What are dental crowns?
A dental crown is a personalized cap that covers a damaged or weakened tooth. It is used to restore its shape, strength, and size.
Key features of dental crowns:
- They cover the entire visible area of the tooth.
- It protects weak, cracked, or heavily filled teeth.
- They help in normal biting/chewing function.
- Dental crowns improve the aesthetic value of discolored teeth.
- They are usually placed after root canal procedures.
What are dental bridges?
Dental bridges are used to replace one or multiple missing teeth by “bridging” the gap left in the mouth.
Key Points about Dental Bridges:
- Bridges are considered a permanent solution for replacing missing teeth.
- They will rest on your natural teeth and implants for support.
- Dental bridges help to maintain correct bite alignment.
- It will prevent other teeth from shifting.
- They help to restore your facial structure & smile aesthetics.
Both dental crowns and fixed bridges provide a protective layer to surround teeth to help prevent any further damage from occurring. While they are a great way to protect a tooth from decay, dental crowns do not necessarily provide complete protection against cavities.
Therefore, it is very important that a patient understands the reasons why a dental crown/bridge may develop cavities so that they can avoid the discomfort associated with cavities and save a patient’s smile with less invasive treatment options.
How do cavities form under crowns and bridges?
Crowns and bridges themselves don’t decay, as they are made using materials such as porcelain, metal, or ceramic, which are not home to the bacterial type that causes cavities.
The part of a tooth that is susceptible to decay is the actual living part of the tooth underneath the crown or bridge. Therefore, when referring to a cavity underneath a crown or bridge, we typically refer to a cavity that has developed due to moisture/bacteria forming along the edges and margins of the crown/bridge.
Most frequent causes for tooth decay under a crown or bridge:
Microleakage:
- Tiny gaps can develop between your crown or bridge and natural tooth over time.
- Even if you use the best-fitting crown, there are high chances for saliva, bacteria, or food particles to enter and remain in these spaces, resulting in tooth decay.
Poor Oral Hygiene:
- Crowns and bridges are actually more difficult to maintain and keep clean than natural teeth.
- Deposition of plaque in this area leads to cavities under bridges.
- So, it is important to floss underneath the crown/bridges.
Underlying decay:
It is essential to completely remove any decay if present before crowning the tooth; otherwise, the residual bacteria will gradually create a cavity from under the crown.
Wear & Tear:
- Chewing, grinding, or clenching can make the crown loosen slightly over time, adding additional movement.
- This movement creates opportunity for exposure to bacteria/acid, leading to decay under the crown.
Early signs of a tooth cavity under a crown or bridge:
Unlike the decay found on your teeth, cavities under crowns or bridges are difficult to detect. The signs of decay beneath your dental restoration can be harder to identify because the signs can be mistaken for other problems, such as
- Sensitivity to hotness/coldness: If you experience sudden pain or prolonged discomfort while eating, it may mean that the nerve of the tooth has been affected by decay.
- Biting sensitivity: The structure of decayed teeth gets weakened over time, leading to an acute pain when applying pressure while eating.
- Staining or shadowing near the crown line: Not all decay is visible, but discoloration at the edge can be an early warning sign for caries under the crown.
- Bad taste or odor: Sometimes persistent unpleasant taste and odor in a certain area of the mouth after restoration might indicate possible bacterial activity.
Tips to Prevent Decay Around Crowns and Bridges:
Preventing cavities under crowns is all about maintaining proper hygienic practices and following a good oral routine as well as getting regular follow-up dental care.
Here are things to do:
- Flossing around crowns and bridges:
Cleaning between crowns and bridges is important to get rid of plaque and unwanted food particles that get trapped underneath restorations using flossing devices.
- Regular brushing:
Electric toothbrushes with soft bristles are recommended to remove plaque from around tooth surfaces. Also focus on cleaning the area near crown/bridge placements.
- Dental checkups:
Getting tooth decay under a crown treated at an early stage provides an opportunity for very minimal dental work compared to a larger, more painful, and invasive treatment option.
- Tooth remineralization and fluoride care:
The non-invasive treatment of topical fluoride and re-mineralizing solutions helps in supporting natural tooth structure near the margin of the crown.
- Avoiding harmful dental habits:
Try to prevent and avoid doing things like chewing ice, hard candy, or grinding your teeth that could possibly cause damage or harm to your crowns, resulting in decay.
Treatment steps to prevent tooth decay:
Don’t panic if you get to identify tooth decay underneath dental restorations. Treatment options differ for early to advanced stages depending on the severity of the cavity.
- Minor decay:
In situations like minor or mild cavities, the dentist might suggest you remove the existing crown and clean the decay and cover it with a new crown on the treated tooth.
- Extensive decay:
If the decay gets a little complicated, either treatments like root canals or extractions can be performed before replacing the tooth with a new crown.
- Bridge-specific issues:
In the case of a dental bridge, if there is a cavity only on one abutment of the bridge, the bridge may be repaired partially or replaced fully. This will depend on how stably the individual teeth are connected to each other.
One thing I have learned through many years of experience in dentistry is that catching cavities while they are small allows you to maintain a healthy natural tooth and avoid the need for any extensive restorative procedures later.
Conclusion:
Anyone can face the issue of developing cavities under a crown or bridge. But with good hygiene practices, religious visits to the dental clinic can help to identify and solve these problems under expert guidance. If you need guidance, reach us out.
Your dentist might suggest that you restore the crowns or bridges. These will allow you to maintain healthy teeth and preserve your existing restorations for many years.