I have painful bulge of skin around a tooth that had a root canal 3 years ago, and now need a crown. Should a gingivectomy be peformed before a crown is placed?
Should a Gingivectomy Be Peformed Before a Crown is Placed?
Doctor Answers 6
Sounds to me as if you have an infectious or inflammatory process going on around your tooth. This may indicate a failing root canal treatment, periodontal infection or even a fractured tooth. Make sure to find out if anything like this is occuring prior to having a new crown placed.
I would not pursue a crown until you have had the tooth examined to determine the cause of the painful bulge. This could be a sign of a recurrent infection of the tooth, a periodontal infection, or a crack in the tooth. When it is determined that a crown can and should be placed, a gingivectomy may be needed if their is insufficient tooth above the gums. We use a soft tissue laser to perform this procedure to allow for it to be minimally invasive. The patient is rarely even sore after the procedure and there is no bleeding or need for sutures.
A dental tooth crown should not be placed before you address the painful bulge. It may indicate that there is excessive decay or that there is a failure in the root canal. You should have a candid conversation (maybe multiple opinions) about the tooth and the prognosis before investing more money in it.
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A "painful bulge" on the gum around a tooth is something that should be addressed prior to placing a crown. A gingivectomy, while sometimes necessary before completing a crown procedure, may not be what's needed in this particular case.
If there is indeed excess gum tissue, it should be removed. The real question should be "Why is there excess gum tissue?" If it is caused by an active gum or nerve infection, that issue must be dealt with first.
In the situations when there is a growth of the gingiva in the area where the crown margin is supposed to be, the small gingivectomy under local anesthesia can be easily performed. After the tooth is preped for the crown and before the temporary crown is placed, gingivectomy should be performed
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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