Dental crown

During a routine dental visit, after the examination when a dentist tells you that you have a cavity under a tooth that has a crown, you might wonder how decay could occur under the crown. This is definitely a possible scenario. So let’s find our more in detail about how this decay occurs underneath a crown, how you can prevent it and what is the treatment.

Reasons a tooth needs a crown:

Crown is also called a cap and like the name suggests it covers the tooth and fortifies a weak or damaged tooth. It restores the shape, strength, functionality, and appearance of a damaged or deteriorated tooth. There are a number of instances when your tooth might need a dental crown.

  1. Decayed teeth where large parts cannot be restored with a simple filling.
  2. Teeth that have large fillings that are breaking or leaking.
  3. Fractured or broken teeth.
  4. Recover the bite when teeth are severely worn down.
  5. Hold a dental bridge in place.
  6. Root Canal treated teeth as they become brittle and are prone to breaking.
  7. Enhance the tooth’s appearance: change the size, shape and or color. 


The procedure of the dental crown:

During the process of preparing the tooth for the crown, your dentist first removes all decayed or damaged part of the tooth. The remaining tooth is trimmed down from all outer surfaces to make room for the crown. Once the final crown is fitted to your tooth, it is permanently attached to your tooth.

The crown can be made of different materials like ceramic, metal fused to ceramic, all metal, zirconia, etc. All these are synthetic materials which cannot get a cavity. But your natural tooth that holds the crown can still get a cavity. 

 What is the process of decay under the crown?

You might think that now that your tooth has a crown it is resistant to decay. The answer is not so simple. Although the crown is durable and might come with a warranty, your natural tooth, which is susceptible to a cavity, is right underneath it. The margin, which is the junction of the crown and the tooth that is exposed to the outer surface, is vulnerable to decay. It is at or below the gum level and is constantly in contact with the environment of your mouth.

When plaque is allowed to build up along the margins of the crown, the harmful bacteria that it harbors start to produce acids from the consumed sugar and starch. These acids start to eat away the tooth leading to a cavity and you will eventually need to replace the crown. Hence it is important to maintain proper oral hygiene to remove the plaque from your teeth and crowns as well as follow a healthy diet.

But once the crown is placed on top of the tooth, many people continue with their earlier eating as well as oral hygiene habits. It is taken for granted that the tooth is now strong and protected just like a natural unharmed tooth.

Things you can do to increase your crown’s lifespan:

Cavities and infection can occur underneath a crown which ultimately leads to its replacement. So it’s vital for you to know how you can prevent cavities since it is in your hands.

  1. Meticulous and consistent oral hygiene is essential: Brush at least twice a day and floss once a day. Diligently remove the plaque from around the margins of the crown before it builds up. This is well worth the effort. In some cases, special cleaning tools may be required, which your dentist will explain.
  2. Eat a healthy and balanced diet: Avoid consuming refined sugar and carbohydrates, sweetened and aerated beverages. Avoid or limit snacking in between meals.
  3. Visit your dentist regularly for a checkup and professional cleaning: During these visits, your dentist will monitor the crown, its margins, and the surrounding area so that small issues can be detected and repaired early on without the need for an entire crown replacement.
  4. Rinse your mouth with a fluoride mouth wash before going to bed. Fluoride helps in the prevention of cavities.


How long do crowns last? 

Properly fitted crowns can last on an average anywhere from five to fifteen years. If the crowns are well cared for, keeping in mind the above instructions can last much beyond fifteen years.

Cavities Under Crown

Is detecting decay under a crown easy?

You might not have any symptoms when there is a small cavity under the crown. It is sometimes difficult even for your dentist to detect a small cavity underneath the crown as it may show no evidence clinically, only to be detected at an advanced stage. Your dentist might take a radiograph and depend on the outcome will examine further. X-rays are of not much help in detecting decay under crowns that have metal as the rays cannot pass through metal. Sometimes detection only happens when a patient has pain and until then the decay has reached the nerve and so merely replacing the crown is not sufficient, it needs a root canal treatment followed by a crown.

After the crown is removed your dentist will clean out the cavity from the tooth and treat it. Depending on how much healthy tooth structure is left behind, the crown might not fit and you will need a new crown. The amount of the remaining tooth will decide if additional procedures are needed to build up and fortify your tooth before getting a new crown.

So to sum up, cavity under a crown is a possibility that you should be aware of. This can be minimized with good oral hygiene and regular visits to the dentist for early detection so you can keep the destruction to a minimum. Prominent dental clinics in Mumbai, India have dental specialists who are expert at designing and crafting caps and bridges that are of high quality yet at an extremely reasonable cost.

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