Dental crowns are a popular solution for protecting teeth that are severely damaged or decayed. They cover the tooth completely, providing strength, structure, and protection. While crowns are durable and designed to last many years, they are not immune to problems. One common issue that can occur is tooth decay under the crown.
This can be concerning, but understanding why it happens and how to treat it can help you manage the situation effectively.
In this article, we will explore what happens when a tooth decays under a crown, the signs and symptoms, and what you can do to prevent or treat this issue.
Introduction: What Is A Dental Crown?
A dental crown is a cap that is placed over a damaged tooth. It is designed to restore the tooth’s shape, size, and function.
Crowns are typically used when a tooth is broken, severely worn down, or has a large filling that needs additional support.
They can also be used to protect a weak tooth or to cover a dental implant.
Crowns are made from a variety of materials, including porcelain, ceramic, metal, or a combination of both. Once placed, crowns provide long-term protection and restore the appearance and function of a tooth. However, despite their durability, crowns are not invincible. Over time, decay can occur underneath the crown, leading to a variety of dental problems.
Causes of Tooth Decay Under a Crown
Tooth decay under a crown occurs when bacteria infiltrate the area around the crown, leading to the destruction of the tooth structure underneath. There are several factors that can contribute to this issue:
1. Poorly Fitted Crowns
One of the most common causes of decay under a crown is a poorly fitted crown. If the crown does not fit tightly or if there is a gap between the crown and the tooth, bacteria can enter the space and cause decay. A crown that does not fit properly can allow food particles and bacteria to accumulate, increasing the risk of decay.
2. Worn-Out or Damaged Crowns
Over time, crowns can wear down, crack, or become damaged. When this happens, they may no longer provide a proper seal, leaving the tooth vulnerable to bacteria. This is particularly common with older crowns made from materials that wear down more easily, such as porcelain or composite materials.
3. Improper Dental Hygiene
Even with a crown in place, it is essential to maintain good oral hygiene. If a patient does not brush and floss properly, plaque and bacteria can build up around the crown and the tooth underneath. Over time, this buildup can lead to decay.
Inadequate cleaning of the crown can also allow food particles to accumulate in the gap between the crown and the tooth.
4. Gum Recession
If the gums recede around the crown, it can expose the underlying tooth and create a space for bacteria to enter. Gum recession can happen naturally with age, or it can be caused by gum disease, aggressive brushing, or other factors. When the gums pull away from the tooth, it increases the risk of decay under the crown.
5. Old Fillings Under the Crown
If the tooth under the crown had a filling that was placed before the crown, the filling material may begin to break down over time. This can create spaces where bacteria can accumulate, leading to decay. If the filling is damaged, it can also compromise the seal of the crown, increasing the risk of decay underneath.
Signs and Symptoms of Decay Under a Crown
Tooth decay under a crown can develop gradually, and it may not cause immediate pain or discomfort. However, there are several signs and symptoms to watch for that may indicate that decay is present under the crown:
1. Pain or Sensitivity
One of the most common symptoms of decay under a crown is pain or sensitivity, particularly when chewing or biting down.
You may experience discomfort in the affected tooth when you eat hot, cold, or sweet foods. Sensitivity can also occur when the crown is tapped or when pressure is applied to the tooth.
2. Visible Damage to the Crown
If the crown becomes damaged, cracked, or loose, it may indicate that there is decay underneath. A crown that has become loose or is no longer tightly fitted could be allowing bacteria to enter and cause decay. Additionally, you may notice staining or discoloration around the edges of the crown, which could be a sign of decay.
3. Bad Breath or Unpleasant Taste
Decay under a crown can lead to the accumulation of bacteria, which can cause bad breath (halitosis) or an unpleasant taste in the mouth.
This is often due to the breakdown of food particles and the release of gases by the bacteria that cause decay.
