A scratch on the gum - how to treat it at home

Soldatova Lyudmila Nikolaevna

Candidate of Medical Sciences, Professor of the Department of Clinical Dentistry of the St. Petersburg Medical and Social Institute, Chief Physician of the Alfa-Dent Dental Clinic, St. Petersburg

Today, almost everyone knows that teeth need especially careful care. We buy expensive pastes and use special thread. But, unfortunately, when taking care of our teeth, we completely forget about the tissues surrounding them, while the health of our gums needs to be monitored no less carefully.

Many people are familiar with the symptoms when the gums begin to hurt when pressing between the teeth. And many, unfortunately, ignore this unpleasant pain. Let's figure out what can cause it, what these sensations indicate, and how to relieve unpleasant symptoms.

Causes of pain in the gums when pressing

Remember, discomfort in your gums is a reason to see a dentist. No matter what kind of pain you feel, relatively mild or severe, you need to determine the cause of the problem as soon as possible and begin treating it.

As a rule, pain in the gums when pressed is provoked by three diseases:

1. Gingivitis. This disease is accompanied by swelling of the mucous membrane and bleeding. Inflammation is provoked by microbial plaque, which occurs due to non-compliance or improper oral hygiene.
2. Periodontitis. The disease, as a rule, is accompanied not only by unpleasant sensations, but also by a general deterioration in well-being. The patient feels which tooth is bothering him, as his “elevation” is felt above the other teeth.
3. Periodontitis. The disease occurs due to untreated gingivitis. With periodontitis, the necks of the teeth open, pus oozes from the gums, and the teeth become mobile. The problem affects the entire cavity and can lead to tooth loss.

Associated symptoms

Red gums around the teeth are not the only manifestation of acute or chronic inflammation. Its signs also include:

• pain of different localization,
• bleeding gums,
• reaction to cold and hot,
• discomfort when chewing,
• bad breath.

If you have any of the above problems, you should be examined by a dentist. If you ignore the alarming symptoms, the disease will progress. This can lead to loosening of teeth, formation of fistulas, development of pulpitis and loss of dental units.

Treatment of gum pain

It is important to treat gum disease as soon as possible. Any, even the most harmless pathology, can turn into periostitis with high fever, swelling of the mucous membranes and loose teeth. Moreover, inflammation in the gums releases toxins that provoke the development of blood poisoning.

You should not discount the possibility of pain in the gums when pressing due to illiterate treatment by a dentist. Normally, pain after treatment persists for 1-2 weeks. If the pain continues longer and does not subside, it is important to see a doctor as soon as possible. It happens that after poor-quality dental canal filling, bacteria appear in the voids, which provoke an infectious process.

The dentist may also leave the edges of the filling uneven, causing damage to the gums. In this case, you should definitely consult a doctor so that he can improve his work.

Attacks of pain when pressing on the gums are also common with increased sensitivity of the teeth and gums. However, with proper care, this pain goes away quite quickly. When it occurs, you should use toothpastes and rinses for sensitive teeth.

For example, ASEPTA Sensitive preventive toothpaste allows you to perform oral hygiene without irritating sensitive gums. The combination of 3 desensitizing components - potassium citrate, hydroxyapatite, thermal mud - significantly reduces the sensitivity of teeth and gums.

For more effective prevention of pain in the oral cavity, it is recommended to use ASEPTA gum gel with propolis. In this product, propolis is produced in the form of a gel, which makes it easy to apply to the gums. Prolonged contact with the painful area of ​​the gum allows the gel components to penetrate deeper and promotes rapid healing.

The cause of pain when pressing on the gums can also be various injuries to the gums and teeth, received, for example, when trying to crack nuts or toffee. Such injuries also need to be shown to the dentist as soon as possible, otherwise there is a possibility of an inflammatory process.

What will the dentist do if the gums become inflamed after installing a crown?

First of all, the doctor will order an X-ray to determine the cause of inflammation of the gums under the crown. Treatment by the dentist will also be selected based on this information.

Most often in these cases it is necessary to remove the crown. Additionally, patients are prescribed anti-inflammatory treatment and antibiotics. It is possible to re-prosthetize a tooth after the gums have become inflamed only when the anti-inflammatory treatment has ended. And only then will a new crown be installed.

It is important to understand that folk remedies will not be effective in this case and will not replace seeing a doctor. If you realize that discomfort continues for more than three days, be sure to consult a doctor. Inflammation is a serious process that affects the body as a whole, so it is important to recognize the cause as early as possible and determine effective treatments for inflammation.

