Many believe a crowned tooth is immune to decay. However, decay can still form underneath, often going unnoticed until significant issues arise. Understanding how this decay forms and its potential signs is important for maintaining oral health and protecting crowned teeth.
How Decay Forms Under Crowns
Dental crowns fit snugly but are not hermetically sealed. Microscopic gaps can exist or develop at the crown margin, where the crown meets the natural tooth structure near the gum line. These tiny spaces provide an entry point for oral bacteria, food particles, and acids to seep in and reach the underlying tooth.
Over time, the cement holding the crown in place can wash out, or the crown itself might experience wear and tear, creating or enlarging these vulnerable gaps. A poorly fitted crown also leaves spaces where bacteria can accumulate, making the area difficult to clean effectively. Once bacteria infiltrate these areas, they produce acids that erode the tooth enamel and dentin, leading to decay in the natural tooth structure hidden beneath the crown.
Gum recession can further expose parts of the tooth not covered by the crown, making them susceptible to new decay. Even if a tooth had a root canal before crowning, it can still develop new infections or decay if bacteria were left behind or if the crown’s seal is compromised. This hidden decay can progress significantly before any symptoms become apparent, potentially compromising the tooth’s integrity.
Recognizing the Signs
Identifying tooth decay under a crown can be challenging because the crown itself obscures the affected area. However, several signs might indicate a problem. One common symptom is increased sensitivity to hot, cold, or sweet foods and drinks. This sensitivity might manifest as a dull ache, sharp pain, or throbbing discomfort.
Pain when biting down or chewing is another potential indicator of decay, as the decay can press against nerves or compromise the tooth’s structure. A persistent bad taste in the mouth or foul breath, despite good oral hygiene, can also signal bacterial accumulation and decay underneath the crown. In some instances, a visible dark spot or discoloration, such as a gray or brown shade, may appear near the crown margin, indicating underlying decay.
The crown might also feel loose or shift, which can occur if the underlying tooth structure weakens due to decay. Swelling or inflammation of the gums around the crowned tooth, sometimes accompanied by bleeding when brushing, can also point to an issue. If any of these signs develop, seeking professional dental evaluation is important to determine the cause.
Addressing Under-Crown Decay
When decay under a crown is suspected, a dental professional will conduct a thorough examination. This typically involves a visual inspection of the crown and surrounding gum tissues, along with dental X-rays. X-rays are especially useful as they can reveal hidden decay or structural issues not visible during a clinical examination.
Treatment options vary depending on the severity and extent of the decay. If the decay is caught early and is mild, the dentist might be able to remove the existing crown, clean out the decayed area, and then place a new filling or re-cement the original crown if it is still in good condition. For more extensive decay that has reached the tooth’s pulp, a root canal therapy may be necessary to remove the infected tissue and save the tooth. After a root canal, a new crown is typically placed to protect the tooth.
In severe cases, where the tooth structure is significantly compromised or an infection is widespread, extraction of the crowned tooth might be the only viable option. Following extraction, various tooth replacement options, such as dental implants or bridges, can be discussed. Prompt treatment is important to prevent the decay from spreading and causing further complications.
Preventing Future Decay
Preventing decay under a crown centers on consistent and diligent oral hygiene practices. Brushing your teeth twice daily with fluoride toothpaste helps remove plaque and bacteria, which are primary causes of decay. Paying special attention to the area where the crown meets the gum line is important, as this is a common site for bacterial accumulation.
Daily flossing is also essential to remove food particles and plaque from between teeth and around the crown. Using an antimicrobial mouthwash can further reduce bacteria in the mouth and support overall oral health. Regular dental check-ups and professional cleanings are also important, as they allow a dentist to monitor the crown’s integrity and detect any potential issues early, even before symptoms appear.
Dietary choices also play a role in prevention. Limiting the consumption of sugary and acidic foods and drinks helps reduce the risk of decay, as these can create an environment conducive to bacterial growth and acid production. Choosing a balanced diet rich in fruits, vegetables, and lean proteins, along with drinking plenty of water, supports oral health and helps maintain a cavity-resistant environment.