Expert: Debbie - 2/2/2005

Question
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Followup To
Question -
I have had a persistent bad taste in my mouth ever since receiving a porcelain crown approximately five years ago.  The taste seemed to eminate from the treated tooth, but subsequently has migrated one tooth back to my hindmost upper left molar.  I have consulted numerous specialists, including my regular dentist, an endodontist, a periodontist, my regular physician, and an ear/nose/throat specialist.  None found pathology or could pinpoint cause other than very mild gingivitis.  My dental hygienist mentioned yesterday that "gums don't like porcelain crowns," and that gum recession is not uncommon following the presence of such a crown.  Would you recommend my pursuit of this analysis [I have no other porcelain in my mouth] as a possible cause of the bad taste?  Or do you have any other recommendations based on what little information I've provided?
 I have consulted a second periodontist and have been under his care for the last six months.  He is very interactive, we are approaching this situation in a stepwise manner, but nothing new has developed out of our search for a cause as yet [except this somewhat idle comment by his hygienist].
 Thank you for any wisdom you may be able to share.
Answer -
Sometimes crowns can be food traps - make sure you are flossing that area daily and rinse with some Listerine once a day.  If that dosen't help - then I am afraid you are stuck with it - the periodontist is a good person to stay in treatment with.  Are they sure the crown is not loose?  Sometimes when the seal is broken and the crown needs recemented - it can have a funny taste..

Hope this helps
Debbie

Debbie -
 I floss twice daily, but the use of Listerine was discontinued since good as well as bad bacteria are affected with persistent use [or so I was told].  My crown was replaced at no charge a couple of years ago in case there were gaps around the edges.  The taste, if anything, got worse.  I had a second dentist evaluate both the first and second crowns.  No gaps were found during either examination.
 I don't see my periodontist for another six weeks.  I want to run down in advance of that appointment the hygienist's comment regarding the relationship between gum recession and porcelain crowns.  Any comments?  Secondly, I have been told [but have been unable to substantiate] that this taste could have ramifications regarding heart disease [due to the spread of infection].  Any comments?
 I hope I am not bugging you, but I need as much information for my next appointment as possible.  The taste is persistent, getting close to intolerable, and I have no leads for a suitable treatment for the symptoms, let alone for a cause.
 Thank you again for any advice, if only for suitable questions to pose to my periodontist.
Jan

Answer
It is true that the gum tissues do not like crowns - sometimes they get puffy and sometimes they recede away from them.    Just because you have a bad taste in your mouth does not mean that there is an infection - it could be that you are trapping food in that area.  The risk of heart disease from a persistent infection in the mouth is a real one - but that would apply to a more widespread peiodontal disease  - not the gingivitis that you are experiencing.  We are more concerned about this when there is visible infection - like pus coming from the gums and chronic abcesses.  

Hope this helps
Debbie