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While the dental crown itself cannot become decayed, the underlying tooth structure can. A dental crown is placed after careful shaping and preparation of the tooth surface and then inserted over the remaining tooth structure to restore the crown to its proper form and function.

How Does The Tooth Get Decay Under A Dental Crown?

The most vulnerable part of the interface between the dental crown and the tooth is the area where the edge of the crown meets natural tooth structure. If you are not maintaining good oral hygiene (brushing and flossing) to remove the plaque that lives under the gumline, you can develop a cavity on the underlying tooth and root areas. Once decay develops, it can progress quickly into the tooth and move up and under the crown, undermining the support for the dental crown. The following things can happen if you get tooth decay on a tooth with a dental crown:

-Simple Dental Filling Placed At Margin Of Dental Crown. If the tooth decay is caught early enough, there are times where a simple filling can be placed to restore the tooth. This is only done when complete removal of decay can be accessed from the area. The seal is not as strong and leakage can occur under the dental crown over time.

-Root Canal Therapy. If the tooth decay gets close to or invades into the nerve of the tooth a root canal will be needed to save the tooth. If the tooth has already had a root canal performed, it will need to be rebuilt back up so that a new crown can be placed.

-Crown Lengthening. A crown lengthening is a dental procedure where a portion of the bone surrounding a tooth is surgically removed to allow the dentist access to decay that might run down the side of the tooth. This gives access to restore the tooth and also allows for proper placement of a new dental crown.

-New Custom Dental Crown Fabricated. In most cases, a new crown will be needed to ensure a proper seal and proper coverage over the existing tooth.

Conclusion

It is important to maintain good dental hygiene but it really becomes important once you have dental crowns. A dental crown generally lasts anywhere from 5-15 years if properly taken care of. If they are not cared for they will not last as long and could develop a bigger issue.  The big tip here is to always maintain good dental hygiene and see your dentist regularly to check the crown edges for leakage and decay.



Root canal therapy is a very important tool in a dentist’s list of dental services to save and maintain our teeth. For many, it can be a scary procedure we try to avoid, but with a little educational knowledge, it can take some of the fear away and put your mind at ease. A root canal should not be avoided due to fear, understanding what to expect and why may help you get the dental treatment you need when you need it.

Root Canal Therapy Frequently Asked Questions

What Is Root Canal Therapy?

Root Canal Therapy (also referred to as root canal treatment or endodontic treatment)  is a dental procedure in which the diseased, decayed tooth, or damaged nerve of a tooth is removed and the inside areas (the nerve and canals within the roots) are cleaned, filled and sealed permanently to avoid infection. Without treatment, the surrounding tissues of the tooth (including the gums and bone) will become infected and a dental abscess can form.

A tooth’s nerve and blood vessel provide nutrients and hydration to a tooth as well as sense of temperature. It provides the sensation of hot or cold. The absence of a nerve will affect the strength of a tooth and make it become more brittle and susceptible to fracture if not protected by a crown.

How Do I Know If Root Canal Therapy Is Needed?

Common symptoms related to an infected tooth include tooth sensitivity (to hot or cold temperatures or even both), sensitivity to touch, toothache/sharp pain when chewing, swelling in the area of the tooth, or a bad taste in the mouth. These symptoms need to be evaluated by a dentist immediately to prevent further pain or damage.

What If I Ignore My Symptoms? Will They Just Go Away?

If the symptoms are ignored and treatment is not begun, the inflammation can progress to infection. Infection will continue to invade the tissues and tooth causing the tooth to become more painful and may become a health threat. Once the tooth “dies”, there are only two choices: extract the damaged tooth or perform root canal therapy.

How Is My Tooth Restored After Root Canal Therapy?

Depending on the extent of the damage to the tooth, your dentist can recommend a dental composite restoration to close the tooth or in most cases recommend a dental crown to protect the tooth against future damage. Over time, the tooth with the root canal therapy will dehydrate. This will make the tooth brittle and more susceptible to fracture/breaking. Most often, a crown is placed after root canal treatment is completed to protect the tooth and restore full function.

Is Root Canal Therapy Painful?

