Expert: Mark Bornfeld DDS - 3/4/2009

Question
I have a larger space than usual between my two back molars on my left side.  This often leads to food getting caught which causes significant pressure, headaches, and discomfort.  A few days ago, I went out to eat and this occurred, yet I had no floss. I used toothpicks to get the food out because it was so painful, causing even more pain.  However, now a few days later the gum surrounding those two teeth are extremely inflammed and sensitive, causing immense pain especially when flossing.  I went to my dentist who told me to rinse with hydrogen peroxide, without any specific instruction (ie, how many times per day, how long till it may clear up,etc).  The only thing he told me was to get a $1,000+ crown put on.  Now while I understand this is a long term solution, I am a college student on part-time work benefits and simply cannot afford that investment.  I am now taking Tylenol, rinsing with hydrogen peroxide and antibacterial mouthwash, and using orajel.  I am usually aware that the inflammation is there, but unless I floss or get fibrous food caught in it, it doesn't cause extreme pain.  I have had this space all my life and it has never hurt like this before.  What would you suggest for a more short-term solution?  Is my only option the crown?

Answer
Dear shauna,

From your narrative, it seems probable that you sustained a physical injury to the gums. Assuming this is the case, the best short-term solution would be to implement symptomatic treatment (e.g., application of topical anesthetic products such as Anbesol or similar preparations), and allow time (about a week or so) for the injury to heal. In all likelihood, the symptoms should resolve to the same level as they were before you incurred the injury.

I cannot determine whether a crown is your only option; however, if the space to be closed is less than about a millimeter in width, it may be possible to close it with a filling, which would certainly be more economical if it works.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY