A dental crown is a tooth-shaped cap placed over a damaged or weakened tooth to restore its shape, size, strength, and appearance. While crowns effectively protect teeth, the underlying tooth structure remains susceptible to decay. Cavities can form underneath a crown, often hidden from plain sight.
How Cavities Form Under Crowns
Cavities can develop beneath a dental crown through several mechanisms, even though the crown itself is immune to decay. One common cause is an improper fit or sealing of the crown, which can create microscopic gaps between the crown and the natural tooth. These tiny spaces allow food particles, plaque, and bacteria to accumulate, leading to the erosion of the tooth enamel underneath the crown.
Gum recession also plays a role, exposing portions of the natural tooth structure that were previously covered by the crown. The area where the crown meets the gum line, known as the margin, becomes vulnerable to bacterial infiltration when gums recede. Furthermore, the cement holding the crown in place can break down over time, compromising the seal and allowing bacteria to seep in.
Inadequate oral hygiene practices around the crowned tooth also contribute to decay. If plaque and bacteria are not regularly removed through diligent brushing and flossing, they can build up along the crown margins and initiate decay.
Recognizing a Cavity Under Your Crown
Detecting a cavity under a dental crown can be challenging. However, several signs and symptoms may indicate an issue. Common indicators include sensitivity to hot, cold, or sweet foods and beverages, or pain when biting down on the crowned tooth. Some individuals might experience a constant ache, swelling, or tenderness around the gum line near the crown.
A foul taste or odor originating from the affected tooth can also signal decay. Additionally, discoloration, such as dark lines appearing around the crown margin, might indicate underlying decay. Symptoms can be subtle or absent in the initial stages of decay.
Dentists employ various methods to diagnose cavities under crowns. Visual inspection may reveal changes around the crown, but X-rays are often necessary to detect decay beneath the crown. Probing the margins of the crown with a dental instrument can also help identify compromised areas.
Addressing the Cavity
Addressing a cavity under a crown depends on the extent and location of the decay. If the decay is minor and accessible, a simple dental filling might suffice. In some cases, the crown may be carefully removed, the decay cleaned, and the crown resealed or recemented if it is still in good condition.
Moderate decay typically necessitates the removal of the existing crown to effectively treat the cavity. Once the decay is removed, a new filling or buildup is placed, and a new crown is fabricated and cemented onto the tooth. If the decay has progressed extensively and reached the tooth’s pulp (nerve), a root canal procedure becomes necessary before a new crown can be placed. This procedure removes the infected pulp, cleans the inner chamber, and seals it.
In severe cases where the tooth structure is too compromised by extensive decay, extraction might be the only viable option. Following extraction, tooth replacement options such as a dental implant or a bridge can be discussed to restore function and appearance. Delaying treatment can result in severe pain, infection, abscess formation, and ultimately, tooth loss.
Preventing Future Cavities
Preventing future cavities under crowns involves a consistent and comprehensive oral hygiene regimen. Maintaining excellent oral hygiene is paramount, which includes brushing teeth twice daily with fluoride toothpaste and flossing daily. Special attention should be given to cleaning around the margins of the crown, where the crown meets the natural tooth, as this area is particularly prone to plaque buildup.
Regular dental check-ups and cleanings are important for early detection and prevention. Dentists can monitor the condition of crowns and the underlying teeth, often using X-rays to identify hidden decay. Limiting the consumption of sugary and acidic foods and drinks helps reduce the risk of decay by minimizing the fuel for bacteria that produce harmful acids. Additionally, addressing habits like teeth grinding or clenching can help preserve the integrity of the crown and the tooth beneath it.