A dental crown is a tooth-shaped cap placed over a damaged tooth to restore its shape, size, strength, and appearance. This restoration fully covers the visible portion of a tooth. Crowns are used when a tooth is extensively decayed, fractured, or weakened, or after a root canal to provide structural support. While designed to be durable, often lasting between 5 and 15 years or even longer with proper care, dental crowns are not indestructible and can occasionally come loose or fall off.
Reasons Crowns Dislodge
One common reason a dental crown might dislodge is the weakening of the dental cement. Over time, the adhesive bond can degrade due to daily chewing forces, temperature changes, and saliva, which can slowly dissolve the cement. New tooth decay forming underneath the crown can also compromise its fit. This decay alters the tooth structure, creating a gap that loosens the crown.
Physical trauma or injury can directly dislodge a crown. Biting down on hard foods, or a blow to the face, can exert sufficient force to break the cement bond. Habits like teeth grinding (bruxism) or clenching also place excessive pressure on crowns. This constant force can gradually wear down the cement or the tooth structure, causing the crown to loosen.
An improper initial fit can also contribute to its dislodgement. If the crown was not perfectly seated or precisely contoured during placement, it may not have achieved a strong, stable bond. Insufficient remaining tooth structure beneath the crown can also be a factor. If the natural tooth is compromised, there may not be enough surface area for the cement to bond, increasing the risk of the crown detaching.
Immediate Actions When a Crown Falls Off
If a dental crown falls off, carefully retrieve it and clean it gently. Avoid scrubbing or using harsh chemicals, as this could damage its surface. Next, inspect both the crown and your exposed tooth for damage like cracks, chips, or sharp edges. This assessment helps you inform your dental professional.
Contact your dentist to schedule an emergency appointment. Explain that your crown has dislodged. While waiting for your appointment, you can take temporary measures to protect the exposed tooth and alleviate discomfort. Dental cement kits, available at most pharmacies, can be used for a temporary reattachment, but this is not a permanent solution.
Before attempting any temporary reattachment, ensure the inside of the crown and the tooth are clean and dry. Apply a small amount of temporary adhesive to the inner crown surface and carefully seat it, biting down gently for proper alignment. Be cautious with the exposed tooth, as it may be sensitive to temperature changes or pressure. Avoid chewing on the affected side and avoid consuming hard, sticky, or hot or cold foods.
Preventing Crown Dislodgement
Maintaining diligent oral hygiene is a primary way to prevent crown dislodgement. Regular brushing and flossing around the crowned tooth help prevent new decay at the crown’s margins, which can undermine its fit. Dietary habits also protect your crown. Avoiding sticky foods can prevent the crown from being pulled off, and avoiding chewing on hard items reduces the risk of fracturing the crown or breaking the cement bond.
Avoiding destructive oral habits is also important. Avoid chewing on pens, biting fingernails, or using teeth to open packages, as these stress dental restorations. For individuals who clench or grind their teeth (bruxism), addressing this issue is essential. Your dentist may recommend a custom-fitted nightguard to absorb the forces of grinding during sleep, safeguarding your crowns and natural teeth from wear and dislodgement.
Regular dental check-ups and professional cleanings are important for crown integrity. During these visits, your dentist can examine the crown for wear, cracks, or marginal leakage, and assess the health of the underlying tooth. Early detection of issues, like decay or a weakening bond, allows for timely intervention before the crown dislodges, contributing to its longevity and oral health.
Why Prompt Dental Care is Essential
Seeking prompt dental attention when a crown dislodges is important. The exposed tooth is vulnerable to further damage and decay. Without its protective covering, the tooth is susceptible to bacterial invasion, leading to new cavities or infection. The exposed tooth may also experience sensitivity to temperature and pressure, causing discomfort.
Delaying professional care can shift adjacent and opposing teeth. When a crown is missing, the teeth next to the gap may drift, and the opposing tooth may super-erupt. This shifting can alter your bite alignment and make it challenging or impossible to fit a new crown. Timely intervention prevents these complications, safeguarding your oral health and avoiding more complex, costly procedures.