A dental crown acts as a protective cap, custom-made to fit over a damaged or weakened tooth, restoring its shape, size, strength, and appearance. Crowns are cemented permanently over the entire visible portion of a tooth, starting at or just below the gum line. While dental crowns are designed for durability and can last many years with proper care, issues like gaps forming between the crown and the gum can sometimes arise. These gaps are not merely cosmetic concerns; they can signal underlying problems that require attention to maintain overall oral health.
Understanding Gaps Around Dental Crowns
A gap between a dental crown and the gum line typically indicates a visible space or a compromised seal where the crown meets the tooth structure and gum. Gum recession, where gum tissue pulls away from the tooth, is a common cause, exposing the tooth’s root and creating an open space. This recession can occur due to aging, aggressive brushing, or gum disease. Another reason for a gap is an improperly fitted crown, which may not sit flush against the gum line from the outset. Over time, normal wear and tear can also lead to small gaps as the crown material gradually deteriorates.
Additionally, tooth decay beneath the crown can cause the natural tooth structure to shrink, leading to a noticeable space. If left unaddressed, these gaps can lead to significant oral health problems, including the accumulation of food particles and bacteria. This bacterial buildup increases the risk of tooth decay, gum inflammation, and gum disease, potentially causing sensitivity, bad breath, and even crown failure or tooth loss.
Dentist’s Evaluation Process
When a gap is suspected around a dental crown, a dental professional conducts a thorough evaluation to determine the cause and extent of the issue. The assessment typically begins with a visual inspection of the crown and the surrounding gum tissue to identify any visible spaces, discoloration, or signs of inflammation. The dentist will also gently probe the gum line around the crown to check for any pockets or areas where the gum has detached from the tooth surface.
Dental X-rays are often taken to examine the underlying tooth structure and bone, helping to detect any hidden decay beneath the crown or bone loss. A dental explorer, a fine-tipped instrument, may be used to carefully check the crown’s margins, ensuring there are no ledges or openings where bacteria can accumulate. This comprehensive diagnostic process allows the dentist to identify the precise reason for the gap, which guides the selection of the most appropriate treatment.
Approaches to Repairing Crown Gaps
Minor Gaps
Addressing gaps around dental crowns involves various treatment options, chosen based on the underlying cause and severity of the gap. For very small, superficial gaps, a dentist might apply a sealant or bonding material to close the space and protect the tooth. This can be a quick solution for minor imperfections that do not involve significant structural issues.
Crown Replacement
If the crown is ill-fitting, damaged, or has decay underneath, crown replacement is a common solution. This process involves carefully removing the existing crown, cleaning the underlying tooth, and preparing it for a new crown. Impressions or digital scans are taken to create a custom-made crown, which is then permanently cemented into place, ensuring a snug fit against the gum line.
Gum Grafting and Decay Treatment
When gum recession is the primary cause of the gap, gum grafting may be recommended to restore lost gum tissue. This procedure involves transplanting healthy gum tissue to cover exposed root surfaces, potentially in conjunction with crown replacement if the crown margin is also affected. If decay has formed under the crown, it must be thoroughly removed, which almost always necessitates replacing the crown. In cases where the decay or infection has reached the tooth’s pulp, a root canal treatment might be necessary before a new crown can be placed to restore the tooth’s health and integrity.
Maintaining Crown Health
After addressing a gap around a dental crown, or to prevent one from forming, consistent oral hygiene practices are important for the crown’s longevity and overall oral health.
Brushing at least twice a day with a soft-bristled toothbrush and fluoride toothpaste helps to remove plaque and food particles from around the crown and gum line.
Daily flossing, using traditional floss, floss threaders, or a water flosser, is also crucial for cleaning areas between teeth and around crowns.
Regular dental check-ups and professional cleanings allow the dentist to monitor the condition of the crown and surrounding tissues, detecting any potential issues early.
Avoiding chewing on hard objects like ice or hard candies can prevent damage or loosening of the crown.
If teeth grinding, also known as bruxism, is present, wearing a custom-fitted nightguard can protect the crown and natural teeth from excessive force.