Do Cavities Hurt? What Patients with Crowns or Implants Need to Know

It’s a common assumption: once you’ve had crowns, bridges, or implants, you don’t have to worry about cavities anymore, but even restored smiles are still at risk. Cavities and other complications can develop near or underneath restorations…and when they do, they can compromise both your comfort and the investment you’ve made in your smile.

We help patients in Wilmington recognize signs of decay around crowns, implants, and bridges early so we can treat issues before they become major problems.

Can You Get Cavities with Crowns, Bridges, or Implants?

Your crowns, bridges, and implants can all get cavities, and here’s how each type of restoration can be affected:

1. Crowns and bridges: While the restoration itself cannot decay, the natural tooth underneath still can. Most cavities form at the margin where the crown meets your enamel.
2. Dental implants: The implant itself does not develop cavities, but the surrounding tissue and bone can become inflamed. This condition—known as peri-mucositis or peri-implantitis—can mimic cavity symptoms like soreness, swelling, or even bleeding.
3. Partial dentures or hybrid prostheses: Cavities can still form around the supporting teeth or due to improper hygiene beneath the appliance.

Learn how we maintain and protect restored teeth.

Signs of a Cavity (or Related Complication) Around Restorations

1. Sensitivity at the gumline: Especially near crowns or bridges, this may indicate decay forming at the edge of the restoration.
2. Pain while chewing: This could suggest a new cavity on a nearby tooth, or a loose or failing crown.
3. Bad breath or a bad taste: Decay or trapped bacteria beneath a crown or bridge can cause an unpleasant taste or odor.
4. Gum swelling or bleeding near implants: This can be a sign of peri-implantitis, especially if it persists after brushing.
5. Dark spots or discoloration: Any visible change in color near a crown or filling could point to new decay.

Regular dental visits are essential for catching these issues early. Many complications are painless until they become serious.

When Cavities Don’t Hurt—But Still Threaten Your Smile

Decay doesn’t always come with pain. In fact, many patients only discover cavities under crowns or bridges during routine imaging. Likewise, inflammation around implants may go unnoticed until it leads to bone loss or implant failure.

That’s why we recommend regular exams and digital X-rays to monitor the health of both your natural teeth and restorations. Early detection allows for simpler, more conservative treatment.

Schedule a maintenance visit for your crown, bridge, or implant.

What Happens If You Ignore a Cavity Under a Crown or Near an Implant?

Delaying treatment can lead to more extensive—and more expensive—problems.

Early intervention protects your smile, saves your restoration, and helps you avoid invasive procedures later.

To learn more, visit the American Academy of Implant Dentistry’s page on peri-implant disease.

How Jennifer Pan Prosthodontics Approaches Cavity Treatment

We specialize in diagnosing and managing complications near crowns, bridges, implants, and other complex restorations. Every treatment plan begins with a detailed assessment, followed by a customized recommendation based on the severity and location of the issue.

Depending on your needs, we may suggest:

1. A targeted filling near the margin of a crown or bridge.
2. Crown replacement, if the tooth beneath has significant decay.
3. Deep cleaning or anti-inflammatory treatment around an implant.
4. Strategic monitoring with routine imaging if the issue is early and stable.

See how our Wilmington prosthodontic care protects your full smile.

Frequently Asked Questions

Can implants get cavities?

Not technically. But the tissue and bone around them can become infected due to bacteria buildup, especially if regular hygiene is skipped.

How can I tell if a cavity is forming under a crown?

You may notice increased sensitivity, a bad taste, or discoloration near the gumline. X-rays and a clinical exam are often the only ways to confirm decay beneath a crown.

Do I have to replace the entire crown if there’s a cavity underneath?

Not always. If the decay is minor, we may be able to treat it with a localized restoration. If the tooth structure is significantly compromised, crown replacement may be necessary.

Don’t Let Hidden Decay Undo Great Dental Work

Crowns, bridges, and implants are built to last, but they still rely on healthy surrounding tissue and ongoing care. Cavities near or under restorations are common, but they’re also highly treatable when caught early.

At Jennifer Pan Prosthodontics, we help patients in Wilmington protect their smiles through regular maintenance, expert diagnostics, and thoughtful treatment plans tailored to complex dental work.

Think something might be off with your crown, bridge, or implant? Contact us today to schedule an expert evaluation.