IS IT NORMAL THAT MY GUMS BLEED CONSTANTLY AROUND MY CROWN & BRIDGE WORK?

WHY WOULD MY CROWNS SUDDENLY SHOW A BLACK LINE?

CAN YOU EXPLAIN THE COSTS ASSOCIATED WITH DENTAL WORK?

THE  PORCELAIN FACING OF MY TOOTH BROKE, IS IT BECAUSE I BITE TOO HARD?

MY BREATH IS OFFENSIVE EVEN AFTER BRUSHING. IS IT MY DENTAL WORK?

IS IT NORMAL THAT MY GUMS BLEED CONSTANTLY AROUND MY CROWN & BRIDGE WORK?

Of course not. Reasons for the bleeding may be that;

1, The crowns are over bulked.

2, The crowns are not fitted properly.

3, Invasion of biological width.

In the first case where crowns are over bigger than the original tooth they cause traumatic pressure on the gums, creating an area where bacterial plaque accumulates which causes inflammation and bleeding. Many doctors who place these over sized/over bulked crowns blame the patient for not cleaning properly. If the rest of the areas where no crowns are present aren't bleeding then it is not the patients fault. Something is wrong with the crowns.

In the second case where the crown does not fit properly food and bacteria enter the gap between the crown and the tooth where it is impossible to clean. This causes decaying of the natural tooth underneath the crown and gum inflammation then infection. At this point a root canal would be necessary or if the decay is too advanced the tooth becomes unable to be restored and will require extraction.

The third possibility concerns the attachment of the crown too deeply into the gum and close to the bone which impairs the normal attachment of the gum to the tooth. This creates a periodontal pocket and causes constant discomfort, inflammation and bleeding.

WHY WOULD MY CROWNS SUDDENLY SHOW A BLACK LINE?

A line should never show on a crown unless it was made with a black line (metal collar) and the dentist wasn't able to hide it under the gum line. If the crown is defective or is over bulked, the trauma to the gums will cause the gums to recede and eventually show the black metal collar. If the dentist was at first able to hide the metal collar but the crown was to big, not fitting or too bulky the gum would recede or get inflamed and then this collar would show. Quality crowns, veneers and onlays are made of full porcelain, so that there is no risk of a black line. Other types of crown that need to have metal are made with a porcelain butt margin to hide the metal. In this procedure the metal is cut back 2 mm and a porcelain band is inlayed upon the metal so it doesn't show through.

CAN YOU EXPLAIN THE COSTS ASSOCIATED WITH DENTAL WORK?

Dentistry is costly to practice due in part to the technological equipment required and the materials involved. Leasing and building a dental office is twice as costly per square foot than a regular medical office. To equip a dental practice with offices, multiple operatories each with dental chairs, x-ray machines, fixtures, hand pieces, materials, computers and cameras, reception, waiting rooms, a lab, restrooms is very costly. Overhead includes, a professional office manager and staff, dental assistant, hygienists, laboratories, memberships to associations, licensing, congresses, property and liability insurance which is very high. Dentistry requires 4 to 5 years of post graduate studies just to become a General Dentist. To become a specialist requires 3 years additional education. Good schools cost 80K per year. All doctors have to keep current and this means continuing education to update knowledge and renew licenses. Prosthodontists, general dentists and orthodontists require a laboratory to complete their job. The laboratory technicians need to be very skilled otherwise they could ruin the doctors work. There are cheap factory labs and some Mc-dental outfits outsource their work in order to cut cost. But using labs that are more artistic and local assures the quality of the appliance the doctor is designing and ordering and allows for more direct guidance and doctor input. Skills and artistic components unique to each dental practitioner translate to consistency and the success rates of the patients. Treatment is considered successful when after being completed, provided that the patient is consistent with home care and continuing maintenance care by the hygienist, they do not come back for the same treatment or procedure for over 20 years.

THE PORCELAIN FACING OF MY TOOTH BROKE, IS IT BECAUSE I BITE TOO HARD?

The breaking of a crown or bridge would more likely be due to poor tooth preparation, bad workmanship at the lab, or an unbalanced bite. In properly preparing a tooth to receive a restoration a skilled specialist will reduce the tooth to allow the exact amount of even space (down to a fraction of a millimeter) to accommodate the perfect thickness of porcelain. If it is too thin it will be weak. If it is too thick it will not set correctly on the shoulder the doctor should have so carefully shaped into the base of the receiving tooth. Without an even surface to which a permanent bond can be fixed, the restoration will lose its bond with the tooth, making it susceptible to breakage. Another possibility is an occlusion or unbalanced bite. A general dentist may not have had the skills that a specialist in prosthodontics would have had to foresee the need to adjust or correct the bite prior to permanently affixing the restoration to the tooth.

