Millions of people in the United States and around the world purchase dental crowns to protect, cover, and restore teeth that would otherwise be difficult to restore. A dental crown requires preparation of the destroyed tooth to support and restore its natural shape and function. Since the tooth is not noticeable, some patients mistakenly think that it is protected against cavities. But the truth is that the underlying dental and root structures remain vulnerable to tooth decay. A dental crown is a tooth-shaped coping made up of different solid components; the most characteristic are metal, porcelain, resin and ceramics. Dentists generally suggest crown placement when there has been significant damage to the tooth structure above the gum line, but the root remains healthy. Tooth structures under the crown can still be affected by bacteria that cause cavities. Bacteria usually seep through the space between the crown and the gum line, called the margin. If oral plaque, a sticky biofilm of cariogenic bacteria, accumulates at the margin and is not removed, a cavity will eventually appear under the crown. In this article, we explain for what cases we offer crowns at JDental in NYC.
Dental crown vs implant
Unlike crowns, implants are used when the patient has a complete loss of their tooth, including its root. Under these conditions, the entire tooth will be replaced by an implant made of a biocompatible material that cannot be affected by decay. This is the case because there are no natural teeth that can suffer from cavities. That said, dental implants are still susceptible to a type of infection called peri-implantitis caused by poor dental hygiene. Peri-implantitis affects the supporting tissue around the implant and can lead to implant failure. When is a dental crown needed? Dental crowns are an advanced type of indirect operative dentistry. Dental crowns are necessary when teeth have suffered significant damage, affecting their shape, function and aesthetics, which cannot be restored with direct techniques. The most common reasons why a dental crown is needed are:
To repair a fractured tooth that cannot be rebuilt with a simple process.
To protect a tooth that has been weakened, usually due to cavities.
To strengthen a tooth that has had a root canal.
In some cases, a crown may be recommended after a root canal to prevent tooth fracture.
To cover a discolored tooth.
A crown can be made to match the color of the surrounding teeth.
Covers a deformed tooth.
To support dental bridges.
How to detect cavities under crowns?
When decay develops under the dental crown, it usually progresses rapidly, undermining the remaining tooth. Therefore, it is essential to identify a cavity as soon as possible. Some signs and symptoms that may indicate the need for an early dental exam are:
– Pain when chewing
– Sensitivity of the teeth to cold or sweet foods.
– Swollen gums
– Bleeding when brushing
– Visible brown or gray spots on the margin
Usually the infected area is small, making it difficult to detect the defect. Dentists can use radiography (x-ray), CariVu, and other advanced dental imaging techniques to determine if a cavity is forming under the crown without removing it. How to prevent cavities under dental crowns? The most effective way to avoid cavities, including cavities under a dental crown, is to adopt proper regimens of personal dental hygiene. For this reason, you should brush your teeth at least twice a day, paying special attention to cleaning the edges of the crown. In addition, flossing or using an oral irrigator is practically mandatory to keep dentures in good condition. Good oral hygiene can prevent the buildup of plaque and bacteria from entering the space between the crown and the gum line. Complying with all the controls scheduled by your dentist is essential to keep your crowns in optimal condition. How to treat cavities under dental crowns? Prompt treatment of cavities is essential to stop its progression. Left untreated, cavities can lead to tooth loss and other serious consequences. There are several ways to treat cavities under a dental crown.
Repairing the margin
If cavities are detected at an early stage, the dentist could clean the rotten material and do a simple dental restoration. This dental filling, placed on the edge of the dental crown, may be enough to restore your oral health. Root canal
If tooth decay has progressed to affect the dental pulp (nerve), endodontic (root canal) treatment may be necessary. During root canal treatment, endodontists remove the pulp that contains the nerve endings that cause pain. Crown lengthening
Crown lengthening is a procedure to reshape the gum tissue, bone, or both to further expose the tooth surface. This procedure is usually necessary when cavities progress below the gum line.
In many cases, dental crowns must be removed to treat and remove the decay tissue underneath. After the cavities have been completely cleaned, the old crown cannot be used because it is impossible to match the shape of the original tooth. A new crown must be made, ensuring a perfect fit. The placement of a new crown is only possible if the structure of the remaining tooth can still support it.
For more severe cases, where cavities have not been treated, the rot will continue to deepen until it reaches the pulp. In this scenario, dentists will evaluate whether root canal therapy is possible; otherwise, tooth extraction will be necessary. Tooth extraction is the best option when tooth decay is irreparable and the surrounding gum tissue and bone density are low.
Dental crowns are an effective treatment to maintain severely damaged teeth. Although, at first glance, a dental crown may appear to cover and protect the entire tooth, there is a small area at the base of the crown where the tooth that supports the crown is still exposed to the oral cavity. For these reasons, it is important to note that maintaining good oral hygiene (i.e. brushing and flossing regularly) is vital to the longevity of treatment. If you’re worried about potential harm to your dental crown, please contact Dr. Jessica DeSouza to schedule a consultation to make sure you’re on track for success with your oral health.