How Can Decay Be Prevented Under a Crown?

Once you have decay that starts under a dental crown the best long term solution is usually to replace the crown.  If the decay present is VERY small and at the margin a composite material can be used to fill the area after the decay is removed.  Keep in mind that many times this is a short term approach.  I would say to replace the crown with a new all porcelain crown that can be bonded to your tooth.  These crowns are less likely to get recurrent decay.

Hello, 

To prevent decay under existing crowns, both dental cleanings and home care are super important. Once decay is detected under an existing crow, the usual procedure is to replace the crown, if possible. Sometimes the decay can be so extensive that restore the tooth is questionable. Your best bet would be to get to your dentist at your earliest convenience if you suspect decay. 

If the decay is small it could be managed with flossing and proper hygiene visit and if it's bigger replacing the crown is probably the best solution. 

 

Recurrent decay can occur under fillings as well as crowns if the margins of the restoration are not sealed well and proper oral hygiene and home care is not being practiced by the patient. If recurrent decay has already occurred under a crown, it is best to remove the crown, clean out the decay and make a new crown that seals the tooth perfectly to prevent further tooth decay. An accurate final impression and a crown that seals the margins after having examined under a microscope by the laboratory technician can assure a more successful outcome and longer lasting restoration.

 

 

 

When we look at crowns with recurrent decay, we must take a number of factors into consideration.

*  Is the decay extensive (deep) or shallow?

*  Is the area of decay easily accessible to dental instruments?

*  Can the dentist be sure to remove all the decay without removing the crown?

The simplest solution is to place a small filling at the crown margin where the tooth and the crown meet to eliminate the decay and seal the crown, in order to prevent the decay from getting worse.  If the decay is too deep, or inaccessible it is best, although more complicated to remove the crown and place a new one after the decay is removed. 

It's important to remember that when a tooth has a crown placed on it, it is because that tooth already has a history of being filled and refilled.  The reason to place the crown is to protect and fortify an already structurally compromised tooth.  If the decay under the crown is not treated properly and is allowed to progress, by the time it is properly dealt with, there may not be enough healthy tooth structure left to work with.

Prevention is the best approach.  Brush your crown well, floss around it daily, and use a toothpaste that contains fluoride.  Be sure to visit your dentist for your regular active maintenance visits so that if a problem arises, it can be caught while it is a small problem and dealt with in a timely manner.