A dental crown, often referred to as a cap, is a custom-made covering that fits over a damaged or weakened tooth. It restores the tooth’s shape, size, strength, and appearance, providing a protective layer. Despite their protective nature, crowned teeth can indeed become infected, posing a risk to the underlying tooth structure and surrounding tissues.
How Dental Crowns Get Infected
Infections under or around a dental crown can arise through several pathways, even though the crown itself is an inert material.
New decay can develop at the margin where the crown meets the natural tooth structure. If this margin is not perfectly sealed or if oral hygiene is inadequate, bacteria can accumulate and produce acids that erode the tooth enamel, leading to a cavity beneath the crown.
Gum disease, also known as periodontal disease, is another route for infection. If the gums surrounding a crowned tooth become inflamed and infected due to plaque buildup, the infection can spread deeper, affecting the bone and ligaments that support the tooth. This compromises stability and creates bacterial pockets, potentially reaching the tooth’s root or pulp.
A tooth crowned after a root canal treatment may still develop an infection. This can occur if the initial root canal did not completely eliminate all bacteria from the complex root canal system, or if new bacterial contamination occurs. Over time, dormant bacteria can reactivate or new bacteria can enter through microscopic leaks, re-infecting the tooth.
Physical damage to the crown or tooth can also create entry points for bacteria. A crack in the porcelain or metal of the crown, or a fracture in the tooth beneath it, can expose the sensitive inner structures of the tooth to oral bacteria. This allows bacteria to invade the pulp chamber, leading to inflammation and infection. Additionally, severe trauma to a crowned tooth, such as a direct blow, can damage the blood vessels and nerves within the pulp, causing them to die and become infected.
Recognizing an Infected Crown
Identifying an infected capped tooth often involves a range of symptoms that can vary in intensity.
Persistent throbbing pain, especially when chewing or applying pressure, is a common indicator. Sensitivity to hot or cold temperatures that lingers can also signal an issue with the tooth’s pulp.
Swelling in the gums around the crowned tooth or even facial swelling can occur as the infection spreads. The affected area may also feel tender to the touch, both around the tooth and in the adjacent jawbone. A foul taste in the mouth or pus draining from around the crown are clear signs of an active bacterial infection.
Advanced cases can lead to systemic symptoms. These include a low-grade fever, general malaise, or swollen lymph nodes in the neck. Discoloration of the gum tissue around the crown, appearing redder or darker than usual, can also indicate inflammation and infection beneath the surface.
Addressing an Infected Crown
When an infected capped tooth is suspected, a dentist performs a thorough clinical examination. This includes dental X-rays to visualize the bone structure and the tooth’s roots, revealing signs of infection or bone loss. The dentist may also test the tooth’s vitality to assess the health of the pulp.
Treatment options depend on the cause and extent of the infection.
If the infection is localized in the pulp, root canal therapy is often the primary treatment. This procedure involves removing the infected pulp tissue, cleaning the root canals, and sealing them to prevent further bacterial invasion. This can often be performed by creating a small opening through the existing crown.
If the infection stems from a poorly fitting or compromised crown margin, replacing the crown may be necessary to achieve a proper seal and prevent bacterial leakage. This ensures bacteria cannot re-enter the tooth.
For infections primarily caused by gum disease, periodontal treatment, including deep cleaning procedures like scaling and root planing, will be performed to eliminate bacteria and reduce inflammation in the surrounding gums. This helps restore gum health and prevent further spread of infection.
In severe cases where the tooth cannot be saved, extraction may be the only option. Antibiotics may be prescribed to help control the bacterial infection, but they are generally not a standalone solution.
Preventing Infection in Capped Teeth
Maintaining excellent oral hygiene prevents infections in capped teeth. This involves brushing thoroughly at least twice a day and flossing daily, paying particular attention to the area where the crown meets the gum line. Regular removal of plaque and food debris minimizes the risk of decay and gum disease around the crowned tooth.
Routine dental check-ups and professional cleanings are also crucial for early detection and prevention. These visits allow dentists to identify decay, gum inflammation, or crown integrity issues before they escalate into infections. Early intervention can often prevent more complex and costly treatments.
Dietary habits play a role in oral health. Limiting sugary and acidic foods and drinks reduces the fuel for decay-causing bacteria. Avoiding harmful habits like chewing hard objects protects the crown and tooth from cracks or fractures. For those who grind or clench teeth (bruxism), a nightguard protects the crowned tooth from excessive forces and damage. Crown quality, including precise fit and material, also impacts its long-term success and infection resistance.