MY BREATH IS OFFENSIVE EVEN AFTER BRUSHING. IS IT MY DENTAL WORK?

There are a few possibilities. One likely cause would be an "open margin" which is a gap between the natural tooth and the restorative material used to create the crown, filling, bridge, or veneer. This is caused by an imprecise fit of the restoration which allowed for food and bacteria to build up and start eating away at the natural tooth. The slow process of decay may take months or years to even get to the point of an issue even being detectable by the patient, usually in the form of sensitivity to hot and cold at first, which is why regular checkups and cleanings are necessary. During a proper cleaning or yearly check-up the hygienist should notice the issue before it becomes a problem. X-rays would also show a problem occurring before the proms get to far advanced. If left untreated, the open margin will lead to the rotting of the tooth under the restoration causing a bad taste in the mouth, bad breath, and the failing of the restoration. Letting it get to this point, the tooth may become unsalvageable, then an extraction and implant would be necessary. If a dentist does not make a perfect restoration that matches your natural strike , however much nicer it may look, it will fail.

CAN YOU EXPLAIN THE COSTS ASSOCIATED WITH DENTAL WORK?

Dentistry is costly to practice due in part to the technological equipment required and the materials involved. Leasing and building  a dental office is twice as costly per square foot than a regular medical office. To equip a dental practice with offices, multiple operatories each with dental chairs, x-ray machines, fixtures, hand pieces, materials, computers and cameras, reception, waiting rooms, a lab, restrooms is very costly. Overhead includes, a professional office manager and staff, dental assistant, hygienists, laboratories, memberships to associations, licensing, congresses, property and liability insurance which is very high. Dentistry requires 4 to 5 years of post graduate studies just to become a General Dentist. To become a specialist requires 3 years additional education. Good schools cost 80K per year.  All doctors have to keep current and this means continuing education to update knowledge and renew licenses. Prosthodontists, general dentists and orthodontists require a laboratory to complete their job. The laboratory technicians need to be very skilled otherwise they could ruin the doctors work. There are cheap factory labs and some Mc-dental outfits outsource their work in order to cut cost. But using labs that are more artistic and local assures the quality of the appliance the doctor is designing and ordering and allows for more direct guidance and doctor input. Skills and artistic components unique to each dental practitioner  translate to consistency and the success rates of the patients. Treatment is considered successful when after being completed, provided that the patient is consistent with home care and continuing maintenance care by the hygienist, they do not come back for the same treatment or procedure for over 20 years.

THE  PORCELAIN FACING OF MY TOOTH BROKE, IS IT BECAUSE I BITE TOO HARD?

The breaking of a crown or bridge would more likely be due to poor tooth preparation, bad  workmanship at the lab, or an unbalanced bite. In properly preparing a tooth to receive a restoration a skilled specialist will reduce the tooth to allow the exact amount of even space (down to a fraction of a millimeter) to accommodate  the perfect thickness of porcelain. If it is too thin it will be weak. If it is too thick it will not set correctly on the shoulder the doctor should have so carefully shaped into the base of the receiving tooth. Without an even surface to which a permanent bond can be fixed, the restoration will lose its bond with the tooth, making it susceptible to breakage. Another possibility is an occlusion or unbalanced bite. A general dentist may not have had the skills that a specialist in prosthodontics would have had to foresee the need to adjust or correct the bite prior to permanently affixing the restoration to the tooth.

MY BREATH IS OFFENSIVE EVEN AFTER BRUSHING. IS IT MY DENTAL WORK?

There are a few possibilities. One likely cause would be an "open margin" which is a gap between the natural tooth and the restorative material used to create the crown, filling, bridge, or veneer. This is caused by an imprecise fit of the restoration which allowed for food and bacteria to build up and start eating away at the natural tooth. The slow process of decay may take months or years to even get to the point of an issue even being detectable by the patient, usually in the form of sensitivity to hot and cold at first, which is why regular checkups and cleanings are necessary. During a proper cleaning or yearly check-up the hygienist should notice the issue before it becomes a problem. X-rays would also show a problem occurring before the proms  get to far advanced. If left untreated, the open margin will lead to the rotting of the tooth under the restoration causing a bad taste in the mouth, bad breath, and the failing of the restoration. Letting it get to this point, the tooth may become unsalvageable, then an extraction and implant would be necessary. If a dentist does not make a perfect restoration that matches your natural strike , however much nicer it may look, it will fail.