Does removing the excess filling in a tooth cause tooth gap?

Question

Hi doctor,

I have gone to see a different dentist after I retire. My first appointment with the new dentist, they took x-rays, and the dental hygienist started to clean my teeth. She noticed an excess cement that was from my crown procedure a couple of years ago and stated that it had to be removed because it is irritating the gum in between my crown and my other tooth. By the way, when I was young, they could not save the tooth, so when they extracted it, the tooth or molar next to it started shifting in an angle creating a hole in between the two teeth. Food gets stuck in there, but when my dentist replaced the crown two years ago, I started getting relief. Until now when I went to the new dentist and her dental hygienist told me that she would remove the excess cement. That is where it started going bad and annoying. Food was getting stuck in between the teeth again.

My question is, do you think my previous dentist did the crown like that in purpose (putting excess cement to somewhat cover the hole ), or is the dental hygienist right about her findings or diagnosis? Mind you, I did not get examined by the new dentist until after the hygienist cleaned and removed the excess cement. It took her awhile to remove it and my gum was terribly bleeding. I was not hurting, but it was definitely unpleasant. Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern. I saw the attachment you provided for example and got your point. (attachment provided to protect patient identity).

Removing excess cement stuck in between the crown and natural tooth is a correct procedure. This excess cement flow happens during crown fixing. This should be removed during the crown fixing appointment or the review appointment. But sometimes, this cement flows, very deep into the gums which cannot be seen clinically and easy to miss during crown fixing appointment. It can only be seen in the x-ray.

This excess cement irritate the gums constantly and pushes the gums still further down thereby increasing the space between the two teeth. Your gums should be inflamed in that region due to constant irritation. That is why you had gum bleeding in that area when the cement is removed. Please have your next appointment with the dentist. A clinical photo or your x-ray is required to determine the next procedure to stop your food lodgement.

Depending on the amount of space present, gum height in that region, your dentist may recommend you to use a periodontal proxy brush (if the space is more and cannot be closed) or close the space by a filling to the nearby tooth, or advise a new crown to compensate the space created by the previous cement flow.

And please do note that advice has been given with the details provided and present clinical photo. The x-ray of the current clinical scenario is ideally required for a correct diagnosis and treatment planning.

I hope this helps.