Dental crowns are a cornerstone of restorative dentistry, widely used to repair and enhance the functionality and appearance of damaged or decayed teeth.
At NYC Smile Design, we often encounter patients with crowned teeth or those considering this treatment who are concerned about the possibility of developing cavities beneath a crown.
Drawing on years of experience in cosmetic and restorative dental practices, this blog aims to address these concerns, shedding light on the susceptibility of crowned teeth to decay and providing expert advice on how to best manage and protect your dental health.
Understanding Dental Crowns
Dental crowns are custom-fitted caps that are placed over a tooth to restore its shape, size, strength, or appearance. They are designed to encase the entire visible portion of a tooth that lies at and above the gum line.
Crowns traditionally have been made from various materials, including porcelain, ceramic, metal, or a combination of these. Modern crowns are typically made of porcelain and ceramic substrates. These are popular for their natural appearance and strength, matching the color of natural teeth, and preferred by dentists because of the ability to bond them to the natural tooth structure as opposed to simply gluing or cementing them in. Metal crowns are prized for their durability and are often used for primary (baby) teeth. When an adult back/posterior tooth is restored with metal, they are usually made with precious metals that can last a long time.
How Cavities Can Form on Crowned Teeth
Understanding how cavities can develop under crowned teeth is crucial for maintaining the integrity and longevity of your dental restorations.
Crown Edges
The area around the base of the crown, especially where the crown meets the natural tooth, is particularly vulnerable to decay if it is not properly sealed. This crucial juncture is called the margin. If the margin is not perfectly flush with the tooth, tiny gaps can form, allowing bacteria and plaque to seep underneath the crown. Over time, these bacteria can cause decay in the natural tooth beneath the crown, which might not be noticeable until it has caused significant damage.
Contributing Factors
Several factors can increase the risk of developing cavities beneath a crown:
- Poor Oral Hygiene: If regular brushing and flossing are neglected, plaque—a sticky film of food debris, bacteria, and saliva—can accumulate around the crown's edges. Plaque that is not removed can harden into tartar or calculus, a breeding ground for bacteria that produce acids, leading to tooth decay.
- Gum Recession: Over time, the gums may recede or pull away from the teeth, exposing more of the tooth and the crown's edges to bacteria. This recession can create new spaces under the crown that are difficult to clean and more susceptible to decay. This is especially true if the recession exposes the root surface which does not naturally have a protective layer of enamel on it.
- Material and Fit of the Crown: The type of material used for the crown and how well it fits can also affect the risk of decay. Porcelain and gold crowns, for example, are smooth and less likely to attract plaque than other materials, but if they are not well made they will not fit snugly at the gum line, leading to problems. A crown that does not fit correctly can trap food and bacteria, leading to decay around the margin and under the crown. Reasons they do not fit snugly around the margin include- poor impression/scanning techniques which do not capture the exact position of the crown preparation margin line, sloppy lab/ techniques that do not respect the importance of the exact fit of the crown to the margin designed by the dentist, human error, and missed bonding or cementing issues.
Maintaining crowned teeth involves diligent care and attention to prevent these issues. Regular dental check-ups are crucial as they allow your dentist to monitor the health of your crowned teeth and make adjustments to the fit and seal of the crown before serious problems develop.
Preventing Cavities in Crowned Teeth
Preventing cavities in crowned teeth is key to ensuring the durability and effectiveness of your dental crowns. Here are essential strategies and practices to help safeguard your crowned teeth against decay.
Good Oral Hygiene
Maintaining excellent oral hygiene is crucial. Regular brushing and flossing, particularly around the crowned tooth, can help prevent plaque buildup and keep the area free of decay.
Regular Dental Check-ups
Routine dental check-ups and cleanings are essential to ensure the crown remains well-sealed and free from decay. These visits allow your dentist to monitor the health of your crowned teeth and address any issues before they escalate.
Avoidance of Sugary Foods
Limiting the intake of sugary foods and beverages can reduce the risk of tooth decay. Sugars can promote bacterial growth and acid production in the mouth, which can attack the tooth structure.
Wearing Prescribed Protection- Occlusal Guards or Nightguards
Not using your prescribed guards to prevent or control clenching and grinding can put excess pressure on your crown and break the seal around the margins. This can lead to decay as described above.
What to Do If You Suspect Decay Under a Crown
If you suspect decay under a dental crown, it's important to recognize the signs and take prompt action to address the issue and prevent further damage to your tooth.
Signs of Trouble
If you have a crowned tooth, it’s important to watch for signs that might indicate a problem, such as decay developing under the crown. Common symptoms to look out for include:
- Pain: If you start experiencing discomfort or pain around a crowned tooth, especially when biting down or when the tooth is exposed to very hot or cold temperatures, it could be a sign of decay under the crown.
- Sensitivity: A sudden increase in sensitivity to hot, cold, or sweet foods and drinks can also be a red flag.
- Visible Gap or Changes: If you notice a visible gap or dark brown or black line forming between the crown and your gum line, or if the crown seems to be shifting position, it's important to get it checked out. These changes can expose the underlying tooth to bacteria, leading to decay.
- Changes in your bite around the crown: a loose or inflamed tooth under a crown will change the way you bite and feel off or uncomfortable. It may even illicit pain.
These symptoms should prompt you to seek immediate dental advice to prevent further issues.
Immediate Steps
If you notice any of the above symptoms, it’s crucial to act quickly:
- Contact Your Dentist: The first step is to call your dentist and describe your symptoms. They can advise you on how to manage your discomfort and will likely schedule an appointment to examine the crown.
- Avoid Delay: Waiting too long to address potential decay can lead to more serious complications, such as infection or damage to the underlying tooth structure, which might require more extensive treatment.
Treatment Options
During your visit, if your dentist discovers decay under the crown, there are several possible courses of action:
- Replacing the Crown: If the decay is extensive, the old crown may need to be removed, the decay cleaned out, and a new crown fitted.
- Additional Dental Work: Sometimes, treating decay under a crown can also involve treatments like fillings which build up the decayed tooth structure or even a root canal, depending on how deep the decay has penetrated into the tooth.
- Temporary Solutions: If a new crown can't be placed immediately, your dentist might install a temporary crown to protect the tooth while the new crown is being made.
Fixing Your Cavities
While crowned teeth are protected, they are not immune to cavities. Understanding how to care for your crowned teeth and recognizing the signs of potential problems are vital steps in maintaining both your crowns and overall oral health.
To ensure your dental crowns and overall dental health are maintained, schedule regular check-ups with your dentist. Early detection and intervention are key to managing any issues and keeping your smile healthy and beautiful.
If you're experiencing discomfort or suspect a cavity under your crown, don't wait for the problem to worsen. Schedule a consultation with NYC Smile Design today. Our expert team is ready to assess your situation with the utmost care and provide personalized solutions to keep your smile healthy and beautiful. Contact us now to ensure your dental health is in the best hands.
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