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Advanced cosmetic and general dentistry

Why Are My Gums Inflamed Around My Porcelain Veneers?

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My gums are inflamed around all four of my four-month-old veneers. I have no inflammation over my teeth without veneers. My dentist’s assistant said it must be because I don’t floss, but that’s not true. My gums burn some and stay inflamed. I saw my dentist last week, and she removed some cement around the veneers and smoothed some rough surfaces behind my teeth. It helped somewhat.

I would like to know what to do next and what could have happened during my veneer placement to cause puffy gums. My dentist didn’t seem too concerned. Last week, I saw a periodontist who said my gums are healthy, so something else must be causing the inflammation. Thanks. Lyla

 

Lyla,

Most patients who work in cosmetic dentistry are conscientious about taking care of their teeth. We understand how frustrating it can be when you brush and floss as instructed but are blamed for problems with your cosmetic dentistry restorations. Although we can’t identify the cause of your gum inflammation without an exam, we can explain some possibilities.

Why Are Your Gums Inflamed Around Your Veneers?

When your gums are inflamed around your veneers, the most likely cause is excess cement left around the veneers. The cement can get beneath your gumline and irritate it. Cosmetic dentists who regularly place porcelain veneers cure the cement in the middle of the tooth and clean off the excess to prevent overflow around your porcelain veneers.

A porcelain veneer held next to a tooth

Porcelain veneers should not cause gum inflammation

If your dentist removed some cement during your follow-up visit, the cement may still be causing inflammation.

Margin irregularity

Margin irregularity is unevenness where the porcelain veneers and teeth meet. Although a periodontist said your gums look healthy, they are inflamed. You will get a better diagnosis from a cosmetic dentist who is not associated with the dental practice you have visited.

Porcelain veneer position

If your veneers are too far under your gumline they can reach the gingival attachment and cause inflammation.

Sensitivity to porcelain veneers

Although porcelain veneers rarely provoke a reaction, some patients experience sensitivity.

Schedule a consultation with an experienced cosmetic dentist for a second opinion on whether your gum inflammation relates to your new veneers.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

Why Does My Temporary Bridge Make My Face and Jaw Hurt?

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I have had a dental bridge since 2017 that includes my lower right first premolar through my second molar. Although the bridge was still comfortable, my dentist recommended replacing it before I began to have problems. She took impressions of my mouth and placed a temporary bridge. I take ibuprofen every day because the bridge hurts. The entire left side of my mouth and jaw hurt. It hurts to speak and chew more than anything, and my gums are slightly swollen. My dentist took x-rays and said they looked okay. She cannot explain my pain. Of course, I am not allowing my dentist to order the final bridge because this temporary bridge hurts so badly. My dentist recommended an endodontist, but I do not have an appointment until early next month. Why would I suddenly need a root canal? Based on my description, why would a temporary bridge cause ongoing pain? Thank you. Kurt from NH

 

Kurt

Thank you for your question. One of our dentists would need to examine your bridge, teeth, and X-rays for an accurate diagnosis. However, we will explain three factors that might cause a temporary bridge to hurt.

Why Would a Temporary Bridge Hurt?

Diagram of a dental bridge

Dental bridge

A temporary bridge can hurt because your teeth are sensitive after preparation, irritated by bacteria, or the bridge is not optimal.

  • Sensitive teeth after preparation – Placing a bridge requires shaving down teeth on the sides and top so the bridge ends will fit over them. Teeth prepared for a bridge can ache and be sensitive to cold and hot temperatures, food, and drinks. Removing a bridge and preparing teeth for a new one are traumatic events.
  • Irritation from bacteria – If a dentist finds decay beneath a dental bridge or its components, bacteria could have infected and irritated your teeth.
  • Bridge position – A bridge that does not fit well can affect your bite. When you eat, the opposite teeth (upper or lower) can hit the bridge teeth harder than usual and make them ache. You can feel jaw or neck pain and get headaches, too.

Referring You to a Root Canal Specialist

When a dentist cannot identify the cause of your pain, they may refer you to a root canal specialist (endodontist). The endodontist will examine your teeth, possibly x-ray them, and test their sensitivity.

Although some dentists delay making the permanent bridge, others place it with temporary cement. It gives the dentist time to observe your teeth and see if the sensitivity resolves. An X-ray will show whether the tissue inside the tooth is infected or died and requires root canal treatment. Prompt care can help preserve the tooth, preventing the spread of an infection or the need for a dental implant.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

Why Does My Temporary Crown Keep Falling Off?

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My temporary crown saga feels like a never-ending loop! It all started with the first one popping off just 30 hours after it was placed. My dentist glued it again, only to have it dislodge after two hours. I got a new temporary crown, but pieces of it chipped off until Sunday night when the whole thing came off. I was compliant with eating, so I don’t know why I’ve had problems with the crown. I have an appointment next month for the final crown. It’s safe to that I don’t have much confidence in the permanent crown now. Should I reject the crown from my dentist and start over with a new dentist? – Thanks. Cyan

Cyan,

Two dental crowns

Your temporary crown reflects how your final crown will look and feel

We understand your anxiety about your upcoming permanent crown placement, and the issues you’ve experienced with the temporary crowns are certainly raising understandable concerns.

