Veneers have recently risen in popularity thanks to several celebrities and their high-profile smiles. However, as a dental professional, I worry that the increasingly large numbers of veneer-wearers aren’t familiar with the maintenance that their refurbished teeth still require. Though veneers are often purchased for cosmetic reasons and crowns are placed out of necessity, the care required to support both is strikingly similar. Flossing plays a crucial role in the longevity of both crowns and veneers. Ironically, most crowns could have been prevented by flossing and once in place, the health and upkeep of those crowns is dependent on consistent flossing. In this article, I speak mostly about crowns, but all of this information is equally true of veneers.
The majority of cavities I see in my practice are cavities that have occurred between the teeth. This is particularly disappointing for two reasons. One, the enamel between our teeth is the smoothest, the thickest, and the least susceptible to decay. So that means that plaque and bacteria have to live undisturbed for extended periods of time in order for a cavity to occur. Simply put, if all you do is brush your teeth, but you don’t floss your teeth, you will eventually get cavities between your teeth. The second reason that cavities between the teeth are so sad is this; when a dentist drills out a cavity on the biting surface of the tooth, roughly 75% of the tooth structure that is drilled out is decay and the remaining 25% is healthy or non-decayed tooth structure. However, with cavities that occur between the teeth, in order to access the decay, roughly 80% of the tooth structure that gets drilled out is healthy tooth structure compared to 20% decayed tooth structure.
You might be asking, why am I spending so much time explaining cavities and fillings when this blog is about crowns and veneers? Easy. Almost all teeth that have crowns first had a large filling, a filling that became necessary due to a cavity between the teeth. Therefore, it’s not too far of a stretch to say that a person who flosses is less likely to need a crown.
So, let’s say that your dentist recommends that you get a crown. Maybe you have a large filling that is failing, or maybe a critical portion of your tooth has fractured due to trauma. A crown is essentially a porcelain or metal cap that goes all the way around the tooth. This envelopes the tooth in a strong material which means that wherever you bite on the crown, biting force is distributed evenly across the entire surface. This means that teeth with crowns very rarely fracture. With the tooth protected under the crown, your home care efforts should be focused on the margin (the area at the gumline where the crown meets the tooth). No matter how skilled a dentist or lab technician is, that transition from crown to tooth will never be seamless. That doesn’t mean that every crown margin is destined for decay, but it does mean that the most likely spot for a cavity to occur on a crowned tooth is at the margin.
If you know a crown is in your future, flossing regularly is the best way to ensure the process goes well. Having healthy gums can play a huge role in getting the best fit and tightest seal while placing a crown. When I am finishing crown prep, I take special care to create a smooth margin right at the gumline. I am essentially giving my lab technician clear instructions on exactly where I want the crown to seal against the tooth. As I am prepping this part of the tooth, contact with the edge of the gum tissue is inevitable. Once the tooth is ready, in order to get a good impression, I pack an expanding cord into the pocket between the tooth and surrounding gum tissue. As I am prepping the margin along the gum tissue and packing the cord into the pocket, it’s immediately evident whether or not the patient flosses based on how much their gums bleed.
While it is certainly possible for inflamed gums to be a result of improper brushing, most inflamed, bleeding gums are a result of little to no flossing. While we have some effective tactics to control the bleeding, I am sure every dentist in America will agree with me when I say that getting a great impression to create the permanent crown is much easier if the gums aren’t bleeding. In other words, the patient is a flosser. The same principle applies two weeks later when I remove the temporary crown to cement the permanent crown. Creating a great seal with the cement between the underlying tooth and the new crown is incredibly difficult if the gums are bleeding right where the seal is most critical.
While crowns fit all the way around the tooth, veneers are mainly bonded to the front face of the tooth. Every dentist does their veneers a little bit differently, but the concept of the margin as we discussed it with crowns also pertains to veneers. This means that the area where your tooth transitions to the veneer needs to be the focus of your cleaning efforts. In many cases with veneers, this margin is right between the teeth, which means that the most critical spot to clean is in a place that your toothbrush can't reach. It also means that your dentist can't see or feel this area with his eyes or instruments. Needless to say, flossing and flossing well with veneers is extremely important.
Fortunately, the sonically vibrating Gum Sweeps on the Slate Electric Flosser are designed to effectively clean veneer and crown margins with their ribs and bristles. The flosser’s vibrations disrupt bacteria and stimulate the gums between the teeth better than any other product on the market! If adopted early in life, it’s legitimately possible to prevent the cavities/fillings that are precursors to crowns. If you’ve decided to commit to veneers or are in need of crowns, you should also be investing in tools like the Slate Flosser to help yourself properly care for them.
I’ll end with a story about my wife’s youngest sister. Two of her upper front teeth were naturally skinny so she decided to get veneers to make her teeth a more ideal width. She had been using a Slate Electric Flosser for roughly a year when the time came for her dentist to prep her teeth and take an impression for the veneers. At the end of the appointment, when the dentist was packing the cord between her teeth and gums, she commented that my sister-in-law’s gums were the healthiest she had ever seen! Buy yourself a Slate Flosser today and become your dentist’s new favorite patient.