Shadowing Case 5: If you like it, put a CROWN on it!

7/22/23

Today, I observed another procedure to installing a crown! The patient was an elderly woman. She had a cavity under a gold crown she had already installed. This procedure is time-consuming. In some cases, the hole/cavity loosens the crown allowing the dentist to just remove the cavity and reinstall the crown. However, to solve this issue, the current crown must be removed to treat the cavity.

The Procedure

Instruments for this procedure

Removing a permanent crown is a difficult procedure. Dr. Kwon started by creating a hole in the dental crown and removed the insides that were infected by the cavity. She then cleans the inside using water and power tools. After drilling and cutting the gold crown in half, Dr. Kwon was able to remove both pieces.

After removing the cavity, Dr. Kwon filled the hole with a special dental filling and carefully sculpted it. She checked the bite of the patient using an articulating paper and proceeded to creating a mold/impression for the new crown!

Dental impression materials

Dr. Kwon creates an impression of the tooth and creates a temporary crown. The permanent crown would be sealed later.

Check out "Shadowing Case 1: Types of Crowns" if you want to learn about the impression and crown-making process!

Now, you might be thinking: "If crowns cover the top and sides tooth, how can cavities form?". There are 2 types of decay that could be caused: Marginal and residual decay. Marginal decay is when the marginal area near of the edge of the tooth (which is not covered by the crown) develop a cavity. Bacteria and food particles may leak inside of the crown which would be a primary cause of a cavity development. It is very difficult to brush in these areas, so it is important to give extra care when brushing and flossing. Residual decay is when an existing decay continues to grow. This would likely happen when your dentist missed some decay on the tooth before placing a dental crown. Between both cases, a marginal decay tends to be more common among patients.

Tips to avoid cavities developing under crowns

1. Pay special attention to teeth with crowns when brushing (at least twice a day)

2. Floss carefully around the gums at least once a day

3. Limit intake of sweets and small foods like chilly flakes

4. Avoid teeth grinding (it can loosen you crown)

5. Have regular checkups to inspect your crown

6. Follow these tips like a king/queen to keep the crown!

Source: https://www.byte.com/community/resources/article/cavity-under-a-crown/

Oral health is FOR.ALL!