A dental crown is a fixed prosthetic placed over a damaged or weakened natural tooth. While the crown material cannot decay, the underlying tooth structure, known as the abutment tooth, remains susceptible to bacterial infection and plaque buildup. A microscopic margin exists where the crown meets the gumline, providing an environment where oral bacteria can accumulate. Neglecting this area can lead to gum inflammation, secondary decay, and crown failure. Proper daily flossing is necessary to ensure the longevity of the crown and the health of the surrounding tissue.
Standard Technique Using Floss Threaders
Cleaning the space below the contact point between a crown and the adjacent tooth often requires a floss threader or specialized floss with a stiff end, such as Superfloss. A floss threader is a small, flexible loop designed to carry regular dental floss into areas where it cannot be snapped down. This tool bypasses the tight contact area, allowing the floss to reach the gingival margin where the crown meets the gum.
To begin, a length of traditional floss is threaded through the loop of the threader, or the stiff end of the Superfloss is used directly. The rigid tip is gently inserted from the cheek side underneath the contact point and pulled through to the tongue side. This action positions the softer, cleaning portion of the floss around the base of the crown and the adjacent tooth.
Once positioned, the floss should be wrapped into a “C” shape, hugging the side of the crown and extending slightly below the gumline into the sulcus. The floss is then moved with a gentle vertical or “shoe-shine” motion to scrape away plaque and debris from the surface of the abutment tooth and the crown’s margin. This motion must be thorough to effectively disrupt the bacterial film that forms along the crown’s base.
After cleaning one side of the crown, reposition the floss to clean the other side of the contact point, following the same “C” shape and vertical motion. When cleaning is complete, the floss should not be pulled upward to remove it from between the teeth. Instead, carefully release the floss from one hand and pull it sideways or forward/backward through the contact point until it is completely free.
Specialized Tools for Complex Restorations
While the floss threader technique works for single crowns, appliances like bridges or implants require different tools. A dental bridge consists of multiple fused units, making it impossible to pass floss between the individual caps. To clean the area beneath the bridge unit that spans the missing tooth space, floss threaders guide Superfloss or regular floss directly underneath the prosthetic.
The specialized, spongy section of Superfloss is useful for cleaning the underside of a bridge’s pontic, allowing for comprehensive removal of trapped debris and plaque. Alternatively, small interproximal brushes can be carefully inserted beneath the bridge. The brush size must be appropriate to avoid damaging gum tissue and should not be forced into tight spaces.
Water flossers, also known as oral irrigators, offer a supplementary method for cleaning around complex restorations. These devices use a targeted stream of pressurized water to flush out loose debris and plaque from hard-to-reach areas, such as crown margins or under bridges. Using a water flosser once daily can help reduce bleeding and plaque accumulation, making it a beneficial addition to the daily oral care routine, especially for individuals with dexterity challenges.
Avoiding Damage and Recognizing Issues
Maintaining the health of a crown involves proper cleaning technique and careful attention to any signs of potential failure. When flossing, guide the floss gently and avoid snapping it forcefully against the gum tissue, which can lead to trauma or recession. Excessive pressure can also damage the delicate margin of the crown, potentially creating a larger gap for bacteria to enter.
Improper removal technique, such as pulling the floss upward with force, can potentially loosen a crown if the cement bond has weakened. Remember that flossing should be a gentle, deliberate process focused on scraping the tooth surface, not sawing the floss back and forth.
A few signs indicate that a crown or surrounding tissue requires professional evaluation. Persistent bleeding, swelling, or redness of the gums around the crown may suggest inflammation or a poor fit. An unpleasant taste or persistent bad odor can signal bacterial buildup or decay beneath the crown. Additionally, if the floss continually frays or catches on the crown’s edge, it suggests a rough or improperly sealed margin that needs inspection.