It is possible for tooth decay to develop under a dental crown. A dental crown is a cap placed over a damaged or decayed tooth, restoring its shape, size, and function. While crowns are a robust solution, they do not make the underlying tooth immune to further decay. Bacteria can still accumulate at the edges of the crown, leading to new cavities.
How Decay Under a Crown Develops
Decay under a crown can occur for several reasons, despite the crown’s protective function. A primary factor is marginal leakage, which happens when the tight seal between the crown and the natural tooth structure weakens over time. This creates microscopic gaps, allowing bacteria, food particles, and saliva to seep underneath the crown. Once these elements penetrate, decay-causing bacteria can erode the tooth.
Gum recession can also expose the tooth’s surface beneath the crown’s margin, making it vulnerable to decay. This exposed area becomes a prime spot for plaque and bacteria accumulation. Decay can also progress if the tooth was not thoroughly prepared or if residual decay was left behind before crown placement. Fractures or cracks in the crown can also provide an entry point for bacteria, leading to decay.
Recognizing Signs of Decay Under a Crown
Identifying decay under a crown can be challenging because it is not always visible. Increased tooth sensitivity, particularly to hot, cold, or sweet foods and drinks, is a common indicator. This sensitivity can manifest as a sudden, sharp pain or a persistent, dull ache. Pain when biting or chewing is another frequent symptom, suggesting pressure on the affected tooth.
Swelling or tenderness around the gum line near the crowned tooth can also signal an issue, possibly indicating an infection. A persistent foul taste or odor from the crowned tooth may also point to bacterial activity and decay. There might be a visible dark spot or discoloration at the crown’s margin, or the crown might feel loose, indicating weakened underlying tooth structure.
Treatment Options for Decay Under a Crown
Treatment for decay under a crown depends on the extent and severity of the decay. For minor decay, a dentist might be able to remove the old crown, clean out the decayed tissue, and place a new filling or re-cement the existing crown if accessible. This approach aims to save the existing tooth structure.
If the decay has advanced deeper into the tooth and reached the pulp, or nerve, a root canal procedure may be necessary. This involves removing the infected pulp, cleaning, and sealing the root canals to prevent further infection. A new crown is often placed after the root canal. If the tooth is extensively damaged and cannot be saved, extraction may be the last resort, followed by dental implants or bridges to replace the missing tooth.
Preventing Decay Under a Crown
Preventing decay under a crown largely mirrors the practices for maintaining overall oral health. Maintaining excellent oral hygiene is important, including brushing teeth thoroughly twice a day with fluoride toothpaste. Daily flossing is also important, specifically around the base of the crown and along the gumline, to remove plaque and food particles that can accumulate in these areas. Incorporating an antimicrobial mouthwash into your routine can further reduce bacterial load.
Regular dental check-ups and professional cleanings are recommended for early detection of any issues, even before symptoms become noticeable. 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. Avoiding habits like chewing on ice or using teeth as tools can prevent damage to the crown, which could otherwise create openings for bacteria. Addressing conditions like teeth grinding (bruxism) with a nightguard can also protect crowns from excessive wear and potential fractures.