Gum scrape during mouth guard molding

Joined
Aug 22, 2021
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I find myself in an urgent situation and would appreciate assistance and/or reassurance. My son recently was fitted for a night mouth guard, and when the technician was removing the mold tray, she pulled it out quite forcefully resulting in a 7mm round scrape of gum being removed exposing his jawbone! This is directly under his back molar. There was no bleeding, he thought he was hurting from his routine cleaning. He’s been in quite severe pain. When we returned to tell her, she said that gum will grow over the exposed jawbone and gave him oracort to be applied 4 times a day, together with Tylenol 3 for the pain. It’s been 10 days since and it looks the same, no new gum tissue seems to be growing to cover the scrape and cover his exposed jaw bone! I’ve googled everything I can think of, but can’t find an answer to whether gum will grow over and fill in over his jaw bone. Will he need a gum graft procedure or will it eventually close with time? He can’t eat anything but soft food and it’s been terrifying thinking that gum will not grow back. Thank you for reading and would appreciate any assistance!
 

Dr M

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Good day

Do you perhaps have a photo of the area? It is very unusual to remove gum tissue and exposing bone during an impression.
 

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Joined
Aug 22, 2021
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Good evening Dr M,

I appreciate your reply, and I thank you! It’s quite difficult to take a photo as I can’t get back enough to focus. The photo I’m attaching “may” show the white “lesion” or is a reflection in the mirror of a tooth? We went back to the dentist yesterday and she now said that the white scrape doesn’t appear to be either his impacted wisdom tooth, nor is it his exposed jawbone! She said the scrape appears to be healing as it went from a size of 7mm round last week, to 6mm by 5mm yesterday. My son feels no evidence of healing as he’s experiencing severe pain still. She now says that perhaps his gum is also bruised from the trauma and that she does feel thin gum there. She assured us that it was NOT osteonecrosis, and that it should heal and pink up again in a few weeks. She doesn’t find it necessary for a referral to an oral surgeon to look at it instead to continue with the Oracort and Tylenol and to follow up with her again next week to monitor any possible healing progress. He was healthy before the mouth guard impression but this is still frightening.

Do you believe that the gum will pink up and the white patch will heal and disappear? I still don’t understand why it’s white and looks like bone. Thank you again for reaching out to me!
 

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Dr M

Verified Dentist
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Good day

Usually a traumatic lesion can appear yellow as healing progresses, due to scar tissue or granulation tissue formation. This will then gradually transition to pink.
I would maybe consider using additional anti-inflammatory medication. Tylenol does not have strong inflammatory properties.
I would monitor this area only. I also agree that it should heal by itself.
 

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Joined
Aug 22, 2021
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Good day Dr M

Thank you for your reassurance, and I greatly appreciate your reply and following up with me!

In addition to the Oracort and Tylenol 3, the dentist also prescribed
Chlorhexidine Gluconate oral rinse and Tantum oral rinse on our last follow up visit 2 days ago. He’s also been using salt water rinses a few times a day.

The dentist had initially prescribed Naproxen 500mg for the pain but at the time it did little to alleviate it, so that’s why she then prescribed Tylenol 3 on our last visit. As Naproxen is an anti inflammatory perhaps he can once again try it instead of the Tylenol, being the better choice as an anti inflammatory medication for his pain.

His gums and lesion are still quite inflamed and painful, and he’s still only eating soft food. It’s difficult to tell whether the lesion has any yellow tinge to it (not as white as bone) to verify whether the healing process has begun. We will be following up with her again next week for monitoring. Do you know a rough timeline on how long the healing process will ultimately take?

I thank you again for your assistance, reassurance and explanation of the healing process and that he will heal in time!
 

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