Dental crowns serve as protective caps for damaged or weakened teeth, restoring their function and appearance. Though crowns are durable, the natural tooth structure beneath or surrounding gum tissues remain susceptible to issues. Infections can develop in these areas, compromising oral health and leading to serious problems. Understanding how to identify, address, and prevent such infections is important for dental health.
Identifying an Infected Crown
Recognizing signs of an infected crown is important for timely intervention. Persistent pain, from a dull ache to a sharp throbbing sensation, often worsens when chewing or biting. Gums around the crowned tooth may appear swollen, red, or tender. Heightened sensitivity to hot or cold, especially lingering discomfort, can also signal an issue.
A foul taste or persistent bad breath, not resolved by hygiene, often indicates bacterial infection. In advanced cases, visible pus may discharge from the gum line, or a small bump (an abscess) might form. A loose or shifting crown can also indicate compromised underlying tooth structure. Systemic symptoms like fever or general unwellness can occur with severe infections.
Common Reasons for Crown Infection
Infections under a dental crown arise from bacterial infiltration of the tooth or surrounding tissues. New tooth decay beneath the crown is a frequent cause. Even with a crown, the natural tooth remains vulnerable to decay, especially if oral hygiene is not properly maintained. Bacteria convert sugars into acids, eroding tooth enamel and creating cavities that can spread to the pulp and nerves.
A compromised seal between the crown and tooth can allow bacteria and food particles to seep underneath, leading to decay and infection. This occurs if the crown is ill-fitting, chipped, cracked, or worn, creating bacterial pathways. Sometimes, a pre-existing infection, like from an incomplete root canal, can flare up beneath the crown. Trauma to the tooth or crown, or progression of gum disease (periodontitis) around the crowned tooth, can also contribute to bacterial entry and infection.
Potential Complications Without Treatment
Neglecting an infected crown can lead to serious health problems. The infection can progress, forming a dental abscess—a pocket of pus causing intense pain and swelling. Untreated, this abscess can spread beyond the initial tooth. It may extend to the surrounding jawbone, causing bone loss, or to adjacent teeth and gum tissues.
In serious instances, infection can spread to other areas of the head and neck, including facial soft tissues, or lead to sinus infections, especially if near the maxillary sinus. Although rare, untreated dental infection can enter the bloodstream, leading to systemic conditions like cellulitis, endocarditis (heart valve infection), or even sepsis. Ultimately, untreated infection can compromise tooth structure, making extraction necessary and resulting in tooth loss.
Professional Treatment for Infected Crowns
When an infected crown is suspected, a dental professional conducts a thorough examination, often including X-rays or CT scans, to assess the infection’s extent and location. Treatment varies depending on the infection’s cause and severity. If infection reaches the tooth’s pulp, root canal therapy is commonly performed. This involves removing infected pulp, cleaning and disinfecting root canals, then sealing them to prevent reinfection. A root canal can often be performed through an existing crown, though sometimes the crown may need removal.
If the issue is new decay under the crown and the tooth is salvageable, the dentist may remove the existing crown, clean the decay, and place a new, properly fitting crown. If the tooth is extensively damaged or the infection too severe to treat, extraction may be the only option. Antibiotics may be prescribed to control infection and reduce inflammation, but they are not a standalone cure and must be combined with a definitive dental procedure to address the source.
Steps to Prevent Crown Infection
Preventing crown infection involves consistent oral hygiene. Brushing twice daily with fluoride toothpaste and flossing once a day removes plaque and food debris from around the crown and between teeth. Using an antibacterial mouthwash can further reduce oral bacteria.
Regular dental check-ups and professional cleanings are important. These visits allow dentists to identify potential issues, such as decay or a compromised crown seal, early, before they escalate into serious infections. Addressing gum disease promptly is important, as healthy gums provide a better seal around the crown. Avoiding chewing on hard objects, which can chip or crack the crown, helps maintain its integrity and protective barrier.