Typically, root canal therapy should cause no more discomfort than a simple dental filling). The pain most people associate with root canal therapy is due to the infection that develops. Root canal therapy actually relieves the pain by removing the dental infection and pressure.

What Are The Advantages Of Root Canal Therapy?

Saving the natural tooth with root canal treatment has many advantages:

-Efficient Chewing.

-Maintains Normal Biting Force And Sensation.

-Natural Looking Appearance.

-Protects other teeth from excessive wear or strain.

Root Canal Therapy helps you maintain your natural smile, continue eating the foods you love and limits the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last as long as other natural teeth and often for a lifetime.

Are There any Risks Or Complications?

Over 90 % of root canal therapy procedures are successful. However, there is a chance of a failed root canal. Sometimes the root canal therapy needs to be redone due to diseased canal offshoots that went unnoticed, the fracture of a filing instrument, or a fracture or perforation in the root. The signs of a root canal therapy failure are marked by a return of pain, pressure, and sensitivity.

Is There An Alternative To Root Canal Therapy?

There are other options. One includes extracting the infected tooth. Then the question becomes how to replace the tooth. A few options are possible and these include a dental bridge and a dental implant. The success rate of root canal therapy is over 90% so it is an excellent option to save your own natural tooth if at all possible.

What Can You Expect After Root Canal Therapy?

Most patients feel some sensitivity for a few days afterward. For many it is easily relieved with an over the counter pain medication (aleve or ibuprofen).

Can Root Canal Therapy Be Avoided?

Some tips include maintaining good dental hygiene, see your dentist and hygienist regularly, eat a well balanced diet, and wear a custom made sports mouthguards to decrease dental trauma. Root canals, unfortunately, are not entirely unavoidable, and may happen even with good hygiene and care.

Root Canal Therapy Conclusion

Many are fearful of the root canal therapy procedure but in reality it is not the horror that many believe it to be. Root canal therapy is an easy way to save your teeth in the event of dental trauma, decay, or dental infection. Knowing what to expect can go a long way to alleviating any fears you may have. It is important to save your natural teeth whenever possible.



Wisdom teeth or third molars generally erupt into the mouth between the ages of 17 and 25. These molars come in behind our 2nd molars which came in at about 12 years old. Most people develop 4 wisdom teeth, while others may develop less or even sometimes more than 4. Wisdom teeth commonly become an issue because of lack of room or odd positioning. Wisdom teeth can affect other teeth in the mouth by moving them, damaging root structure or causing tooth decay or periodontal issue. Wisdom teeth can come in sideways, horizontally, backwards, or even become impacted (partially or fully  unable to erupt into the mouth). When these complications arise, it is recommended that the wisdom teeth are removed to avoid permanent damage to other teeth.

What To Expect Following Wisdom Teeth Extraction

While most wisdom teeth extractions go quite easily with little to no pain or complications. There can always be complications no matter how minor they may seem. These can include:

-Bleeding. This is quite normal following any type of oral surgery. It is not unusual to see slight bleeding or oozing into the saliva following wisdom teeth extraction. Excessive bleeding ( mouth filling with blood) is not normal and your dentist or surgeon should be contacted immediately. The general instructions given by your doctor to control this oozing or slight bleeding is to bite down on a fresh gauze pad for about 30 minutes. You can repeat if necessary. This usually does the trick but if more action is needed biting on a moist tea bag will help even further. Tea bags contain tannic acid which helps with clotting of the blood. Activity should be limited directly following surgery. If bleeding continues or you are unsure of what to do, call your dentist immediately.

-Pain/Discomfort. Some minor pain following wisdom teeth removal is normal. A dull ache is expected after the local anesthesia wears off. This usually will subside on its own over 8-12 hours following surgery. Your dentist or surgeon will evaluate what may be necessary for pain management based upon your particular surgery. For more severe pain your dentist or surgeon will give you a prescription pain medicine. It is important to note that most prescription pain medication is much stronger and will make you groggy and reduce your reflexive actions. Driving as well as alcohol intake should be avoided while on these painkillers. The pain should begin to subside within 8-12 hours and be almost gone by end of 2nd day. If pain persists call your dentist immediately as you may be experiencing dry socket. A dry socket occurs when the blood clot gets dislodged prematurely from area where the tooth was extracted. Symptoms of severe and/or throbbing pain at the surgical site 3-4 days following surgery, that does not respond to pain medication, can indicate a dry socket in the area of the wisdom teeth. If this occurs call your dentist so they can relieve your pain.

