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Sore gums beneath dental caps

The in shower oral irrigation setup for sore gumsSore gums: It is surprising the discoveries you make in life in simple conversations; in this case a discussion about aching gums around crowns.  Both my wife and I try to floss and brush on a regular basis.  We both use the low cost battery powered tooth brushes, that to us almost work as well as expensive brushes which we have both used in the past.  We both use floss, different flosses, and I use a flossing tool, but because of a bridge she does not.  Coincidentally we had both been having problems with localized sore gums, and I think she said it first, it is always around the teeth that have crowns (or caps).  I chimed in and said yes, it is the capped teeth that have sore gums.  I had been doing what my dentist suggested, with some success, using a saline rinse.  I have a very basic technique for this, I take about a 1/4 teaspoon of salt, flip it into my mouth with a spoon, grind it up with my teeth and start swishing, simple!  I have since added one farfetched addition to this, a small dab of coconut oil as well, search for "oil pulling" for information about this.  The saline rinse does help with inflammation around the crowns, but it was not solving the problem.

The pulsating jet

A pulsating jet of water seemed like the next thing to try, but we have actually owned a pulsating nasal irrigator, which does work for its purpose, but really was not powerful enough for flushing ones gums.  The nasal irrigator also had draw backs, it was difficult to use, messy, required decontamination, had to be plugged in, the tank filled every time, etc.  So knowing this I went looking for something easier, and the shower installed gingival irrigator (gum washer) fit the bill nicely.  At least once a day we could get a good flushing of our gums.  The ShowerBreezeTM, RediBreezeTM, and QuickBreezeTM, are available from OralBreeze.com.  The Redi and Quick "Breeze" provide oral irrigation from your bathroom sink.  I think I would like to try the RediBreeze next.

Is irrigation effective?

I have included several references to research below, with one big surprise.  These are references listed by the NIH; National Institutes of Health.  From our non-scientific experience, irrigation is very effective.  In our case there is just a constant stream of water, not pulsation, but I believe the pulsation in many units is simply a side effect of the pump used and is not necessarily desirable.  I would think one would want a predictable very controlled gentle pressure.  Not an insignificant pressure, but one appropriate to flush out foreign material.

Important

It was always under the crowns where gingival issues occurred.If you are using a powered pulsating irrigator, I would say the preponderance of the literature suggests you only use an intermediate setting, not the highest pressure.  Especially a powered pump probably produces a very high instantaneous pressure during the pump stroke.  Dentists seemed to be concerned about these high pressures and gums separating from the tooth.  I know I have backed down a little on the pressure I use from our shower unit.  I have a photo of the valve to the right indicating where I usually set it, about one third open.  Fully down pointing at the hose below is fully on.

Something you should notice

When I started, and even now, when I use the shower jet, even right after flossing and brushing, I get these little bursts of flavor, very subtle, and from this realize a tiny flake of something just flipped out of one of my gums.  As you get older, I am sure these tendencies to collect extremely tiny bits of food in your gums increase.  Reading the studies about hypertension drugs below was astonishing, these drugs are intended to help prevent heart disease, but they actually promote a situation where bacteria can invade you gums and recent studies are leaning toward the belief that bacteria from your gums can migrate to your heart.

Installing our particular unit

It was fairly easy to install with one proviso, the sealing washer provided is very soft, for it to seal well, very little pressure is required when threading the unit onto the shower piping.  The problem for us is we like to use a shower spray head, and they are heavy, really distorting the washer provided.  Ours is barely sealed, but, if it did leak it would only leak into the shower anyway.  Also I ended up eventually replacing the double sided tape holding the hose and two detachable fan jet heads.  One thing to watch out for is forgetting to turn the valve off on the irrigator before you turn the shower off.  If you leave that valve open, water can spray everywhere when you start the next shower.

Oral irrigation is by far the best

Both my wife and I have found that using an oral jet irrigator daily in the shower has made a large improvement in our problems with sore gums below our crowned teeth.  Neither of us have any discomfort in this regard.  So obviously this is something we recommend to all.

Hope this helped, Bob.

Sources and References:

  • NIH, efficacy of oral irrigation "However, there is a positive trend in favor of oral irrigation improving gingival health over regular oral hygiene or tooth brushing only."
  • NIH, irrigation and flossing "The results of this clinical trial indicate that when combined with manual or sonic tooth brushing, oral irrigation is an effective alternative to manual tooth brushing and dental floss for reducing bleeding, gingival inflammation, and plaque removal."
  • NIH, effects of hydrogen peroxide rinses "...elicit overwhelmingly negative subjective reactions in normal individuals, they are not recommended for oral care."

Here is quite a surprise:

  • NIH, Gingival enlargement in antihypertensive medication "Patients taking antihypertensive agents are at increased risk for gingival enlargement and inflammation is ..."
  • Cochrane Collaboration "Antihypertensive drugs used in the treatment of adults (primary prevention) with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg) have not been shown to reduce mortality or morbidity in RCTs."
  • Journal of Periodontology, Gingival Enlargement 20 drugs cause enlarged gums! "Plaque: The severity of gingival enlargement in patients taking these medications correlates well with poor plaque control and is commensurate with the degree of plaque induced inflammation"
 

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BHT Revised: 03 Apr 2017

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