Could I get a canker sore after a dental crown at age 45?

Question

Hello doctor,

I am a healthy 45-year-old female. Seven days ago, I had a crown replaced at the very back of my top left side (the old crown chipped and broke off). My mouth is very small, so the dental staff often has difficulty working in the back of my mouth. When the hygienist used one of the suction instruments, it pushed up against my gum and caused me pain for most of the procedure. I was expecting some soreness in the area, which I have had all week. Yesterday it was feeling very sore, so I decided to look at the gum. There are three circular areas - two small and one large, which appeared like cankers to me.

I sent a photo to my dentist, and she agreed they are cankers from injury to the gum. I have attached a photo for you as well. The large sore (above the area of my missing tooth) is hurting quite a bit, mostly when my tongue or something touches it, but it hurts most of the time. I have been taking Advil (Ibuprofen) to help relieve the pain. As far as I can tell, the teeth are not in pain, and I do not notice any sensitivity to hot or cold. I think the pain is mostly coming from the gum. I have had root canals where the crown and missing tooth are. Currently, I am taking Bisoprolol, Wellbutrin (Bupropion hydrochloride), Dexilant (Dexlansoprazole), and Marvelon (Ethinylestradiol and Desogestrel).

I have a few questions:

Do these look like canker sores to you as well?
Do they look like abscesses to you, or do they look infected? Should I be on an antibiotic?
Is it possible for them to cause pain in the area even if nothing is touching them?
If they are cankers, how long can I expect to have them (it has been seven days since the procedure)?
Is there anything I can do to help with the pain?
Is there a point at which I should call the dentist?

Thank you so much for your help.

Answer 1

Hello,

Welcome to icliniq.com.

I have seen the images enclosed (attachment removed to protect the patient's identity). I will suggest a series of instructions in the follow-up messages. Please go through and follow accordingly. If any doubts, you can always follow up.

Usually, such ulcers or sores are caused by pressure or trauma. These ulcerations are generally self-limiting, meaning they heal in a week or ten days maximum. But if you observe they are reddening or have a white patch-like appearance that worsens over time, you need to reconsider me for antibiotic prophylaxis. In these ten days, you can follow these simple strategies to prevent them from aggravating and make them disappear.

Lukewarm salt water rinse several times a day.
Use an antiseptic mouthwash like Chlorhexidine or Betadine gargle twice a day. That will lessen the sore size.
Alternatively, you can apply ointment containing Lidocaine and Choline salicylate to the affected areas.
Right now, there is no need for an antibiotic. You need to wait and watch if it aggravates over the next few days.

Simple salt water rinsing and antiseptic mouthwash will help eliminate the ulcers. For pain, you can use the local antiseptic gel suggested.

I hope this has helped you. Please feel free to reach me again, in case of further queries.

Thank you.