Are Porcelain Veneers Causing My Gums to Burn and Be Inflamed?

What can cause gum inflammation after getting porcelain veneers? Three months ago, I had eight veneers placed on my upper front teeth. Since then, my gums have been consistently inflamed and have experienced a burning sensation.

A dental assistant attributed this to my brushing habits, suggesting I wasn’t cleaning them adequately. However, I’m diligent about oral hygiene and have followed all post-procedure instructions for my veneers, but the inflammation hasn’t improved.

During a one-month follow-up, my dentist removed some cement and smoothed rough surfaces behind the teeth. This offered slight relief, but after two months, the inflammation lingers. Will I need my veneers removed? Thanks. Mali from NY

Mali,

It’s understandable to be concerned about persistent gum inflammation after receiving new porcelain veneers. There are several common reasons this can occur, and identifying the cause can help your dentist or a gum specialist provide effective treatment.

What Can Cause Gum Inflammation After Porcelain Veneer Placement?

Porcelain veneer cementing technique, irregularities where your tooth and veneer meet, veneer placement, and other factors can cause gum inflammation. Below are five possible causes of gum inflammation after getting porcelain veneers.

• Excess Cement After Veneer Placement: The most frequent cause of gum inflammation after porcelain veneer placement is residual cement. This is particularly true if the cement has seeped below the gumline. Dentists who specialize in porcelain veneers typically place a veneer by curing only the central portion of the cement, which allows easy removal of soft excess before it fully hardens. The fact that your dentist removed some cement during your one-month follow-up visit makes excess cement most likely the cause of your gum inflammation.
• Irregularities at the Veneer Margins: Occasionally, the edge where the veneer meets your natural tooth can be uneven, forming an overhang. Although your periodontist provided a vague assessment of your margins, a second opinion from an independent cosmetic dentist would offer a more objective evaluation.
• Extended Use of Temporaries: Wearing temporary veneers for a prolonged period, such as the five weeks you mentioned, can sometimes irritate the gums. However, this type of inflammation usually presents challenges during the bonding of the permanent veneers, which doesn’t seem to have been an issue for you.
• Veneers Placed Too Deeply: If the veneer’s margin extends too far into the gum sulcus (the natural groove around your tooth), it can impinge on the delicate gingival attachment, leading to inflammation.
• Material Sensitivity: Although rare, some individuals may experience sensitivity or an allergic reaction to the porcelain or ceramic materials used in veneers.

We recommend seeking a second opinion from a dentist with post-graduate training in cosmetic dentistry. The dentist will determine whether you need further treatment from a periodontist (gum specialist).

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post.

 

Will My Wisdom Tooth Surgery Cause Nerve Damage?

My lower right wisdom tooth is partially impacted. I’m 35 now, so my risk of nerve damage is probably higher. I saw an oral surgeon last week. The surgeon reviewed the X-ray from my dentist and said he recommends removing the tooth. The surgeon didn’t take a 3D scan. How do I know whether nerve damage is a factor? Thanks. Khalid

Khalid,

It’s a common misconception that wisdom teeth should only be addressed when they start causing problems. Your situation highlights why this thinking can be problematic. Wisdom teeth are significantly easier to remove before their roots fully form, thicken, and before the surrounding bone becomes denser. For you, the extraction will likely be more complex now. However, your lower left wisdom tooth needs to be removed; delaying the procedure will only increase the risks and difficulty, and it’s only a matter of time before an infection develops.

What’s the Risk of Nerve Damage with Wisdom Tooth Removal?

We can offer some reassurance regarding your lower left wisdom tooth: it doesn’t appear to be impinging on your nerve. While any responsible oral surgeon will mention some inherent risk (as there always is), a 3D scan should enable them to safely navigate around the nerve. Be aware that some oral surgeons may overstate the risks to protect themselves legally, but this doesn’t diminish the procedure’s safety with careful planning.

Concerns About Your Other Wisdom Teeth

We are less certain about your lower right wisdom tooth. The roots appear very close to the nerve canal, possibly even wrapping around it. The tooth’s angle, while making extraction more difficult, isn’t a risk. Being close to a root canal tooth simply means the surgeon needs to be more precise; however, a skilled surgeon should manage the removal effectively. This procedure should not permanently alter your facial structure; while swelling is expected initially, it will subside within a few days.

We advise ensuring you have an excellent oral surgeon perform this procedure. It would be wise to have them remove both your upper wisdom teeth at the same time. They are also impacted and need to be extracted. Additionally, ask your surgeon to evaluate the proximity of the lower right wisdom tooth to the nerve using the 3D scan, and consider having it removed as well, unless it genuinely impinges on the nerve.

 

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post. Read why many of his patients say he is one of the best dentists in town.