been stuck in for the
past 3 years?

Thanks for the help.

Jim

but I'm out of people to try - unless you
can recommend a great Dentist in the Detroit area (NE suburbs).

Jim S wrote:


How in the world can I find a "good" Dentist at this point that can FIX
the problem vs. this ongoing nightmare that I've been stuck in for the
past 3 years?

Thanks for the help.

Jim


You should always question when you think things aren't right. You
should be able to get answers too. I just don't know that you're going
to get a good answer over the internet.
I've never been to Michigan (though my wife is a graduate of Michigan
State). But if Troy is anywhere near you, I would definitely consider
looking up Dr. Stephen Mancuso--I think that's where he is. (Fair
warning--he LOVES Cerec--but from what I've heard, he's an absolute ace
at it).

Steve

On Tue, 06 Feb 2007 19:40:33 GMT, Mark & Steven Bornfeld <bornfeldmung@dentaltwins.com> wrote:


Jim S wrote:



How in the world can I find a "good" Dentist at this point that can FIX
the problem vs. this ongoing nightmare that I've been stuck in for the
past 3 years?

Thanks for the help.

Jim


You should always question when you think things aren't right. You
should be able to get answers too. I just don't know that you're going
to get a good answer over the internet.
I've never been to Michigan (though my wife is a graduate of Michigan
State). But if Troy is anywhere near you, I would definitely consider
looking up Dr. Stephen Mancuso--I think that's where he is. (Fair
warning--he LOVES Cerec--but from what I've heard, he's an absolute ace
at it).

Steve


He is an honest to goodness master of the craft.
Have seen him operate in person, would have zero
hesitation letting him treat me.

but I'm out of people to try - unless you
can recommend a great Dentist in the Detroit area (NE suburbs).