September 8, 2013 by Nicholas Calcaterra DDS 104 Comments This is one dental myth that I wish I did not have to see.
After years of practicing dentistry, I can say that this happens about 98% of the time when there is decay on a tooth which already has a crown. Seeing is believing, so let’s take a look at a photo I took of a patient in my dental office in Orange, CT. A cavity, known more formally as dental decay, evident underneath a crown on a lower molar on a patient of mine in Orange, CT.
By looking at the photo, you can see that it is possible to get decay under a crown. So the myth is busted!
Dental decay (known less formally as dental cavities) occurs when bacteria inside the mouth ingest certain foods and then attack the teeth. When it comes to teeth with crowns, the area most susceptible to developing decay is the margin. The margin, as you would guess, is where the crown meets the tooth.
The above photos, descriptions, and x-ray show that even with a crown, a tooth can still develop a cavity. Crowns will protect an already weakened tooth but you still need to brush and floss sensibly. Crowns are a good fix for a lot of dental problems but you have to treat them like real teeth! I was in to see my dentist yesterday to have her look at a ten yr old dental bridge that has some hot cold sensitivity lately. OMG, I’m kind of laughing at some of the responses here when people say that their x-rays show decay under a crown. A dentist for example can take an explorer, and probe underneath the crown at the gumline and check the depth.
A lot of what you are saying is true but I think you are incorrectly paraphrasing what some people say. The past couple of days I had food stuck in between my teeth twice…one time it stayed stuck for a couple of hours. I was not there to perform an exam nor view your x-rays so I can only base my response using my own experiences. A very common problem that can occur while a patient has braces is the formation of white spots during treatment.  When the braces are removed, some patients will have unsightly white spots and they wonder why they are there.
Primary or baby teeth have very thin enamel and cavities grow deep quickly.  Whereas, with the permanent teeth, the enamel is very thick and a cavity grows slowly.
If you think you have a cavity forming, see your dentist quickly for restoration.  Seeing your dentist in a timely manner may prevent tooth loss and cost less. Teenage boys are taking anabolic steroids to attract girls, win friends and even to intimidate bullies. Researchers at the University of Glamorgan visited three local gyms and found that nearly 60% of the males were taking steroids. Over time, it becomes easy to identify people who take steroids, but you need to get used to seeing examples. If one of your friends or family members is taking steroids, try to encourage them to get professional help, say the recovery specialists at Valley Hope Association. Steroids are different from most illegal drugs in that they don’t give any direct high to the user.
Tickets for UFC Manila 2, happening on October 15, officially go on sale this August 15, but you can get 10 percent off on tickets as early as August 10. An injection in the upper left can give your left nostril the feeling that it is running when it really is not. She told me after taking an xray of one of the bridges supporting teeth that I have a pretty big cavity inside of this crown.
Calcaterra, first off I really do have a dental-phobia of sorts and have a situation that is freaking me out.
However, the decay is certainly not going to diminish in size over 1 year, and will most likely get worse. That being said, it can sometimes be difficult to effectively remove all the decay in these situations.

