A dental crown is a custom-made cap placed over a damaged tooth to restore its shape, strength, and appearance. While the crown protects the underlying tooth structure, it creates a microscopic junction at the gum line, known as the crown margin. This margin forms a tiny crevice where plaque bacteria and food debris collect, making the area highly susceptible to decay and gum disease. Since traditional brushing and flossing struggle to clean this boundary, specific tools and special attention are necessary to maintain the health and longevity of the crowned tooth. Ignoring this interface can lead to inflammation, infection, and potential failure of the dental work.
Cleaning the Crown Margins
The first line of defense against problems around a crown is consistently cleaning the crown margin. Proper toothbrushing involves using a soft-bristled brush with gentle, circular motions directed toward the gum. This technique helps sweep away the sticky film of plaque that accumulates right at the edge of the crown.
When flossing around a single crown, the technique is similar to a natural tooth, but with one difference. Slide the floss gently into the space between the teeth, forming a C-shape around the crown’s base to clean below the gum line. Once the area is clean, carefully pull the floss out sideways from the contact point instead of pulling it back up. This prevents snagging the crown or potentially dislodging a restoration that is not fully cemented. Using waxed floss is beneficial as it is less likely to shred or catch on the crown’s margins.
Targeted Methods for Sub-Crown Spaces
Cleaning the spaces beneath a crown, especially the underside of a bridge’s artificial tooth (pontic), requires specialized equipment designed to thread below the restoration. Traditional string floss cannot reach these areas because the teeth are fused together, creating a “plaque trap” where bacteria thrive and cause persistent odor. Specialized tools like floss threaders or Superfloss are engineered to navigate these complex contours.
Floss Threaders and Superfloss
A floss threader is a stiff, plastic loop that guides a strand of regular dental floss under the bridge or through tight spaces. Once the floss is guided through the gap, it is wrapped around the pontic and gently moved back and forth to scrub the entire underside of the artificial tooth. Superfloss offers a convenient all-in-one solution. It features a stiffened end that acts as its own threader, followed by a thick, spongy filament designed to maximize contact and wipe away debris and biofilm from the irregular surfaces beneath the dental work.
Water flossers, also known as oral irrigators, provide an excellent alternative or supplement to manual flossing. They use a targeted stream of pressurized water to flush out trapped material. The pulsating action is highly effective at dislodging bacteria and food particles from hard-to-reach areas, including crown margins and under the pontic. For best results, hold the tip at a 90-degree angle to the tooth and trace it along the gum line, allowing the water to penetrate and flush the entire area. Some devices offer specialized tips, like the Plaque Seeker tip, which combines manual scrubbing with hydrodynamic cleaning around complex restorations.
Interdental brushes are another targeted tool, consisting of a small, conical brush designed to clean the sides of the crown and the gap between teeth. These brushes come in various sizes, allowing users to select the correct diameter to fit precisely into the space between the crown and the adjacent tooth. When properly sized, the bristles sweep away plaque that a regular toothbrush misses, particularly at the contact point where the crown meets the neighboring tooth.
Recognizing When Professional Intervention is Needed
While diligent at-home cleaning is fundamental, certain signs indicate a need for professional evaluation beyond routine checkups. Persistent bad breath that does not improve with specialized cleaning may signal a significant buildup of trapped bacteria or decay beneath the crown. An increase in tooth sensitivity, especially to hot or cold temperatures, can be a symptom of gum recession exposing the root surface or new decay forming along the margin.
Any change in the gum tissue surrounding the crown, such as noticeable swelling, redness, or bleeding when brushing or flossing, suggests localized gum inflammation or disease. A crown that feels loose, wobbles, or shifts even slightly is an urgent indicator that the cement seal has failed or that the underlying tooth structure is compromised. Visible damage, like a crack or chip, requires immediate attention to prevent bacterial infiltration. Regular six-month dental checkups and professional scaling are necessary to monitor the crown’s integrity and remove hardened plaque (calculus) that cannot be cleared with home care tools.