I had a CEREC crown done about two months ago. The assistant warned me that my gums weren’t very happy around the preparation site and that I should use saltwater rinses a few times a day for about a week. She said that it would help heal the area quicker, but made no note of what to do if it didn’t heal. I did the rinses, but my gums are still incredibly tender and they bleed the instant I brush there. What gives?

-Mark in Georgia

Dear Mark,

The first concern would be infection, but if you’re not in pain and aren’t experiencing any swelling, that’s probably not the culprit. Provided you are healthy, the area should have healed by now. Occasionally people with certain health conditions or those who smoke take longer to recover, though.

More than likely, your gums are irritated either directly or indirectly by the CEREC crown, which can happen with any kind of crown. Sometimes it’s a little more difficult for patients to get between the teeth and floss when there is a restoration. When that happens, bacteria flourish and the gums become irritated, red and inflamed, plus they’re more prone to bleeding. The good news is that it’s an easy fix and correcting it simply requires extra time with hygiene. If you’re using regular floss, try switching to a floss pick or other implement to clean between the teeth and be sure to brush gently. You’re likely to see a lot of red for the first few days you really get in there and clean, but it should taper off in the coming weeks. Keep up with the saltwater rinses while you wok to restore health to the gum tissue. If you’re already cleaning well, it’s also possible that the margins of the CEREC crown are irritating your gums. If this is the case, improving your hygiene further will still help, but the only real fix is to have a new CEREC crown made.