How to relieve pain when pressing on the gums

Remember, only a dentist can help eradicate the pain experienced when pressing on the gums or teeth. It is important to quickly determine the cause of the discomfort and prescribe proper treatment. However, to eliminate discomfort before visiting a doctor, you can try the following methods:

• Take painkillers, such as paracetamol or analgin. The main thing is not to overdo it with such drugs, as they can be addictive and negatively affect the functioning of internal organs.
• Brush your teeth properly, trying to free the inflamed cavity from plaque and food particles.
• Rinse your mouth with a solution of baking soda, furatsilin or potassium permanganate.

Remember, it is strictly forbidden to warm your cheeks and gums or apply warm compresses to the sore spot. Heat can trigger more severe inflammation. Also, you should not take antibacterial or anti-inflammatory drugs without a doctor’s prescription.

It is also prohibited to put analgesics into the cavity of a diseased tooth. This popular method is far from safe: you can not only cause an infection, but also get a serious burn to the mucous membrane.

Probable Causes

Let's look at several factors that could cause gum problems:

• Poor preparation. Before fixing the crown, the doctor must carefully prepare the teeth: remove the nerve and conduct a thorough cleaning. If any procedure was not carried out under sterile conditions, an infection may enter the soft tissue.
• Inappropriate design. If the dental crown does not match the size of the natural tooth, sooner or later this will lead to rubbing of the mucous membrane. Constant friction will provoke an inflammatory process.
• Exceeding the service life. The average lifespan of crowns is from 5 to 10 years, depending on the material from which the product is made. After the set period, gaps form and the product no longer fits tightly to the tooth. As a result, micro food particles become clogged in the holes, which leads to rotting and inflammation.
• Inadequate dental care. If you do not follow basic hygiene rules, this can result in various complications, including gum disease.

Treatment for gum pain

The treatment tactics for pain in the gums when pressing depends on the cause of the disease. If the pain appears due to problems with the teeth, the canals are filled or refilled. The doctor removes the source of inflammation. Advanced stages of the disease are treated with surgery and removal of the diseased tooth.

If the cause of pain in the gums when pressing is their inflammation, it can be relieved with medications prescribed by the dentist. As a rule, in such cases, the doctor prescribes antibiotics or other penicillin drugs. Rinse must be prescribed.

Folk remedies – decoctions of medicinal herbs – also help relieve pain and inflammation. Oak bark, chamomile, and sage perfectly remove unpleasant sensations. A solution of baking soda with a few drops of iodine also helps relieve inflammation.

Other popular methods for treating inflammation at home are:

• Propolis tincture
  has antibacterial and antimicrobial effects. To prepare it, dilute a teaspoon of tincture in 200 ml of water. You need to rinse your mouth with propolis up to five times a day.
• Massage with oils
  has a beneficial effect on the gums. It is not at all difficult to do: apply a few drops of tea tree, eucalyptus, juniper or fir oil to the pads of the thumb and index fingers of one hand. You need to massage the gums gently for 5-10 minutes. After the massage, you should not rinse your mouth.
• Aloe
  also contains many anti-inflammatory components. For gingivitis or stomatitis, you can chew a fresh leaf of this plant a couple of times a day.

How to treat gum disease

Treatment of sore gums

Before the dentist prescribes a treatment program, it is necessary to undergo a diagnosis:

1. General visual examination of the oral cavity for caries and other related diseases.
2. Palpation of gums, periodontal zones, identification of painful reactions.
3. Sight X-ray or panoramic tomography of the jaw.

When the diagnosis is made, carious and allergic factors are excluded, the patient is prescribed home treatment, which includes:

• Daily rinsing with antiseptic solutions (chlorhexidine, miramistin and their analogues).
• Antibacterial and analgesic ointments and gel (Cholisal, Kamistad, Metrogil-denta, etc.).
• If necessary, a course of antibiotics and antihistamines to stop the further spread of inflammation.

Surgical intervention is required only for hypertrophic forms of gingivitis, a detected dental cyst or purulent periostitis. In other situations, doctors try to avoid invasive methods so as not to injure the gum tissue even more.

