Question:
I have two upper molars that are spaced such that there is just enough
room for food to constantly become wedged between them, but not enough
room for the food to unwedge itself easily. It seems that almost every
meal jams something between these two teeth, and I have to floss it out.
The problem is that sometimes I don't even notice until it starts to
hurt, and then I floss it out and that seems to irritate it even more,
even though the space between is then clear. The pain is in the gum
between the teeth somewhere, not in either of the two teeth. As far as
I know (as of my last dental check-up), there isn't any decay in there,
and the gum doesn't bleed when I floss or brush it, and it doesn't look
inflamed or anything (as far as I can tell without any fancy dental
mirror to look).
What can I do to help avoid stuff getting stuck, and what's the best way
to get stuff out? How do I know I'm not jamming stuff even harder into
the gum when I try to floss it out? There aren't any teeth missing on
that side or anything (except wisdom teeth removed long ago), and I
don't think either tooth has rotated out of position or anything--they
just seem to be at just the right critical distance apart.
Answer:
I suspect a periodontal pocket. I would insert a gutta percha point (similar
to what is used in root canal therapy) take an x-ray, and show it to the
patient.
Treatment? Depends on the extent of damage
Do you know if there are fillings on either of the surfaces facing
the space between the two teeth?
If the contact between the two teeth is weak, food will pack in
between the teeth. So-called vertical food impaction can certainly lead to
a gum problem, as Joel alluded to.
If one of the teeth is restored on the proximal surface (in between
the two involved teeth), I frequently try replacing the filling, taking
special care to create a strong contact between the teeth.
When there is no food stuck, try gently lowering floss between the
teeth. If the floss drops in easily, you have a weak contact.
Strengthening the contact will likely minimize this food impaction. The
area should be carefully checked for gum problems, and if there is a small
pocket it should be monitored for 6 months or so to see if eliminating the
food impaction leads to improvement in the gum. If there is a large pocket
or the pocket doesn't improve, I'd recommend seeing a periodontist (gum
specialist).
One more thing. You should be using floss on a daily basis to clean in
between your teeth, not just to dislodge impacted food. Check with your
dentist to make sure your flossing technique is correct.
Yeah, well, I just flossed between two molars on the bottom (one of
which is capped), and they are so snug together that the floss broke. I
then had a blob of floss stuck between them. I couldn't grab it with my
fingers. I had to go in there with some needlenose pliers, grasp one
end of the floss as firmly as I could, and pull it out. I got most of
it out, but it still feels like there is something stuck. No more
house-brand floss! From now on, it's Johnson & Johnson only!
Floss brands are one of those things that personal preference is
important. If J&J doesn't shred, good. They also make a shred-resistant
floss that's very good. Glide floss is also exceptionally shred resistant
(but expensive).
If there are teeth you can't get between, tell that to your dentist as
well. Sometimes old fillings between your teeth can get rough enough to
shred floss. Some of these fillings may need replacement.
I found some J&J Reach waxed floss. It's like piano wire compared to
that cheap stuff. Got rid of the cheap stuff stuck between my teeth in
a flash.
I'm not familiar with other brands, except I think I've seen Butler
around, but I don't know about them.