4. Swelling or Tenderness in the Gums
If decay progresses, it can cause the gums around the crown to become swollen or tender. This could be a sign that infection is present. In some cases, you may notice pus or drainage coming from the area around the crown.
5. Cavities or Holes Around the Crown
In more advanced stages, you may notice visible holes or cavities around the edges of the crown. This can occur if the decay has spread beyond the crown and into the tooth structure beneath. In some cases, the tooth may begin to feel loose or wobbly if the decay has caused significant damage.
What Happens If Tooth Decay Goes Untreated?
If tooth decay under a crown is left untreated, it can lead to more serious complications. The decay can spread to the rest of the tooth, weakening it further and potentially leading to tooth loss. If the decay reaches the pulp (the soft tissue inside the tooth), it can cause an infection that may require a root canal to save the tooth.
In extreme cases, untreated decay can cause an abscess, which is a pocket of pus that forms around the infected tooth.
Abscesses can be painful and may require more extensive treatment, such as tooth extraction. The infection could also spread to other areas of the mouth, increasing the risk of systemic issues.
How to Prevent Tooth Decay Under a Crown
Preventing tooth decay under a crown is essential for maintaining oral health and prolonging the life of the crown. Here are some steps you can take to minimize the risk of decay:
1. Maintain Good Oral Hygiene
Brush your teeth at least twice a day with fluoride toothpaste and floss daily to remove plaque and food particles from around the crown and the rest of your teeth. Using an antimicrobial mouthwash can also help reduce bacteria in your mouth and prevent decay.
2. Visit Your Dentist Regularly
Regular dental check-ups are essential for detecting any problems with your crowns and overall oral health. Your dentist can examine the crown, check for any signs of decay, and address any issues before they become serious. Professional cleanings can also help prevent plaque buildup around the crown.
3. Address Gum Health
Taking care of your gums is just as important as caring for your teeth. Brush your gums gently and consider using a soft toothbrush to avoid causing gum recession. If you notice any signs of gum disease, such as bleeding or swelling, consult your dentist for treatment.
4. Avoid Hard or Sticky Foods
To avoid damaging your crown or putting pressure on it, try to avoid hard or sticky foods. Chewing on ice, hard candies, or sticky foods like caramel can cause damage to the crown or the tooth underneath, increasing the risk of decay.
5. Ensure Proper Fit of Your Crown
If you notice that your crown feels loose, cracked, or damaged, visit your dentist immediately. A crown that is not properly fitted can allow bacteria to enter, leading to decay. Your dentist can assess the fit of your crown and replace it if necessary.
How Is Tooth Decay Under A Crown Treated?
If decay is detected under a crown, your dentist will evaluate the extent of the damage and recommend the best course of action. Treatment options may include:
1. Filling or Replacing the Decayed Portion
If the decay is not extensive, your dentist may be able to remove the decayed tissue and fill the cavity with a dental filling.
This will restore the tooth’s function and prevent further decay.
2. Root Canal Therapy
If the decay has reached the pulp of the tooth, a root canal may be necessary to remove the infected tissue. After the procedure, the tooth will be sealed and a new crown may be placed.
3. Crown Replacement
If the decay has compromised the crown or the underlying tooth structure, your dentist may recommend replacing the crown entirely. This may involve removing the old crown, addressing any decay, and placing a new crown to protect the tooth.
4. Tooth Extraction
In extreme cases, if the tooth is too damaged to save, extraction may be necessary. Once the tooth is removed, your dentist will discuss options for replacing the missing tooth, such as dental implants or bridges.
Conclusion
Tooth decay under a crown can occur for various reasons, including poor fitting, damage to the crown, or inadequate oral hygiene. While this can be concerning, early detection and proper treatment can help prevent more serious complications.
By maintaining good oral hygiene, visiting your dentist regularly, and addressing any issues with your crown, you can keep your tooth healthy and extend the life of your dental work. If you experience any signs of decay under a crown, consult your dentist promptly to ensure the best outcome for your oral health.
