Sometimes, even after the placement of a dental crown, an infection can occur underneath the crown. This is either because the original root canal failed to remove all of the infected material, or because bacteria have found their way under the crown. When this happens, your dentist must remove the infected material before it causes too much damage.
After examining your dental crown, your dentist will need to decide what will work best for your particular case.
Your Dentist Can Attempt to Remove the Crown
The first thing most dentists will do is try to remove the crown to get to the infected tooth below it. But this is a challenging task because if they use too much force, they could break the crown. Worse, they could damage the underlying tooth structure, which might then call for a tooth extraction. As such, if your crown doesn't come off easily, your dentist will then choose to drill through the crown.
If, however, your dentist can remove the crown easily, and no breakage occurs, then they can access the infected material, remove it, and then replace the crown over the remaining tooth structure.
Your Dentist Can Drill a Hole Into Your Crowned Tooth
If your dentist cannot remove the crown safely, then they will drill an access cavity into the crown instead. They can then access the infected material within the remaining tooth structure and remove it. If all goes well, your dentist will then fill the hole in the crown, and you'll be able to use it as before.
But, just like removing a crown, drilling through a crown is risky. If your crown breaks or develops micro-cracks while your dentist drills a hole through it, then you'll probably need to replace it after the root canal.
Your Dentist May Need to Replace the Crown
If the drilling or removal process damage your crown, then it won't be possible to replace it. Your dentist will need to replace the crown. But before they can do this, they have to reshape the remaining tooth structure and ensure there is enough structure to support the new crown.
Your Dentist May Need to Extract the Tooth
If the decay under the crown is too extensive, something that might happen if you wait too long to have the tooth treated, then a root canal won't be enough to save the tooth. Your dentist will need to extract the tooth. Otherwise, if they do place a crown when there isn't enough tooth structure remaining, the crown will fail quickly.
You can replace the tooth with a dental implant if your dentist needs to extract the tooth.
If you are experiencing pain under your dental crown, see your dentist as soon as possible. The faster you act, the more likely that your dentist can perform a root canal and save your tooth and its crown.
To learn more, reach out to a local root canal service.