Ultra-sensitive gums - anyone else?

[flosser]

Hi,

I'm SO GLAD I found this place. I've had ultra-sensitive gums since I was a small child. Eating 'sharp' things like potato chips was painful. I had gum surgery when I was 20 which really helped. But I still canNOT tolerate having a 'cleaning' done without alot of novacaine and nitrous. I floss every day religiously -- no matter what. 20 minutes every morning. If I miss just one day, I would have inflammations. I missed a small spot last month and now I have a big problem and have to have a dentist to a cleaning with the novacaine -- which never dulls the pain completely for this. THe appointment is Saturday and I'm a wreck.

Anyone else have a life-long problem like this? I can't find anyone else who has gums like these. They inflame when anything it put near them -- braces, TMJ plate, etc. I've had a root canal for 11 years without a crown because I don't want the crown up near my sensitive gums.

Can anyone commisserate?

[letsconnect]

I can't really comment on the ultra-sensitive gums (maybe someone else can?), but just wanted to say that in, err, trendy dentistry circles these days, crowns are usually placed above the gumline rather than below (bit of a change from 11 years ago)... so if there's any chance of that tooth fracturing, you might want to look into this .

[gdentalfear]

admin said:

I just wanted to say that in, err, trendy dentistry circles these days, crowns are usually placed above the gumline rather than below.

Just wanted to second that: I had a crown placed about 5 years ago. It is DEFINITELY above the gum line (and I don't think my then dentist was particularly "trendy", LOL).

By-the-way, not all teeth that had RCT need a crown (I also have one of those without a crown), but as "let's" said, you don't want that tooth to fracture.

Good luck on Saturday. We'll be thinking of you!

G.

[Fearful]

Hello,
I hope you don't mind my jumping in here with a question about something you all brought up, and I don't understand. Are you saying a crown should be below the gumline? I think mine are below the gumline on the outer part of my teeth, but are above the gumline on the inside part.......and I can see a dark space. I'm not sure I understand what's "right" and what's not. Thanks!

[letsconnect]

It's kinda complex... there are lots of factors involved here. Generally speaking, the literature suggests that placing the margin of the crown below the gumline (a so-called "subgingival margin") is associated with a greater risk of inflammation of the gum tissue. So a lot of dentists these days would say that it's best to place the margin very slightly above the gumline ("supragingival margin").

But... it's not always possible to do that. For example, a porcelain-fused-to -metal (PFM) crown on front teeth would need to be placed slightly below the gumline so that the metal doesn't show (because of aesthetic concerns). If, on the other hand, the margin doesn't show (as in the case of rear teeth), the margin should probably be placed very slightly above the gumline. It is quite common for the margin to be placed slightly supragingivally (above the gumline) on the inside part (the "lingual" side - i. e. the side facing the tongue), and subgingivally (below the gumline) on the side facing the cheek (the "buccal" side). Often this is done because of esthetic concerns, but there can be many other reasons, for example decay that extended below the gumline, or inadequate crown height - the real tooth crown, that is, rather than the lab crown. There are a number of other reasons why one might have to place the crown margin below the gumline.

So basically, while supragingival placement is preferable, aesthetic concerns, choice of crown materials and technique (PFM, gold, porcelain, CEREC; bonded or cemented), and various dental reasons can all influence whether the crown is placed supragingivally or subgingivally (or at the gumline, which if my memory serves me right is called equigingivally).

Oh, and note the disclaimer below...

Does the above make sense? It's just a short summary (any dentists reading this, feel free to chime in)

[Fearful]

THanks Letsconnect,
I understand now. I think what was confusing me, was understanding "above the gumline and below the gumline" when talking about the upper teeth........since the upper teeth are upside down!

[letsconnect]

Ah, I should've copped onto that... by "below the gumline", I meant "going underneath" and being slightly covered by the gum, regardless of whether the tooth in question is a top or bottom tooth. By "above the gumline", I meant that the crown sits above the gum tissue. Sorry about the confusion !