Q: I have extensive upper crown and veneer work. Recently I lost my two front teeth and had them replaced with two dental implants and two crowns. I noticed I now have a black triangle-shaped hole at the gum line between the two teeth, formerly occupied by pink gums. What happened?
A: Nothing is worse on a date than when she or he says: “Sorry, but you have something stuck between your teeth.” I’m all for honesty, but now that’s WAY too honest for me. I once came off the podium after giving an all-day dental seminar in Ohio, only to realize my fly was open the whole day. (I never understood why I received a key to the city of Columbus form the Mid-Ohio Dental Association at the lecture’s conclusion. Crazy.)
You have what is called a blunted papilla with resulting gingival embrasure. Translation: “You are missing gum between the teeth.” This can happen from any dental work and from lack of oral hygiene and professional cleanings.
To help avoid this with implants, I place the implants into a pre drilled scooped-out, trough in the bone to allow bone to rise up like undulating waves between the front teeth. Each “peak” in the wave, acts like a scaffold, supporting the gum between each tooth. Another method I use in 99% of my implant surgeries is “Flapless/Incision-less surgery”. No scalpel, no stitches and only one surgery; not two. A tissue punch is used to access the bone. This prevents shrinkage and recession of the gum following the placement of the final crowns or bridges.