I have new spaces between my teeth after a cleaning

Question:

In June 2009 a dentist performed the advanced cleaning procedure they
identified as a full mouth debridement. The dentist also measured the
distance between the bottom of the enamel and the top of the gum. This was
painful as the measurement device pressed into what I assume was soft enamel
or dentin.

The reason for my concern and my question here follows. Before the cleaning,
my gums completely filled the gaps between my maxilla 7, 8, 9 and 10(top front teeth). After
the cleaning, between 9 and 10, a 1.5 millimeter gap exists. And, between 9
and 8, and between 8 and 7, a 0.5 mm gap exists. In other words it appears
that the dentist created gaps during the cleaning process. I definitely had
a lot of blood when I rinses after the cleaning. Did the dentist make a
mistake?

The dentist recommended that I come back for the second part of the cleaning
including having the undersides of my gums cleaned. Another dentist during
another previous appointment recommended the same. Based on the apparent
damage to my gums, I have ignored this. I have not had my teeth cleaning
since.

Answer:

Wow, your ability to relay the information in dental terminology is quite impressive

So first we will explain exactly what happened and then we will explain the reaction of your gums to the procedure.

A full mouth debridement is an extensive cleaning procedure that involves cleaning the surfaces of your teeth including the tooth surfaces (root) located under the gums.  A dentist performs a periodontal probing to determine if a patient needs a debridement.  Based off of your information, it looks like the dentist recorded your probing depths, meaning he used a probe to measure the depths of the pockets around your teeth.  This information tells us whether or not your gums are inflamed, meaning that you are experiencing gingivitis (please see our article here for more information on gingivitis).

It looks like you had inflammation of your gums.  The major factors in your situation that point us in this direction are the following:

• Bleeding during a cleaning or probing indicates inflammation of gums/gingivitis
• Shrinkage of the gums after the cleaning was performed indicates that the gums were inflamed and are now healing

So now, the dentist performed the debridement and you see spaces that didn’t exist before.  Let’s explain fully why this occurred.

• There is a possibility that you had calculus deposits.  Calculus is a hardened buildup that can accumulate, over time, on teeth.  Sometimes, it appears as tooth structure, but is actually harmful to the teeth.  Calculus usually accumulates around the gumline.  If the dentist removed calculus, spaces can now appear in those newly cleaned areas.
• Your gums are now healing.  Before your gums were inflamed.  Gums become inflamed when there are bacteria, food deposits, plaque, or calculus that remains on the teeth near the gums.  The body’s defense system attempts to fight the foreign invaders resulting in inflammation and tenderness of the gums.  Some signs of inflammation include the following:
  • Red gums
  • Puffy gums
  • Gums that bleed when flossing

Healthy gums should appear coral pink (or slightly pigmented based on ethnicity), firm and tight.

So don’t worry, the dentist definitely didn’t mess up.  Your gums are now healing after the extensive cleaning was performed.  If the spaces in your teeth concern you, return to your dentist and he/she will be able to better assess the situation from this point.  More than likely, once the gums return to full health, the spaces will resolve.  Or, if you had periodontitis, meaning bone loss accompanied the gum inflammation, there are procedures the dentist can use to solve the problem.

Hope this helps and good luck,

Save My Smile Team

Does flossing reduce bad breath?

Question:

Does flossing reduce bad breath?

Answer:

Yes it definitely plays a role in reducing bad breath.  Bad breath can be caused by a number of factors.  Some of these factors include decay in a tooth, bacteria or food debris trapped under the gum line or between teeth, plaque or calculus (tartar) accumulations, bacteria located on the tongue, bad oral hygiene habits, etc.  Flossing definitely needs to be incorporated into a daily routine, in addition to brushing after each meal, to better fight bad breath.  If you practice great oral hygiene habits and don’t have any decayed teeth or plaque, and yet still experience bad breath, maybe you should visit your dentist.  He/she may be able to identify a possible cause that could have been overlooked.

Good luck!

The tooth under my crown is hurting

Question:

Help!!  The tooth under my crown is hurting.  What does this mean and what should I do?  I’ve only had this crown for one year!!

Answer:

Sorry to hear that your tooth is in pain.  This can mean a number of things.  For starters, it could mean that there is a carious lesion/cavity under your crown.  Sometimes, bacteria are able to find its way under the margins of crowns if not cleaned properly (see article on brushing).  There is also a possibility that some of the bacteria was not removed after the dentist prepped your tooth for the crown.  Or, the pain can be coming from your crown not being correctly adjusted in your mouth.  It could be “too high”, which means your bite could be off, and may need to be reduced by the dentist.

Your best bet is to go to the dentist to evaluate your options.  First, make sure the dentist runs a couple of tests to ensure that the pain is indeed coming from that tooth.  Sometimes, pain in one area is projected to a nearby area, this phenomena is called referred pain and occurs quite frequently.  If the dentist identifies this tooth as the source of the pain, then you’ll have a couple of options.  The crown may just have to be readjusted, which will only take a few moments, or it may have to be removed and the situation assessed from there.  Depending on the extent of bacterial invasion, you may just need the crown re-prepped, a root canal, or even an extraction.  Also, depending on your dentist’s office polices, he/she may offer to re-do your crown for free.

Good luck!