Should I Replace My Crown After Periodontal Treatment?

Periodontal disease, braces?

Hello, I would like to consult about a dental issue.
A few days ago, I visited the dentist and was diagnosed with periodontal problems.
The dentist mentioned that I need anesthesia for periodontal treatment, and one of the affected teeth already has a crown.
The dentist suggested that after completing the periodontal treatment, I should replace the crown as well, stating that even if the periodontal issue is resolved, the gum tissue will not properly fit with the existing crown.
Even if new gum tissue grows, it will not create a proper seal with the original crown, which could lead to bacterial accumulation and recurrent inflammation.
Should I get a new crown, or will the gum tissue restore its fit with the original crown after the periodontal treatment? Thank you.

VIC, 20~29 year old female. Ask Date: 2016/05/28

Dr. Zeng Guanghui reply Dentistry

Teeth with braces that require treatment due to periodontal disease may have issues if the edges of the braces do not fit snugly against the gums.
Even if the periodontal disease is treated, plaque can easily accumulate in the gaps where the fit is not tight, leading to a recurrence of periodontal disease.
Therefore, it is recommended to create a new set of braces with better fit after the treatment of periodontal disease.

Reply Date: 2016/05/28

More Info

When it comes to managing dental health after periodontal treatment, particularly concerning the replacement of crowns, there are several important factors to consider. Your dentist's recommendation to replace the crown after periodontal treatment is grounded in sound dental principles, and I will elaborate on why this is often necessary.

First and foremost, periodontal disease can lead to the loss of gum tissue and bone around the teeth. When you undergo periodontal treatment, the goal is to restore health to the gums and surrounding structures. However, even after successful treatment, the gum tissue may not return to its original state. This can create a situation where the existing crown does not fit properly against the newly contoured gum line. If the crown is not well-sealed against the gums, it can create spaces where bacteria can accumulate, leading to further inflammation and potential reinfection.

Your dentist's concern about the crown not fitting well after the gums heal is valid. Crowns are designed to fit snugly against the tooth and the surrounding gum tissue. If the gum tissue has receded or changed shape due to periodontal disease, the existing crown may no longer provide an adequate seal. This can result in food particles and plaque accumulating around the crown, which can lead to recurrent gum disease, decay under the crown, or even tooth loss.

Moreover, the material of the crown itself can also play a role in this decision. For instance, metal crowns may not provide the same aesthetic appeal as porcelain crowns, especially in visible areas. If you are considering cosmetic improvements alongside functional ones, this might be an additional reason to replace the crown.

In terms of timing, it is generally advisable to wait until the periodontal treatment has stabilized before making any decisions about replacing the crown. This allows the dentist to assess the health of the gums and ensure that any inflammation has subsided. Once the periodontal health is restored, your dentist can evaluate the fit of the existing crown and determine whether a new crown is necessary.

If you decide to proceed with a new crown, your dentist will take impressions of your teeth after the gums have healed. This ensures that the new crown will fit properly with the new gum contour. The new crown will not only help in preventing further periodontal issues but will also provide a better aesthetic outcome.

In conclusion, while it may be tempting to keep the existing crown, the potential risks associated with not replacing it after periodontal treatment are significant. A new crown can help ensure a proper fit, reduce the risk of reinfection, and improve your overall dental health. It is essential to have open communication with your dentist about your concerns and the best course of action for your specific situation. Always prioritize your dental health, and don't hesitate to seek a second opinion if you feel uncertain about the recommendations provided.

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