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Have puss pocket at gum line that bleeds slightly. Had crown put on teeth. Related?

About 3 months ago I had a root canal and then a few weeks later a temporary and then finally a crown put on one of my bottom back teeth . There is a little puss pocket at the gum line that bleeds slightly. I was at my detist last week and he took a new xray . There was nothing on the xray that he was concerned about but said we would keep an eye on the gums. Would an xray show if the tooth under the crown is infected? Or is this an issue with my gums?
Asked On : Fri, 22 Feb 2013
Answers:  8 Views:  773
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Dentist 's  Response

Thanks for asking the query,

After successful root canal treatment th etooth is completely devitalised, disinfected and sealed to the apex , so there are no chances of pain.

Sometimes due to food lodgement between the tooth and the crown surface there is accumulation od bacteria , plague, calculus and other irritants in the pocket leading to infection and abscess formation.

As the x-ray is normal there is no problem with the root canal treatment.
I would suggest you to go for deep scaling and polishing followed by curettage.

Maintain a good oral hygiene, use chlorhexidine mouthwash gargles twice daily.

Hope this helps out.

Answered: Sun, 7 Apr 2013
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Dentist Dr. Farah Hussain's  Response
hi and welcome ,

X ray examination definitely shows radiolucent areas of infection present in the tooth.
As you have got your x ray done and it seems to be normal , i suspect puss pocket on your gum line is caused due to gingival abscess.

Gingival abscess is caused due to infection caused by poor oral hygiene , accumulation of bacterial plaque , calculus or other irritants in the gum pocket that leads to infection and abscess formation.

trauma to the gums , physical or chemical trauma by food stuffs may also lead to gum abscess.
It can be treated by deep scaling of the gum pocket and root planing of the teeth surfaces.

Abscess cavity is excised surgically and the area is curretted followed by a course of antibiotics will solve the problem.

so please visit a dentist and get the evaluation and treatment done .
i hope this helps,
take care
Answered: Sat, 23 Feb 2013
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Dentist Dr. Anshumala Singh's  Response
dear friend,
thanx for sharing your concern,

root canal treatment is done to save your tooth , in this treatment, tooth as whole structure is saved by just entering into the pulp canal, cleaning it, shaping the canal and finally obturating it aseptically.which you have already undergone.

after that a suitable crown is placed on that, so that it helps in functional and para functional movements of teeth, at the same time bearing the load, while chewing and transmitting the same effectively downwards to the periodontium.

as you have mentioned your dentist has taken xray which appears normal to him. that means your root canal treatment is absolutely fine.

your problem lies with the supporting structures called periodontium, which holds the teeth in place (endoperio lesion).

A problem in supporting structures can make the teeth loose (mobile) and finally fall off.
so this is equally important.

any infection anywhere in tooth or in supporting structures is clearly visible in xrays.

your dentist says, to keep an eye on gums that is because he wants to check if there is any further progression in infection in gums. as you already have bleeding, pocket and pus. if this progress , deep scaling and curretage has to be carried out to restore the the periodontal health.

for now,you can do warm saline rinses , use chlore hexidine mouthwash 2% and maintain very good oral hygiene.
this should help
Answered: Sun, 24 Feb 2013
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Dentist Dr. Bindiya Bhaskar's  Response

The pus pocket at the gum line may be due to-

periapical infection

misplaced crown

improper oral hygiene resulting in gum infection the gum line.

I would suggest you to get a deep scaling done.

Tooth has to be re-rct done if there is periapical/secondary infection.

Antibiotics has to be administered to remove the bacterial infection.

an x-ray will help to guide in such conditions.
maintain good oral hygiene.



Answered: Fri, 22 Feb 2013
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Dentist Dr. Inderpreet Singh's  Response
endo perio leasions or purely endo and perio lesions are commonly seen.your problem looks to be related to gums . this could also result due to faulty crown margins, which cause plaque accumulation and subsequent infection. so your dentist must carefully curettage ( clean the area ) and put u on tetracyclines adn watch for the infection to subside. if the infection is still there the rct has a problem.
Answered: Sat, 23 Feb 2013
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Dentist, Implantology Dr. Gaurav Goel's  Response
It is most probably the issue with the gums because of poor crown.
Most probably the margins of the crown that has been put are not accurate. when this happens, there is food lodgement between the crown and the gums, which is difficult to clean. it can lead to inflammation and infection in the gums. also it can cause caries in the tooth under the crown. In my opinion, you should get the crown removed and that should help relieve the symptoms in few days. and after that get a new crown made.
Meanwhile, Put some salt in warm water and rinse with it 4-5 times a day.
if you want further opinion, pls send the xray .
Answered: Sat, 23 Feb 2013
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Dentist Dr. Abid Pasha's  Response
Apart from the crown and the pulp, supporting structures that connect the root of the tooth to the the bone can get infected too, (these structures are called as Periodontium.).

There are times when the pulp and the periodontium get infected simultaneously, this we call as an Endoperio lesion.
The pulpal infection has been taken care of by the Root canal treatment. The perio part needs attention. Visit a periodontist(a specialist for the periodontium), he will advise you on what needs to be done.
Thank you.
Answered: Fri, 22 Feb 2013
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Dentist Dr. Neha Gupta's  Response
Thanks for sharing your concern with us
causes of pus pocket at gum line is due to gum disease or gum infection.
You have to go for regulars cleanings after every 6 months. Along with this maintain very good oral hygiene like brushing twice daily along with flossing. Do warm saline rinses 2-3 times a day along with antibiotic course including amoxycilline 500mg TDS & ibuprofen 400 mg TDS.
i will advise you to visit your dental surgeon and go for an check X-ray for proper treatment of these teeth.
You can contact me again directly through my profile.
Dr Neha Gupta
Answered: Sat, 23 Feb 2013
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