Q: I noticed after a new crown was cemented that is does not meet the gum line. I see the darker, yellow color of the root of the tooth now. Is this an issue; does it need to be re-done?
A: I love when I get a question that relates to a current issue I am having with an actual patient. This question is as popular as: “Hey doc; why do dentists have the highest suicide rate?” (It’s actually construction workers, followed by veterinarians.)
It is completely unpredictable as to the final position of the gum line after any restorative treatment or gum surgery. Many patients have what is called a thin“periodontal bio- type”. Even the best fitting crowns, veneers and bridges can still allow the gum to pull away, revealing the root surface.
The only reason to re-do the case is if a gap exists underneath the crown; what we call an open margin. This can lead to decay under the crown. Or, if the root exposure is located in a blatantly obvious esthetic area that shows in the smile.
It’s very easy for a dentist to play Monday morning quarterback and tell a patient with a little gum recession that her crown needs to be re-done. Don’t fall for this; get a third opinion if necessary.
Beware: Redoing the work can STILL cause the gum to recede even more! You do not want to keep chasing the gum line by redoing the work over and over again. You have to accept nature’s ability to reach a state of equilibrium.