Dental crowns are a common solution to protect damaged or decayed teeth, providing strength, structure, and a natural appearance. They can last for many years with proper care, but sometimes, a cavity can form under the crown, potentially leading to discomfort, complications, and the need for further treatment.
While it may sound alarming, understanding what causes cavities under crowns, how to identify them, and the treatment options available can help ensure you’re prepared to take action when needed. Let’s dive into the complexities of cavities under crowns and explore how they affect your dental health.
What Causes a Cavity to Form Under a Dental Crown?
A dental crown acts as a cap that covers a tooth, often following a root canal, a large filling, or a damaged tooth. When done correctly, crowns are designed to seal the tooth beneath, protecting it from further damage and decay. However, even with the protection of a crown, cavities can still form underneath. But how does this happen?
1. Poor Fit or Sealing of the Crown
If a crown doesn’t fit properly, it can leave small gaps between the tooth and the crown itself. These gaps allow food particles and bacteria to sneak in, creating an environment where plaque and tartar can accumulate. Over time, this accumulation leads to the development of cavities. An improperly sealed crown can also allow saliva and moisture to seep under the crown, making it easier for decay to start.
2. Gum Recession
Gum recession can expose parts of the tooth that are not covered by the crown. When the gums recede, the area under the crown may become more susceptible to bacteria and decay. Even if the crown itself is intact, gum recession can compromise the seal around the crown, allowing bacteria to enter and cause a cavity.
3. Normal Wear and Tear
As with any dental restoration, crowns can wear down over time. The cement holding the crown in place can also break down, and this can lead to gaps between the crown and the tooth. Additionally, crowns made from materials like porcelain may become chipped or cracked, which can provide a pathway for bacteria to enter. Over the years, the tooth underneath may still face stress and decay, despite the crown’s protective role.
4. Lack of Oral Hygiene
Good oral hygiene is essential for keeping your teeth and gums healthy, and that includes teeth with crowns. If you neglect to brush and floss regularly, bacteria can build up around the crown, potentially causing decay to form under it. Even if the crown is well-sealed, poor oral care can still lead to problems beneath the surface.
How Can You Tell If There Is A Cavity Under A Crown?
Detecting a cavity under a crown can be tricky, as the crown covers the tooth, making it difficult to see any visible signs of decay. However, there are several symptoms and methods that can help alert you to a potential problem.
1. Pain or Sensitivity
One of the first signs that something may be wrong under your crown is pain or sensitivity. You may experience discomfort when biting or chewing, or you might feel sensitivity to hot or cold temperatures. If the pain is persistent or worsens over time, it could be a sign of a cavity forming underneath the crown, or possibly an infection in the tooth.
2. Gum Swelling or Bleeding
Another indicator that something is happening under your crown is swelling or bleeding around the gumline. This could mean that bacteria have infiltrated the area around the crown and are causing irritation or even an infection in the gum tissue. This could be a sign that a cavity has formed and is affecting the surrounding tissue.
3. Visible Darkening or Staining
While a cavity under a crown is often hidden from plain sight, it’s still possible for staining or darkening around the edges of the crown to occur. If you notice any changes in color near the base of the crown or if it starts to look loose or ill-fitting, it may be time to see your dentist.
4. X-rays
The most definitive way to detect a cavity under a crown is through dental X-rays. X-rays allow your dentist to see beneath the crown and check for any signs of decay or damage to the tooth underneath. Regular dental checkups that include X-rays are essential for monitoring the health of your crowned teeth, especially if they’re older or have had previous treatments.
What are the Treatment Options For a Cavity Under a Crown?
If a cavity does form under a crown, it’s important to seek treatment right away to avoid further damage to the tooth. There are several treatment options available, depending on the severity of the cavity and the condition of the tooth underneath.
1. Re-Cementing or Replacing the Crown
In some cases, the issue may be a loose or poorly fitting crown rather than a serious cavity. If bacteria haven’t fully infiltrated the tooth, your dentist may simply remove the old crown, clean the area, and re-cement a new or existing crown in place. This can help restore the tooth’s function and prevent further decay.
2. Filling the Cavity Under the Crown
If a small cavity forms under the crown, your dentist may be able to remove the decayed portion of the tooth and fill it with a dental filling. Once the filling is placed, the crown can be re-cemented. This is typically a less invasive option, but it’s only possible if the cavity is small and the tooth underneath is still structurally sound.
3. Root Canal Treatment
In more severe cases, the decay under the crown may have reached the nerve of the tooth, causing infection or significant damage. In this case, your dentist may recommend a root canal to remove the infected tissue and prevent the infection from spreading. After the root canal, the tooth is typically fitted with a new crown to restore its function. Root canals can be highly effective at saving teeth, but they are more invasive than simple fillings or re-cementing.
4. Extraction and Replacement
If the decay is too extensive to save the tooth with a filling or root canal, your dentist may recommend extracting the tooth entirely. While this is often a last resort, there are several options for replacing the missing tooth, including dental implants or bridges. Implants are particularly effective in providing long-lasting, natural-looking replacements that function similarly to your original tooth.
Is It Possible to Save a Tooth With a Cavity Under a Crown?
In many cases, yes, it’s possible to save a tooth with a cavity under a crown. Early detection and treatment are key factors in preserving the tooth. If the cavity is caught early enough, your dentist can often remove the decay, clean the area, and fill it with a new material without having to extract the tooth. In some cases, if the damage is confined to the outer layers of the tooth, a simple filling may be all that’s needed.
However, if the cavity has progressed to the point where the infection has spread to the tooth’s pulp (nerve), a root canal may be necessary. Root canals have a high success rate, and many teeth that undergo this treatment can last for many years afterward, often with the same crown being placed again.
If the damage is too severe and the tooth cannot be saved, your dentist will discuss extraction options and offer solutions for replacement, such as a dental implant, which can restore both form and function.
Cavities under crowns are a reminder that even with a protective restoration in place, dental health is an ongoing process. Whether it’s due to poor fitting, wear and tear, or lack of proper oral care, a cavity can form under a crown and cause complications. Being aware of the symptoms, understanding the treatment options, and staying on top of regular dental checkups can help you catch problems early and keep your smile healthy for years to come.
If you suspect you have a cavity under a crown, don’t delay in seeking dental care. Early intervention can often save your tooth and restore your crown, protecting both your smile and your overall oral health. Regular visits to your dentist will ensure that your crowned teeth—and the rest of your smile—stay strong, functional, and beautiful for the long haul.
Is It Time to Check Your Crown? Schedule a Consultation with Cornerstone Dentistry Today!
If you’re experiencing discomfort or notice changes around your crown, don’t wait! At Cornerstone Dentistry, we specialize in detecting and treating cavities under crowns, ensuring that your smile stays healthy and strong. Our team is dedicated to providing the highest quality care to help you preserve your tooth and restore your crown whenever possible.
Contact Cornerstone Dentistry today for a thorough examination and expert advice. Let us help you keep your smile shining bright for years to come!
