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Periodontics/gum inflammation

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tooth 10
tooth 10  
QUESTION: I have gum inflammation in the gums above tooth 10 (left of the implant.) From the attached x-ray, please tell me what you think may be causing this inflammation.

ANSWER: Dear Bill,
Tooth #10 has a very deep pocket on the side that faces the implant.  Due to the bone loss that took place in this area and where the implant has been placed you now have a pocket or space between the tooth (#10) and the abutment of the implant.  This is going to be very challenging to keep clean and as a result you may have inflammation in the area.  This space needs to be cleaned thoroughly at least every 3 months to maintain health.  Did the dentist who took the x ray review this with you?

Good Luck
Dr. Siegelman

---------- FOLLOW-UP ----------

QUESTION: Thanks for your rapid reply. When you say cleaned at least every 3 months, does that means by a professional dental hygienist? Does the hygienist have to use any special technique, or is it just the usual cleaning as would de done on other teeth?
My dentist suggested removing the crown and removing the gold post to get a better view as to what is happening inside. He also thinks the inflammation may be due to the fit of the crown. From the x-ray, how do the margins of the crown appear to you?

Answer
Bill, I think you need to see the specialist who placed the implants.  I don't think your general dentist has any concept of what is going on.  As far as cleaning that area goes, yes a dental hygienist can do it but it does require special instruments.  I have no way of knowing if they have those or if they are doing it right.  I am very limited in how much I can help you using this forum.  

Good Luck
Dr. Siegelman

Periodontics

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Bryan M. Siegelman, DDS

Expertise

I can answer any question relating to the diagnosis and treatment of periodontal disease. I can also answer questions relating to the placement and restoration of dental implants.

Experience

I have been practicing Perioodontics for the past 20 years. I limit my practice to periodontics and implant dentistry. I am a diplomate of the American Academy of Periodontology. I am in private practice in Pennsylvania and am on staff at the local hospital in my home town. My practice website is www.gumsolutions.com

Organizations
American Academy of Periodontology, Academy of Osseointegration, American Dental Association, American College of Dentists, Pennsylvania Dental Association

Education/Credentials
I have a BS from Muhlenberg College, I did a general practice residency at St. Joeseph's Hospital and Medical Center in Paterson, NJ. I received my DDS degree and specialty certificate from the University of Maryland Dental School.

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