Can Dental Crowns Get Cavities? Tooth Decay Risks

Can braces cause cavities?

Hello Doctor: My lower right last molar has undergone root canal treatment and has a crown.
Five months ago, I noticed that the crown seemed to suddenly develop a cavity, which gradually got larger...
Last week, I visited a small clinic, and they confirmed that there is indeed a large cavity.
The doctor suspects that a fracture in the root may have caused a gap in the crown, leading to decay.
Why would a crown also develop a "cavity" and create a large hole??? It is made of metal on the inside and ceramic on the outside...
Also, could there be other possible causes? Do you have any recommended doctors (I am in Taipei)? Thank you!

Gong Wan, 30~39 year old female. Ask Date: 2013/11/04

Dr. Zhang Xiangyuan reply Dentistry

Dear online friend,
Based on your description, it appears that you have undergone root canal treatment and received a porcelain crown, yet you are still experiencing cavities.
It is indeed possible for teeth with crowns to develop caries.
Common reasons for this include inadequate oral hygiene leading to decay, pre-existing cavities within the tooth, poor fit of the prosthesis, or other conditions as described by your dentist.
As long as the tooth remains, there is a possibility of developing cavities or experiencing fractures.
I recommend that you consult with your dentist to evaluate whether the tooth can be preserved, whether a new crown should be fabricated, or if extraction or other treatments should be considered.
Regarding treatment, any qualified dental clinic or hospital should be able to provide an assessment and treatment plan.
You may want to discuss your options with a trusted dentist before deciding on the subsequent treatment plan.

Wishing you a smooth treatment process.
Thank you for your inquiry.

Reply Date: 2013/11/04

More Info

Dental crowns, while designed to protect and restore teeth, can indeed develop cavities, which is a common concern among patients. Understanding the reasons behind this phenomenon can help in preventing further dental issues.

Why Do Cavities Form Under Dental Crowns?
1. Microleakage: One of the primary reasons cavities can form under crowns is microleakage. This occurs when there is a gap between the crown and the underlying tooth structure. Over time, saliva and bacteria can seep into these gaps, leading to decay. Factors contributing to microleakage include improper fitting of the crown, wear and tear, and the quality of the dental cement used during the crown placement.

2. Material Properties: The materials used in dental crowns can also play a role. Metal-ceramic crowns, which you mentioned, have a metal base covered with porcelain. While the porcelain is aesthetically pleasing, it can be more prone to chipping or cracking, potentially exposing the underlying metal and creating spaces for bacteria to thrive.

3. Underlying Tooth Condition: If the tooth beneath the crown had pre-existing decay or structural weaknesses, it could lead to problems after the crown is placed. If the tooth was not adequately treated before the crown was placed, it might develop decay that can progress under the crown.

4. Oral Hygiene Practices: Poor oral hygiene can lead to plaque buildup around the crown margins. If not cleaned properly, this plaque can harden into tartar, which can contribute to decay. Regular brushing, flossing, and dental check-ups are crucial for maintaining the health of crowned teeth.

5. Stress and Bite Issues: If the crown is subjected to excessive forces due to bite misalignment or grinding (bruxism), it can lead to cracks or gaps, allowing bacteria to enter and cause decay.

Recommendations for Prevention and Management
1. Regular Dental Check-ups: It's essential to have regular dental visits for professional cleanings and examinations. Your dentist can monitor the condition of your crowns and the underlying teeth, catching any potential issues early.

2. Maintain Good Oral Hygiene: Brush twice a day with fluoride toothpaste and floss daily, paying special attention to the areas around the crown. Consider using an antibacterial mouthwash to reduce plaque buildup.

3. Dietary Considerations: Limit sugary foods and beverages, as they can contribute to tooth decay. Instead, focus on a balanced diet rich in fruits, vegetables, and whole grains.

4. Address Bite Issues: If you suspect that your bite may be causing stress on your crowns, consult your dentist. They may recommend adjustments or a night guard to protect your teeth from grinding.

5. Consider Crown Replacement: If a crown has developed significant decay or if the underlying tooth structure is compromised, your dentist may recommend replacing the crown. In some cases, a root canal may be necessary if the tooth is infected.

Conclusion
In summary, while dental crowns can protect teeth, they are not immune to decay. Factors such as microleakage, material properties, oral hygiene, and bite issues can contribute to the development of cavities under crowns. Regular dental care and good oral hygiene practices are vital in preventing these issues. If you have concerns about your dental crowns or suspect decay, it is crucial to consult with your dentist promptly. They can provide personalized recommendations and treatment options based on your specific situation. If you're looking for a dentist in Taipei, consider seeking referrals from friends or family or checking online reviews to find a reputable professional.

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