Dealing with Gum Discomfort After Dental Work: What to Do Next? - Dentistry

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Gum discomfort?


Hello Doctor, around early September when I had my braces removed, I discovered a secondary cavity in my lateral incisor.
It was excavated and filled; the cavity was deep but not yet reaching the nerve.
After the filling, I have had no issues with chewing, but occasionally I feel some swelling in the inner gum, and sometimes it hurts when I press it with my tongue, though sometimes it doesn’t hurt.
I have seen two doctors: Doctor A at a hospital said it was mild periodontal disease and performed about three dental cleanings, while Doctor B at a clinic said the filling was too deep and reached the gum, and he used a tool to scrape the inside of my tooth.
He mentioned that if the pain persists, I might need surgery to cut the gum.
Both doctors tapped on the nearby teeth, and there was no pain.
I would like to ask how I should proceed: should I continue with regular dental cleanings at Doctor A's office, consider the gum surgery with Doctor B, or seek a consultation at another clinic?

An, 20~29 year old female. Ask Date: 2023/11/08

Dr. Zeng Guanghui reply Dentistry


Hello Ms.
An: If you are experiencing inflammation and pain in your gums, it may be due to the filling being positioned below the gum line, which is putting pressure on the gums.
It is recommended to adjust the filling or consider surgical removal of the gum tissue.
Please return for a follow-up visit with your dentist for further examination.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2023/11/08

More Info


Dealing with gum discomfort after dental work can be a frustrating experience, especially when you have received conflicting opinions from different dental professionals. Based on your description, it seems that you are experiencing some discomfort in the gum area surrounding a recently filled tooth, which may be indicative of a few potential issues.

Firstly, it is essential to understand that after dental procedures, especially those involving fillings, it is not uncommon to experience some level of discomfort or sensitivity. This can be due to several factors, including the depth of the filling, the technique used, and the healing process of the surrounding tissues. In your case, since the filling was deep but not close to the nerve, the discomfort may be related to the gum tissue itself or the way the filling interacts with your bite.


Suggested Steps for Management:
1. Monitor Symptoms: Keep track of your symptoms. If the discomfort is mild and intermittent, it may resolve on its own as the gum heals. However, if the pain worsens or becomes persistent, further evaluation is necessary.

2. Follow-Up with A Dentist: Since you have already seen two dentists, it may be beneficial to return to the one who performed the filling (if possible) to discuss your ongoing symptoms. They can assess whether the filling is indeed too deep or if there is another underlying issue.

3. Consider a Third Opinion: If you feel uncertain about the advice given by the two dentists, seeking a third opinion from another dental professional, preferably one who specializes in periodontics (gum health), could provide additional insights. They may offer a different perspective on whether the issue is related to gum disease or the filling itself.

4. Dental Cleaning: Regular dental cleanings can help manage gum health. If A hospital suggested regular cleanings, it might be beneficial to follow through with this recommendation, especially if they have noted signs of mild periodontal disease. Maintaining good oral hygiene is crucial in preventing further complications.

5. Surgical Options: The suggestion from B clinic regarding surgical intervention (gingivectomy) should be considered carefully. This option is typically reserved for more severe cases where there is significant gum overgrowth or infection. If your symptoms do not improve with conservative management, this may be a necessary step, but it should be discussed thoroughly with your dentist.

6. Home Care: In the meantime, ensure you are practicing good oral hygiene. Use a soft-bristled toothbrush and gentle brushing techniques to avoid further irritation. Rinsing with warm salt water can also help soothe inflamed gums.

7. Pain Management: Over-the-counter pain relief medications, such as ibuprofen or acetaminophen, can help manage discomfort. However, consult with your dentist before taking any medication, especially if you have underlying health conditions or are taking other medications.


Conclusion:
In summary, your approach should be systematic. Start by monitoring your symptoms and maintaining good oral hygiene. Follow up with the dentist who performed the filling for a reassessment, and consider seeking a third opinion if necessary. Regular dental cleanings can help manage gum health, and surgical options should be a last resort after conservative measures have been exhausted. Always communicate openly with your dental care providers about your concerns and symptoms to ensure you receive the best possible care tailored to your needs.

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