A persistent itching sensation in the gums is one of the symptoms associated with a pocket in the gums. A pocket is basically a downward extension of the normal gingival sulcus by a couple of millimeters. This may not be evident to the patient, though they are likely to notice a tendency to bleed and an itching sensation.
- Periodontal disease: This is the most common cause of an itching sensation in the gums. Periodontal disease can be difficult to locate in certain cases and can have a variety of clinical presentations. It would be advisable to seek the opinion of a periodontist. A thorough examination of the tooth and its supporting structures will give a better idea of the issue involved. The gingival wall of the pocket may be inflamed which can worsen with constant picking with a toothpick. In fact, a toothpick can do more damage than good as repeated minor injury will not allow the initial lesion to heal.
- Atypical tooth contact: The teeth between which the itching sensation exists might have an atypical contact point. Normally, the teeth contact each other in such a way that food and other debris are directed away from the gums. An atypical contact will reduce the efficiency of this mechanism and can lead to a bacterial build up which in turn will cause an increase in gingival inflammation in the area.
- Allergic reaction: An allergic reaction to an oral hygiene product like a tooth paste or a mouthwash can occur, however these allergies are almost always generalized in nature. It would be extremely rare for a localized area to have an allergic reaction although this possibility should also be explored if no other options seem viable.
- Overhanging restoration: This cause is easy to rule out if the tooth has not been restored at all. However, if it has then a poorly contoured restoration can cause an irritation in the area over a time. Especially if the restoration is an amalgam-based one which can leak out mercury into the surrounding tissues.
The treatment for this condition is not too complicated and would vary little based on the cause identified. If any evidence of periodontal disease is found then periodontal treatment would need to be done.
The presence of a local anatomical defect or improper tooth contours would require that particular cause to be corrected. This may require intentional root canal treatment followed by crowns which change the contact points to a more physiological nature.
The primary thing here is to prevent gingival inflammation to occur in the area. Once a treatment has been attempted, it would still require a strict level of oral hygiene on the part of the patient. This would include the use of floss, mouthwash and a regular checkups with the dentist. The use of toothpicks is discouraged and other interdental aids like unitufted brushes can be used to maintain hygiene in the interdental area.
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