Nutrition: prevention of inflammation

If gingivitis is the cause of pain when pressing on your gums, it is important to review your diet by including healthy foods in your diet. To prevent future diseases, first of all, you need to consume plenty of fresh fruits and vegetables:

• Apples and pears contain a lot of pectin, which helps accelerate tissue regeneration.
• Citrus fruits are a real storehouse of vitamin C, which also helps reduce bleeding and inflammation.
• Black currants, blackberries, and raspberries contain a large amount of minerals and vitamins that increase the body's resistance.
• Carrots, cabbage and zucchini are valuable fiber and vitamins that enhance metabolic processes in the body and accelerate tissue regeneration.

To prevent gum inflammation, professional teeth cleaning is also recommended. The procedure is carried out by a dentist and allows you to eliminate all accumulated deposits and tartar.

So, now you know the most common causes of pain in the gums when pressing. Remember: when your gums or teeth bother you, you should never put off visiting the dentist. The sooner the doctor determines the cause of the problem and begins treatment, the greater your chances of saving your teeth, gums and avoiding possible complications.

Sources:

1. The role of anti-inflammatory rinse in the treatment of periodontal diseases (L.Yu. Orekhova, A.A. Leontyev, S.B. Ulitovsky) L.Yu. OREKHOVA, Doctor of Medical Sciences, Prof., Head of Department; A.A. LEONTIEV, dentist; S.B. ULITOVSKY, Doctor of Medical Sciences, Prof. Department of Therapeutic Dentistry of St. Petersburg State Medical University named after. acad. I. P. Pavlova
2. Clinical studies of antisensitive toothpaste “Asepta Sensitive” (A.A. Leontyev, O.V. Kalinina, S.B. Ulitovsky) A.A. LEONTIEV, dentist O.V. KALININA, dentist S.B. ULITOVSKY, Doctor of Medical Sciences, Prof. Department of Therapeutic Dentistry, St. Petersburg State Medical University named after. acad. I.P. Pavlova
3. The effectiveness of the use of Asept “adhesive balm” and Asept “gel with propolis” in the treatment of chronic generalized periodontitis and gingivitis in the acute stage (Municipal Dental Clinic No. 4, Bryansk, Kaminskaya T. M. Head of the therapeutic department Kaminskaya Tatyana Mikhailovna MUZ City Dental Clinic No. 4, Bryansk

Bleeding gums when brushing teeth

Sometimes blood spots on the brush are perceived as a sign of inflammation, but this is not always the case. Often, the reason is trivial - incorrectly selected bristles or too zealous hygiene. To reduce the risk of injury, dentists remind you of the rules for brushing your teeth:

• Movements of the bristles along the vestibular side should not be from side to side, but up and down, as if sweeping away remnants of food and plaque.
• Medium hardness is optimal, but if you have pathological sensitivity, it is better to buy soft ones (Soft) and even ultra-soft ones (Ultra Soft).
• If the brush is positioned slightly at an angle to the teeth, the chance of better cleaning of gaps increases.
• It is advisable to move along the gum line in a circular motion - additional massage stimulates blood circulation.
• You should spend 40 seconds to a minute cleaning your tongue. Much more bacteria accumulates on its surface than on enamel, but many people ignore this fact.
• If you have an irrigator at home, it is recommended to put periodontal attachments on it at least once a week and clean out the gum pockets. Make sure that the water supply is turned on at minimum power at this moment, otherwise there is a risk of tissue rupture.
• For those who wear braces and other devices, it is better not to skimp on special brushes. A large amount of plaque accumulates under the ligatures and the corrective arch, which must be removed daily.
• It is necessary to change the brush every 2 months, and if you are prone to inflammation - monthly.

Why does a tooth hurt under a crown: reasons

Thus, if you have a toothache under the crown or the gums under the crown are inflamed, the reason almost always lies in poor-quality therapeutic preparation of the tooth for prosthetics. Of course, in most cases, dental therapists take control photographs after filling the canals, but even if they see mistakes, most doctors simply will not waste time and redo something.

Unfortunately, this approach in Russia is the norm rather than the exception. And if your tooth hurts under the crown, then the first thing you should do is an x-ray, which will show one of the main mistakes that dentists make when filling root canals. The image will show whether the tooth can be treated or whether it needs to be removed. The most common mistakes made by doctors include...

Root canals are not filled to the root apex –

Let us remind you that in most cases, teeth must be depulped before prosthetics. Depulping a tooth means that the dental pulp (neurovascular bundle) is removed from it and the root canals are filled. When filling root canals, there are certain standards, the implementation of which helps prevent subsequent inflammation in the area of ​​the tooth roots.