  • Repeated temporary crown failure: While occasional temporary crown detachment is expected, three consecutive episodes are concerning. This could indicate issues with the tooth preparation, the material used, or the bonding technique.
  • Lab-rejected impression: This further raises doubts about the accuracy of the crown preparation. An improper impression could lead to an ill-fitting permanent crown, compromising its longevity and stability.
  • Lack of confidence: Feeling apprehensive when trust in the procedure is shaken is natural. You have every right to prioritize your comfort and well-being.

What Are Your Options When a Temporary Crown Won’t Stay On?

If your temporary crown doesn’t stay on, you can give your dentist another chance to secure it, get a second opinion, or transfer to a new dentist immediately.

  • Second opinion: Consult an advanced cosmetic dentist dentist for an objective assessment. They can evaluate the tooth preparation, analyze the temporary crown issues, and offer expert advice on the permanent crown’s viability.
  • Transferring care: You have the right to switch dentists’ mid-procedure. Your current dentist has an ethical obligation to seamlessly collaborate in transferring your case.
  • Financial considerations: Discuss reimbursement options with your new dentist if your concerns are confirmed. Depending on the situation, seeking partial or full reimbursement from the initial dentist may be realistic.

 

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

 

Why Do My Dental Implants Hurt When I Chew?

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In August 2020, my dentist finished my full-mouth reconstruction, including five implants, seven crowns, and veneers. Two of the crowns on my natural teeth fell off last week, and I have an infection around three of the five implants. My gums are swollen around the implants, and chewing hurts. My dentist relocated last December, and I cannot find a listing for his new dental office. I am anxious about finding a new dentist to reattach the crowns and worried that I would need to repeat the full-mouth reconstruction. Where do I begin? Thank you. Baldwin from CT

Baldwin,

Thank you for contacting Dr. Szarek’s office.

We are sorry to hear about your stressful experience. You can benefit from an exam and a 3-D CT scan to identify the cause of your discomfort. Also, a skilled restorative dentist can determine why your crowns have fallen off.

What Causes Dental Implants to Hurt When You Chew?

Model of a dental implant, including the crown, abutment, and artificial rootDental implants can hurt when you chew if you have an infection around the implants. Usually, the condition is a form of gum disease that can lead to dental implant failure. Signs and symptoms of infection include:

  • Bad breath or a bad taste in your mouth
  • Bleeding around the implants
  • Difficulty chewing
  • Loose implants
  • Pain, aches, or discomfort around the implant
  • Pus around the implants
  • Red or swollen gums
  • Visible implant threads

Treatment for Infection Around Dental Implants

Depending on the cause and extent of infection around dental implants and the quality of your dental implants, treatment options may include:

  • Antibiotics
  • Antimicrobial therapy
  • Laser therapy for your gums
  • Surgery
  • Implant removal, bone grafting, and implant replacement

Find a Skilled Implant Dentist

Look for dentists with advanced implant and cosmetic dentistry training. Dentists who restore implants but do not perform surgery partner with an oral surgeon or periodontist for implant surgery. Dentists with post-graduate cosmetic dentistry training are skilled at identifying the cause of faulty crowns and restoring dental implants.

We recommend scheduling consultations with two advanced cosmetic dentists to discuss your options.

Lowell, Massachusetts, accredited cosmetic dentist, Dr. Michael Szarek, sponsors this post.

Root Canal After Veneers

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I need a root canal after wearing veneers for 12 years. My left upper incisor is infected, so my dentist referred me to an endodontist. A root canal is my only option. My veneers look new, so I am concerned about my tooth turning dark after the root canal or losing the veneer altogether. Also, I got the veneers when I lived in Texas, but now I live in NJ. Although my dentist takes good care of my veneers, I haven’t seen any of her veneers’ cases, so I don’t know if I have confidence in her if I need a new veneer. Am I at risk of losing it? – Thank you. Linda from New Haven, CT

 

Linda,

It is unusual to need root canal treatment for a porcelain veneer tooth. But if a dentist aggressively prepared your tooth veneers and removed the enamel, the tooth is at greater risk for stress and decay.

How to Prevent a Root Canal from Darkening Your Veneer

Root canal after veneers can darken a tooth. But during treatment, your dentist can minimize the effects. After your endodontist performs your root canal treatment, they can preserve your tooth color with these steps:

  • Clean out root canal filling material from the portion of your tooth above the gumline
  • Place a flexible fiberglass post into the tooth root
  • Fill the space with a light shade of dental composite

Since leftover filling and cement darkening after root canal treatment usually causes darkening, the above steps will help. Cleaning out your crown can prevent your tooth from darkening for five to ten years. And your porcelain veneer can prolong the good results.

Will Root Canal Treatment Ruin Your Veneer?

Photo of dental forceps holding a single porcelain veneers, from the office of accredited cosmetic dentist Dr. Szarek of Lowell, MA.

A securely bonded veneer should stay intact during root canal treatment

Root canal treatment should not ruin your veneer. A dentist will access your tooth from the biting surface—not the front of a tooth where your veneer is located. If the dentist who placed your veneers bonded them securely, your veneer would stay in place during root canal treatment.

 

Michael Szarek, DMD sponsors this post. Dr. Szarek is an accredited cosmetic dentist in Lowell, Massachusetts.