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Dentistry/question regarding infection under crown and stained teeth

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Question
Hello Mr. Backlund

I'm a male in my late 20s and a smoker.  The last time I went to a dentist was over a year ago where I was told I had receding gums, an infection under my crown (from a root canal several years ago) and that I would need a deep cleaning.  I did not have the cleaning performed due to financial issues, and also because I felt pressured into doing it.  I was planning to get a second opinion, which I have yet to do, before I spent thousands of dollars for a deep cleaning.  Sometimes when I floss around the crown there is quite a lot of bleeding. This occurs when I do not floss for a few days. When I floss daily there is no bleeding.

What I wanted to ask is:
1. Assuming I do have an infection under the crown, is it wise to keep flossing until I see a dentist and perform a deep cleaning/replacement of the crown? Is the bleeding in fact a good thing, meaning it is getting rid of bacteria, or should I refrain from flossing around that area?

2. Being a smoker, I do have nicotine stains/dark brown spots, between my front lower teeth and behind the teeth.  I have noticed the stain "speading" on the surface/front side of the tooth. Is there a product that you will recommend (a specific toothpaste or use of baking soda) to get rid of those stains?

3. Do you recommend flossing with water (waterpik or waterflosser)? Is this more affective than regular flossing and will it help with the receding gum issue?

I will appreciate your advice, thank you!

Answer
Hi Nasios,

It sounds like you have some things going on that really need treatment. I'll try to help here, but I'm an endodontist, a root canal specialist, but I'm also a dentist, so I'll give it my best shot :-).

1. Assuming I do have an infection under the crown, is it wise to keep flossing until I see a dentist and perform a deep cleaning/replacement of the crown? Is the bleeding in fact a good thing, meaning it is getting rid of bacteria, or should I refrain from flossing around that area?

If the infection under your crown is from a failing root canal, no flossing or cleaning will fix that. You will need to deal with the basic problem. Usually that means re-doing the root canal. Bleeding from your gums is never a good thing. It means there is inflammation in the gums which over time, if not treated, will cause you to lose your teeth.

2. Being a smoker, I do have nicotine stains/dark brown spots, between my front lower teeth and behind the teeth.  I have noticed the stain "spreading" on the surface/front side of the tooth. Is there a product that you will recommend (a specific toothpaste or use of baking soda) to get rid of those stains?

There are many products available to try to remove stains...some better than others. You just need to try some out to see if they work for you. Just be careful as many are quite abrasive and will remove the enamel on your teeth while removing the stain. Your dentist can probably do a better job of removing the stain when they do the cleaning, but the ultimate answer here is to stop smoking and I know that is a tough thing to do, but even if the stain is removed, it will come back if you continue to smoke.

3. Do you recommend flossing with water (waterpik or waterflosser)? Is this more affective than regular flossing and will it help with the receding gum issue?

Nothing beats regular flossing with dental floss. Just make sure you are doing it correctly, i.e. sliding the floss on each side of the teeth, so you are cleaning 2 surfaces between each tooth. Just sliding the floss down the middle between 2 teeth will not do a good job of cleaning.

Good luck! You are taking the right first steps and I urge you to get your gum problem treated. Trying to manage that by yourself may not help depending on how severe your gum problem is. If you are having any bone loss, your situation is beyond your ability to improve things without treatment. If you further delay, you could be at risk of losing your teeth. It would be a good idea to get back to your dentist for a complete exam and then phase treatment over time so resolve your problem and keep finances under control too.

Gary Backlund DMD, MSD

Dentistry

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Gary Backlund, DMD, MSD

Expertise

I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.

Experience

25 years practicing as a specialist

Organizations
American Association of Endodonists, Past President Washington State Association of Endodontists.

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