Dental crowns restore damaged teeth, providing protection and improving appearance. A common question is: can a tooth with a crown still get a cavity? Yes, while the crown itself is made of materials like porcelain or metal that do not decay, the natural tooth structure underneath and around it remains susceptible to cavities. Good oral hygiene remains important even after a crown is placed.
How Cavities Form Under Crowns
Cavities often form at the margin where the crown meets the natural tooth, near the gum line. This area can trap plaque and bacteria if not cleaned properly. Over time, these bacteria produce acids that erode the enamel and dentin of the underlying tooth, leading to decay. Gum recession can also expose more natural tooth structure, making it vulnerable to plaque accumulation and decay. If the crown’s fit is not perfectly sealed or if the cement wears down, tiny gaps can form, allowing bacteria to seep underneath and cause decay.
Recognizing Signs and Preventing Cavities
Recognizing a cavity under a crown can be challenging, as the crown obscures visible signs of decay. Symptoms include sensitivity to hot or cold temperatures, pain when biting, or a persistent ache in the crowned tooth. Other signs include a foul taste or odor, swollen gums around the crown, or dark spots at the crown’s edge if gum recession has occurred. Regular dental check-ups, including X-rays, are important for detection, as dentists can spot issues not visible to the naked eye.
Preventing cavities under crowns involves consistent oral hygiene. Brushing twice daily with fluoride toothpaste and flossing once a day removes plaque and food particles from around the crown and along the gum line. Limiting sugary and acidic foods and drinks reduces decay risk. Regular dental examinations and professional cleanings, typically every six months, allow your dentist to monitor the crown and address issues early.
Treatment Options
If a cavity is discovered under a crown, treatment depends on the decay’s size and location. For small, accessible cavities, a dentist might remove decay and place a filling without removing the crown. In many cases, however, the existing crown may need removal for full access to clean decay and prepare the tooth for a new filling. If decay reaches the tooth’s inner pulp, a root canal procedure may be necessary to remove infected tissue before a new crown. If decay extensively compromises the tooth, extraction might be the only option.