-Swelling. Another very normal complication of wisdom teeth removal. Swelling can usually be found around the mouth and sides of the face. The swelling can be controlled or minimized by the use of ice packs. After 36 hours, ice has little beneficial effect and can be replaced with the application of moist heat to the sides of the face. Moist heat has been found to be helpful in reducing the swelling and increasing the range of motion of your jaws. Most swelling will subside over the course of 3-4 days.

-Dietary Restrictions. Initial nutritional intake should be in liquid form or very soft foods. It is best to avoid chewing on side where wisdom teeth were extracted. Drinking fluids is especially important to avoid dehydration. Stay away from sharp, crunchy foods that can lodge themselves into the extraction site. You need to eat and drink so that you will heal and the stronger you will feel, but not too much if you are experiencing nausea. Do not use a straw when drinking as you may dislodge the clot and cause a dry socket or increased bleeding.

-Nausea/Vomiting. Developing nausea is a real possibility especially if general anesthesia was used. Limit food intake until nausea subsides and try to drink a carbonated beverage (coke or ginger ale) it will help ease your upset stomach.

-Maintain Dental Hygiene. Keeping the mouth clean is important. Rinsing should not be performed the day of surgery. The day after surgery you can rinse 5-6 times a day using a saltwater mix (cup of warm water with a teaspoon of salt). Your doctor will let you know when brushing in the area can resume.

-Bruising/Discoloration. In some cases, this can happen and is very normal. Occurs when blood forms beneath the tissues causing black, green, blue, or even yellow discolorations on the skin. Usually occurs 2-3 days after surgery. Application of moist heat to the area may speed up the healing process.

-Infection. Your dentist may place you on a course of antibiotics if there is an infection present. The Antibiotic prescription should be completed as directed by your dentist and pharmaceutical instructions.

-Jaw Stiffness. This can occur from the jaws being open and stretched for an extended period of time. Normally goes away within a day or two.

Less Likely Wisdom Teeth Complications

-Numbness. This can happen and is generally temporary. Be aware that you can bite your lip or tongue while you are numb so be careful. If the numbness persists call your dentist immediately.

-Fever. Development of a fever is a rare occurence following wisdom teeth removal but it can happen. If the temperature lasts more than a few hours or does not go back down after taking Tylenol or Advil call your dentist.

-Dry, Cracked Lips. This can occur from your lips and mouth being stretched during surgery. Most dentists can minimize this by using vaseline on your lips and skin before surgery to keep them moist.

-Irregular Bony Projections. In some cases, patients may feel bony projections with their tongue. This is the bony walls that housed your wisdom teeth. These projections may need to be removed by the dentist if they persist.

Wisdom Teeth Conclusion

It is important to remember that we are all individuals and our bodies will react differently to different events such as wisdom teeth surgery. Many of us will have no complications beyond pain and slight swelling, but for others, bigger complications may arise. It is important to maintain an open line of communication with your dentist in case an issue arises.

What many people don’t realize, is that a tooth has nerves and blood vessels just like the rest of our body. A tooth is “vital” or alive. There are reasons why a tooth can become non vital, or dead. ItCosmetic Dentist Marielaina Perrone DDS is not always easy to tell, and sometimes can be quite painful.

A dead tooth is simply a tooth that no longer has access to nutrients and blood flow. Our teeth are composed of three layers: the enamel, the dentin and the nerve or “pulp”. A healthy tooth has living cells and tissue inside.This living tissue plays a role in the development of the teeth. The nerve is the part of the tooth that can sense temperature, when you drink or eat something really cold or hot. It can also sense how hard you are biting into something, and feel pain.

All the blood vessels and nerve fibers are located in the pulp and this means that when the pulp is dead, then the tooth is dies as well. What can happen if a tooth becomes non vital, and why does it die?

