Crowns Gone Wild !

This patient received a total of 22 crowns to mask out her tetracycline stained teeth.  The case result was compromised on multiple levels.

The most severe problem in this case is the inflammation of the gum around each tooth.

The margins of the crowns were placed too deep inside the gum pockets.  This problem is known as “violation of the biologic width.”  In such situations the gum is unable to remain healthy.  Severe inflammation occurs in the initial stages, and the inflammation will eventually cause bone loss in the same area.  You can see a line of redness around the neck of the teeth.  Light pressure in these areas is enough for the gum to bleed profusely.

Furthermore, the diagnostic X-rays reveal root canals were done for all the front upper and lower teeth.  According to the patient, the root canals were done in conjunction with the crown treatments… for no apparent reason.

This truly is a case of “Crowns Gone Wild!”

To change a tetracycline stained smile, we do not need to crown every single tooth.  We also don’t need a root canal for every crown we place.  Likewise, the gum should not be chronically inflamed.


Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

About alexnguyen

My career passion is to help enhance, restore, and preserve people's smiles View all posts by alexnguyen

4 responses to “Crowns Gone Wild !

  • Anh

    I have just replaced 6 crowns in the top jaw and have the same problem with all of them, although the treatment was within 1 months. I have asked my dentist to replace 2 of them as one of them is crack and the other is red and pain but my gum around the teeth doesnt heal up at all. What should I ask my dentist next to retreat them as I didnt trust him anymore

    • alexnguyen

      Hi there,
      In my opinion, if the work was not done to standards then you may not be able to get the problem fixed adequately from the same clinician. It is best for you to research a qualified dentist in your area and go for a second opinion. That way you will find out exactly what is wrong. In dentistry, there is no proper way to assess the problem until we review the case with xrays and seeing the dentition in person.
      I hope this helps answer your question. Please let me know if you have any other concerns.

      Alex Nguyen, DDS

      • Nicole

        I need help. My four front teeth are crowns. The gums around my crowns are pink and swollen. My dentist recommend crown lenghting. I really don’t want to do this! It there anything else I can do so that my gums aren’t swollen anymore. My gums are pink and puffy …

  • alexnguyen

    Hi Nicole,

    I would be glad to help you with your problem. However, I will need to have proper radiographs and a clinical examination of your teeth before I can give you a definitive diagnosis and treatment plan. Sometime it can be due to poor fitting margins of the crowns.

    Please contact our office to set up a consultation appointment.

    Thanks !

    Alex Nguyen, DDS

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