Dental crowns and periodontal disease are common oral health concerns. This article explores whether a dental crown can be placed when periodontal disease is present, and the considerations involved.
What is a Dental Crown?
A dental crown is a tooth-shaped cap used to restore a damaged or weakened tooth. It covers the entire visible portion of the tooth, providing strength. Crowns serve several purposes, including restoring a tooth’s original shape, size, and strength, or improving its appearance.
These restorations can protect a cracked tooth, restore a worn-down or broken tooth, or cover a tooth after a root canal procedure. Crowns are fabricated from various materials, such as porcelain, ceramic, metal alloys (including gold), or a combination like porcelain-fused-to-metal. The choice of material often depends on factors like location in the mouth, desired aesthetics, and durability needs.
Understanding Periodontal Disease
Periodontal disease, commonly known as gum disease, is an inflammatory condition affecting the tissues supporting the teeth. It originates from bacterial accumulation in the mouth, forming plaque that can harden into tartar. The initial stage, gingivitis, involves gum redness, swelling, and bleeding, often without pain.
If left unaddressed, gingivitis can progress to periodontitis, a more severe form where the infection spreads below the gumline. This progression leads to the breakdown of the ligaments, soft tissues, and bone that hold teeth in place, potentially causing gum recession, deep pockets around teeth, loose teeth, and eventually tooth loss. Common symptoms include persistent bad breath, changes in bite, and pus around the gum line.
Crowns and Periodontal Disease: The Interplay
Placing a dental crown when active periodontal disease is present introduces significant challenges. While it is generally possible to receive a dental crown with gum disease, the condition must be managed first. Active inflammation makes it difficult to take accurate impressions, which are necessary for creating a well-fitting crown.
An ill-fitting crown can create spaces that trap bacteria, potentially worsening the gum disease and accelerating bone loss around the tooth. If the supporting bone around the tooth is unstable due to periodontitis, the crown’s foundation is compromised, which can lead to accelerated gum recession around the crown and ultimately crown failure. The long-term success of any dental restoration, including a crown, relies on a stable and healthy foundation of gum and bone tissue.
Preparing for a Crown with Periodontal Disease
To prepare for a crown, periodontal disease must be thoroughly managed and stabilized. A comprehensive dental evaluation, including X-rays, helps assess the extent of the disease and underlying bone structure.
Treatment typically begins with non-surgical procedures like scaling and root planing, a deep cleaning that removes plaque and tartar from tooth and root surfaces below the gumline. This process aims to reduce inflammation and infection. In more advanced cases, surgical interventions such as pocket reduction surgery or bone and gum grafting might be necessary to restore lost tissue and create a stable foundation.
Maintaining Oral Health After Crown Placement
Maintaining oral health is important for the success and longevity of a crown, especially for individuals with a history of periodontal disease. Meticulous daily oral hygiene around the crown and throughout the mouth is necessary. This includes regular brushing, flossing, and using interdental cleaning aids to remove plaque and prevent bacterial accumulation.
Regular dental check-ups and professional cleanings are also important components of ongoing care. These visits allow dental professionals to monitor the crown’s integrity and the health of the surrounding gum tissues, enabling early detection and management of any recurrent periodontal issues. Consistent vigilance helps prevent future complications, contributing to the crown’s continued function and aesthetics.