I developed a cavity under the crown.In trying to understand how this could happen i happened to read an article that said when the tooth is removed or a year later the walls of the socket must be cut out with a dental burr.
To generalize though, periodontists don’t treat decay as part of their specialty procedures. This crown has had issues historically, and the last dentist used amalgam to fill a couple of small cracks after looking to make sure the tooth was okay beneath. I started getting some pain in the molar and gum stuck in between this crown and back tooth. An issue with the bite – meaning the crown could be a little high or shaped in such a way that you make more contact with it than you should. It doesn’t hurt at all and there was no mention of it at my last cleaning 6 months ago.
And to add to that, sometimes you need the x-ray to be at the ideal angle for the decay to be visible. If you’re getting food stuck, it is possible there is an issue with either the tooth with the crown or the one next to it. However, in general, when you develop decay that is deep under the gums, it becomes much more difficult to treat. I will say that according to the research, about 10 to 15% of teeth that have crowns placed ultimately need to have a root canal done. My mouth is full of crowns and I’m still having trouble with cavities I hate my teeth. Remember that all cements (and all other dental materials for that matter) have to be approved by various government agencies and be safe. For decades athletes and professional bodybuilders primarily used the drug, and now we are seeing a rise in its use among skinny teenagers who imagine that a chiseled six-pack will lead girls to want them more. Start by looking at the coloring of the skin, and then start to look at the structure of the muscle.
It is normal for them to be initially reluctant, but professionals will be able to increase their chances of getting better. But the problem comes when you increase the amount and remove the perfect balance from the way your body was designed to work. In the long term, the chemical balance within the brain can be affected, and the effects can lead to anxiety, depression and violent behavior. If you combine this with a diet rich in sugar or acid, along with home hygiene that is not ideal, you have a perfect storm. First off, as you correctly point out, the crown usually, but not always, has to be removed to remove all the decay. A dentist is going to use other methods to determine decay, and it’s still a bit of a guessing game.
Sensitivity to temperature or the dreaded air gun can also indicate deterioration of the enamel of the tooth under the crown.
The decay could lead to more food being stuck underneath the crown leading to gum inflammation and then bleeding. But all the periodontists I work with are very good at spotting decay and alerting me (the general dentist) to it.
And surprisingly, denture adhesive will actually work too until you can get in to see a dentist.
Nothing could obviously be seen on an x-ray and I was sent to get a pocket reduction surgery. It had a crown with decay under it and when the root canal dentist x-rayed #15 with a 3-D x-ray, he saw decay under the crown of #14.
I hope if it is extracted, I can get an implant but my dentist thinks the bone is too thin for an implant.
Therefore, when you get decay in a tooth that no longer has a nerve, you are less likely to feel pain. I would seek the opinion of a dentist who does dental implants on a regular basis (typically oral surgeons or periodontists). I went to my dentist, took X-Rays from different angles and nothing came up, no cavities under the edge of the crown, typical place; or anything at the end of the roots.

So yes, I ended up needing a root canal, did that through the crown and next week will put in the guta percha.
Users also suffer psychological effects such as increased aggressiveness, sexual desire and a drift into other types of drugs. One teacher told the Guardian newspaper that he monitors his students and can usually identify when someone gains muscle too fast, in a way that is not possible from regular gym exercise. The drug can also be used to treat medical conditions, like delayed puberty and diseases that eat away at muscle.
Users have been known to become irritable and to become very jealous and protective of their partners, often expressed through bouts of paranoia and aggression. That perfect storm affected the two crown to the upper right on the x-ray, resulting in decay.
He stated it was small and since the backside of my tooth was still stable he could reuse my crown. You do have a legal right to your x-rays so the best thing to do would be to seek a second opinion. I am following your (very helpful) thread and wanted to ask you – is is possible to have decay under the crown, clean it and put the same crown back?
In most cases, a small hole is drilled through the crown, the root canal is done, and then that hole is filled. For a more detailed explanation, you can refer to a page I authored on my main practice website. That was great but then I thought he would clean the decay more than just wiping out and having me rinse with an antibacterial mouth wash.
Bacteria typically gets in because the gun recedes around the crown, and create a small area for decay to get in. The tooth will look smaller, because tooth structure was removed to make room for the crown. Sometimes, depending upon the angle that the x-ray was taken from, you can’t always see decay even when it is there. If not, should it be possible to get a new crown without RCT or is this a sign that root canal is the most likely alternative, followed by a new crown? I am guessing there might be some sort of galvanic current, or something under way not enough to warrant a RCT but enough to cause discomfort.
I did ask if I should get a new crown and it was stated that they would watch it and let me know when it is needed. The pain went away following the pocket reduction surgery but is slowly recurring again after six months. My concern is was it properly treated or should the decay hole have been filled then recemented?? Again through a visual inspection as well as probing around with some tools the dentist may be able to see the beginnings of decay at the gum line. If patient is complaining of obvious pain sensitivity, then this is factored into the diagnosis.
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Lastly, crowns do not last forever, and if you can get 10 years out of them you’re lucky. During the preparation for a crown, the dentist should fairly aggressively push back the gum, so that as it heals it will grow over the edge of the crown. I would say as a patient, when you get a new crown to inspect very carefully the junction of the crown where it meets the gum.

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