Dr. Shah: Hi Mary-Anne, welcome to ask the doctor. What is your question?
Mary-Anne: My question is, what causes the shadow underneath the gum line?
Dr. Shah: Okay, I’m looking at your teeth. Your front two teeth have a root canal treatment done, and because of the root canal treatment quite a few times the tooth gets darker and quite a few times roots also get darker. When you have roots darker, your gums and bone have a little bit of translucency and it’s visible as a dark shadow. I’ll explain to you what can be done later on, but let’s talk about why this happens. You must have seen other people’s mouths or the kids especially when they fall, after a while, the front tooth gets darker. Either it is darker in the shade and sometimes it’s kind of very dark like a black type of? This happens because of when the tooth dies, the blood is there in the tooth, the blood has RBCs and RBCs have hemoglobin, hemoglobin is made up of iron. So, when the iron is there, when iron stays there for a long time, it kind of leaks out and it gives you a black shadow. So, it gets this iron from the blood into the dentinal tubules because dentin is made up of small tubules and then it is visible as a dark shadow or dark color of the tooth. What is the solution? First of all, prevention. Prevention means you should not have an injury, so you have to prevent the injury for the kids, especially whenever they’re playing any sports, even if they’re going on a bike, even if they do play basketball Just here and there have them wear a sports guard. When they wear the sports guard, all the teeth are protected so if any blow happens, the chances of damage to the teeth are very minimal, so have all the kids wear the sports guards. The second prevention is, t this is practically for the dentist, not for the patients, but us. Whenever we do root canal treatment, we need to remove all the contents of the canal and the pulp chamber. Remove all the contents and clean them very well so if there is no part of the blood stage, their chances of having discolorations are very minimal. Go to the treatment part. If it happens to the tooth, that can be fixed easily by internal bleaching. So, after root canal treatment is done, we go inside the tooth and put on the bleaching gel, And then the tooth becomes because what we’re doing is we’re picking, we are picking up those pigments from the tooth which has been created, By the hemoglobin from the blood that will be picked up from the bleaching gel, And the tooth becomes very lighter in color and you will be happy. As far as the root is concerned, we can go up to a certain level into the root, but it is very, very difficult to do the bleaching inside the root and so that way whatever is visible through the gums may not be changed. The only way to change is you can pull those teeth out and put the implant there. Otherwise, it is kind of very difficult to do that, especially if you have a metal post there. Sometimes a metal post is metal, also visible through the tooth and the gums. Now as far as the crown is concerned when you have a dark tooth. If you want to put a crown there, the crowns have translucency. See if you want to put on an E-Max crown. The E-Max crown has a very high translucency, so if the tooth is darker, it will be visible through the E-Max. In that situation, either you do first internal bleaching and then put on that kind of crown, or you can put a crown with an OPEC layer which is porcelain fused to a metal crown or some of the other crowns. They have a very OPEC layer first to cover the tooth and discoloration. Did I answer your question? Yes