Tooth Decay That Extends Below the Gums and How to Treat It!
When you have a cavity or tooth decay that extends below the gums (subgingival) it may be difficult to treat. Most dental restorative materials require a dentist to keep the area dry during the restoration. This can be difficult when decay is below the gums!
Tooth decay occurs in general at the edges of a filling and the remaining tooth. The area below the gums is harder to clean and often decay begins there. Because it is harder to clean patients often do not clean well here. In case you were wondering, cleaning the margins of restorations and cleaning below the gums requires massaging the gums with a toothbrush and flossing or comparable oral hygiene treatment. Areas that are not cleaned well become homes for bacteria and food and other debris and then gum disease starts! Tooth decay starts beside and then below the filling and the tooth breaks down adjacent to the filling or the filling itself becomes rougher. Gum disease leaves the gums more fluid filled and more likely to bleed or ooze.
Try placing a quality filling (especially a tooth colored restoration) in a wet bloody area. It cannot be done! In the case shown here, the patient’s oral hygiene is very good but the gums have responded to the rough filling and subgingival tooth decay by becoming overgrown. Shown here is one way to treat tooth decay that has extended below the gum line. Note the rough amalgam restoration next to the gums with recurrent subgingival decay and gingival inflammation.
The next photo is the same tooth about a week later. A gingivectomy or gum surgery has been completed to remove the excess tissue, access the decay and enable restoration of the tooth. A bonded, tooth colored restoration was placed and the area allowed to heal. The Patient reported no difficulty with healing and very little discomfort.
Whenever possible, it is best to keep tooth restorations above the gums where they are easier to maintain. However, if there is already an existing restoration or decay below the gums the new restoration must be placed there. There are several ways to address this problem. This blog presented one way via gum surgery which also served to remove excess tissue and promote future easier hygiene of the area.
Our office is dedicated to providing the highest quality dental care in a clean, caring and comfortable environment. We serve patients from all over Colorado but most of our patients are from Grand Junction, Palisade and Clifton, Colorado. We would love to hear from you (970) 242-3635 and our office is always accepting new patients.