What Causes a Tooth To Die?

The two main causes are:

-Tooth Decay - Tooth decay or a bacterial infection, when left untreated, will begin to invade deeper into the tooth eventually penetrating through enamel and into the second layer, the dentin. When the decay or infection reaches deep inside the tooth, the cells of the pulp try to fight it off by triggering the inflammatory process. This includes action by the white blood cells. Pus develops when some of the white blood cells die during the battle against the infection. If the infection is not treated at this stage, all the white blood cells will die and the blood flow will stop completely.When this occurs, tooth sensitivity is usually the first sign of trouble and this sensitivity will eventually reach the pulp and results in a severe toothache.

-Dental Trauma – This can occur from traumatic injuries, falls, severe grinding and clenching, biting into very hard objects, and sometimes idiopathic internal resorption (a tooth self destructs from the inside out for no apparent reason) . When dental trauma occurs, the blood supply can be severed immediately, resulting in the pulp dying off. Sometimes it is a slow progressive breakdown as teeth wear and crack from bad oral habits. Prevention is the key whenever possible. This is why sports mouth guards are recommended for all contact sports activities. Nightguards are recommended for clenchers and grinders. Extremely hard foods should be avoided such as popcorn kernels, corn nuts, and the mouth should not be used in place of tools such as scissors or a bottle opener.

Signs and Symptoms

It can be very difficult to identify a dead tooth just by looking at it and that is another reason why it’s important to visit a dentist regularly. It is possible to have no symptoms when a tooth becomes non vital. However, a non-vital tooth may exhibit some a tell tale symptom like turning darker. This discoloration is usually the dead pulp becoming visible. Another sign of a non-vital tooth is an unexplained swelling, or a raised white pimple like area. These signs are normally a result of a periodontal abscess, caused by periodontal disease or injury, which can rupture and produce an infection in the gums and mouth. A dead tooth will eventually become loose due to the destruction of surrounding bone by the infection process. It can also produce a foul odor and even more severe pain.

Cosmetic Dentist Marielaina Perrone DDSTreatment Of A Dead Tooth

Many patients will ask, “If the tooth is dead why not just leave it alone?”.Simply put, the dead tissue in the pulp chamber will become a breeding ground for bacteria. If left untreated, an abscess can occur along with pain and discomfort. There are usually two options for treatment of a non vital tooth:

-Extraction – A tooth extraction can be performed if the tooth is not savable, or it can be chosen due to finances becoming an issue. A tooth extraction is usually the least expensive option but it can also can leave other issues on the long term horizon (such as tooth shifting, cosmetic and functional issues). Once extracted, tooth replacement can be done using a dental implant, a fixed bridge, or a removable denture.

-Root Canal Therapy -  This procedure is performed when a patient chooses to save the tooth. Root canal therapy allows the dentist to clean out the dead tissue and infection, ridding of the decayed part of the pulp. This will allow the dentist to rebuild on the sterile tooth to return full form and function. With today’s modern technology, root canal therapy can be a painless and comfortable experience and, if done early, can save a tooth by preventing further infection and subsequent tooth loss. The procedure usually begins with anesthesia to prevent any pain, then a dentist will make an opening for the cleaning instrument to penetrate the affected inner parts of the tooth. The infection is cleaned out and the opening is then closed with a filling. The tooth can then be bleached to turn it whiter or a veneer or a crown can be placed over the tooth to make it look natural.

How To Prevent A Tooth Becoming Non-Vital

Maintaining a proper dental hygiene regimen including brushing and flossing regularly can prevent the buildup of food and bacteria that gets trapped between teeth and gums, which can cause infection and tooth decay leading to dead teeth. Regular visits to the dentist are also very important, since your dentist will be able to identify and diagnose early signs of tooth issues. There are other early signs that you can recognize on your own that include sensitivity to heat or cold, pain when chewing or biting down, slight discolorations, bad breath, gum swelling and facial swelling. Saving a dead tooth depends on early detection and early treatment. Do not ignore the signs and symptoms – get it checked out to decrease your chances of infection and tooth loss.