Question

Six months ago I had 4 enamel crowns fitted in my lower jaw. Now I have noticed that there is no passage between the two crowns (2 blocks of two). I can't get through either with a toothbrush or dental floss. The oral surgeon said that there is nothing else in a jaw than these two crowns coupled together without a passage. Now I would like a second opinion. B. G. in L. 

Short answer

Even artificial teeth, such as crowns, must always be designed in such a way that they can be cleaned on all surfaces, i.e. that interdental cleaning is also possible. If interdental cleaning is no longer possible, the work has not been carried out correctly.

Every oral cavity is moist and warm (approx. 37°). Food regularly provides nutrients whose components (e.g. carbohydrates) are dissolved in the oral fluid or remain stuck to or between the teeth as food debris. These are ideal living conditions for many types of bacteria! 

Bacteria multiply 

Every oral cavity is teeming with bacteria and they are constantly multiplying. Unfortunately, some species also have the potential to cause great harm. Today, these species are all known, they all have a name and are responsible for well-known diseases such as tooth decay, gingivitis, periodontitis and osteoporosis: Caries, gingivitis, periodontitis or bone loss. However, it is important to know that these bacteria can only cause damage where they occur in large quantities or remain in the same place for a long time and can therefore multiply undisturbed. 

Clean thoroughly every day 

In addition to moderate sugar consumption and the use of fluoride toothpastes, thorough daily tooth cleaning is the best way to prevent damage to the teeth, gums and bone. Each back tooth has 5 surfaces, each front tooth 4 surfaces, which must be cleaned with suitable aids such as a toothbrush, dental floss or small interdental brushes etc. If this is not done or if it is not possible to clean individual areas, there is a much greater risk of localized damage such as caries or gingivitis occurring in these areas. 

Not executed correctly 

Today's scientific findings clearly show that even artificially produced teeth (e.g. crowns or fillings) must always be designed in such a way that they can be cleaned on all surfaces, i.e. interdental cleaning is also possible. Preparatory measures may therefore be necessary on the teeth themselves or on the gums before crowns can be made correctly. One of the most important goals of dental work is that everything that is placed in the mouth can also be cleaned perfectly. In other words: If it is no longer possible to clean the space between two teeth on which dental work has been carried out, then this work has not been carried out correctly. 

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on March 27, 2007