In Fig. 1,2 you can see how well-filled root canals look on radiographs. However, when the doctor does not work and fills the canals not to the top of the root, conditions are created in the unsealed part of the canal for the spread of infection. Failure to fill the canal by just 1-2 mm can already cause inflammation at the apex of the tooth root (Fig. 3).

On X-ray 3 you can clearly see the unfilled part of the root canal (it is shown by a white arrow). Black arrows show the boundaries of a periodontal abscess, which on an x-ray looks like intense darkening in the area of ​​the root apex. The reason for its formation is the development of infection in the unfilled part of the root canal. This dental disease is called periodontitis.

What does inflammation of a tooth look like under the crown (Fig. 4) –

• "Gutta-percha" is a material for canal filling,
• “periapical abscess” is a focus of purulent inflammation in the form of a purulent sac at the apex of the root (depending on the size of the purulent focus, the latter is called either a granuloma or a radicular cyst).

Poor obturation of root canals –

Inflammation can also be caused by poor obturation of the root canal with filling substances (gutta-percha and sealer). Those. the canal can even be sealed to the top of the root, but it is not sealed tightly, with many pores and empty spaces.

This could also be the reason why your tooth hurts under the crown, because... Such poor-quality canal filling also leads to the development of inflammation at the apex of the tooth roots. Poor canal obturation can also be easily determined by a targeted photograph of the tooth.

Perforation of the walls of the root canal –

Perforation is literally “a non-physiological hole.” In other words, this is a hole in the root of the tooth that is created artificially. The only physiological hole in the tooth is at the top of each root. The most common perforations that occur are:

• During instrumental treatment of root canals - using tools for mechanical expansion of the root canal, the doctor can make a number of mistakes. For example, instead of expanding the root canal along its course (from the mouth of the canal to the apex of the root), the doctor will direct the instrument perpendicularly through the canal wall, which will lead to the appearance of a “hole” in the root wall (Fig. 5, 6).

• During fixation of the pin in the root canal, doctors also very often allow perforations if the technique for fixing the pins in the root canal is not followed. Such perforations are also determined by radiographs and corresponding symptoms (Fig. 7).

Fracture of an instrument in the lumen of the root canal –

This happens quite often, but in most cases it is again due to the fault of the doctor. Below you will read about the main reasons for instrument failure in the canal. The only good reason for a breakdown that cannot be blamed on the dentist is if your root canals have a very severe curvature.

• Violation of the technique of rotating the instrument in the root canal - instruments for treating root canals are quite thin and require strict adherence to a certain technique of use. For example, most instruments cannot be rotated more than 120 degrees in the root canal. If the instrument is rotated 360 degrees in the root canal, this can naturally cause a fracture of the instrument, which is associated with the curvature of the root canals.

• Reuse of instruments—breakage of instruments can also occur due to the fact that the doctor uses “old instruments.”
  Instruments for mechanical expansion of root canals are made of special metal. Any metal gets microcracks during loading, which is called “metal fatigue.” Repeated use of an instrument for root canal treatment greatly increases the risk of instrument breakage (24stoma.ru). Tools for canal treatment come in different sizes and differ in thickness. The thinnest instruments have sizes No. 6,8,10, 15. In Europe and the USA, such instruments are generally disposable and their reuse is not allowed. Instruments of other sizes can be reused after sterilization. But in Russia, in the vast majority of clinics, in order to save money, no one throws away such instruments, and they work with them “to the limit.” What affects the incidence of tool breakage.
• When working in highly curved, difficult-to-pass channels - In this case, instrument failure may occur through no fault of the doctor, because
  Instrumentation in such root canals is itself risky. But you cannot refuse and not do it. The presence of a foreign body (piece of instrument) in the root canal or beyond can be determined using an x-ray (Fig. 8, 9). And the problem here is that in most cases it is not possible to remove the instrument fragment from the canal. This prevents high-quality filling of the root canal, which in the vast majority of cases leads to inflammation developing, the tooth under the crown aching, or the gums under the crown hurting.

Expert advice

Contacting little-known dental centers does not always lead to successful results. If dental prosthetics was performed by an inexperienced doctor, it is not at all surprising that inflammation occurred and additional gum treatment had to be sought. Don't try to save money on your health. We strongly recommend visiting only trusted dental clinics.

To reduce the likelihood of complications, follow simple rules:

• If you feel unwell or have a weakened immune system, it is not recommended to undergo prosthetics.
• Take good care of your teeth, including your artificial crown. Brush your teeth twice a day for 5 minutes, use additional hygiene products.
• Massage your gums to improve blood circulation and avoid possible consequences.