I recently had a veneer put on one of my upper front teeth, and a crown on the other. My gums were really sensitive after the work was done, and instead of improving, they have gotten worse. My gums are inflamed and extremely sensitive to the touch, and this just can’t keep on like this.

The dentist who did the work could not fix the problem, so I saw a different dentist, who recommended I see a periodontist, which I did. She treated the gumline, which did not help. Most recently I saw a prosthodontist, who said that the dentist who did the work put the crown too deep and close to the bone. He said that he might be able to improve the situation with perio surgery, but that he cannot “offer any guarantees”, and cosmetic damage to the gum area between my two front teeth is likely to result.

Isn’t there any other solution? I can’t believe I have to chose between the health of my teeth and gums and permanent scarring, when I just spent so much to improve my appearance.

Carl in San Fransisco

Dear Carl,

The problem is indeed the placement of the porcelain crown and porcelain veneer. They are too deep under your gums, which has violated the biologic width of your teeth. Though this phenomenon has only recently been researched, it is disappointing that it took so many professionals so long to determine the cause of the problem. In terms of an alternate solution, it is likely there is not one. You should have the surgery. The situation as it stands right now is not only unsightly, it is dangerous. Left untreated, gum disease can lead to more serious conditions that jeopardize your health.

The prosthodontist is being cautious, because he does not want you to get upset if there is indeed scarring. No judicious dentist would ever offer a guarantee, in any case. No procedure can be guaranteed.

In the meantime, you might want to consider rinsing with Peridex antibacterial rinse to bring down the inflammation. If you do use Peridex, make sure you also brush with Supersmile toothpaste, as Peridex stains the teeth.

This blog is brought to you courtesy of Lafayette Louisiana cosmetic dentist Dr. Mike Malone.