A lost dental crown exposes the prepared tooth structure, known as the abutment, which is normally shielded by the crown. While this situation can be alarming, there are immediate steps you can take to manage the situation and protect the exposed area until you see your dentist.
Cleaning the Exposed Tooth
Yes, you can and should continue to brush the area after a crown falls off, but with significant caution. The underlying abutment tooth is no longer protected by the hard outer shell of the crown and will be highly vulnerable. When cleaning this area, a soft-bristled toothbrush is necessary, using gentle, circular motions to avoid irritating the exposed dentin.
The dentin layer, which is normally covered by enamel and the crown, contains microscopic tubules leading directly to the tooth’s nerve, making it extremely sensitive to pressure and temperature. Consider temporarily switching to a desensitizing toothpaste, which contains compounds that help block the transmission of pain signals to the nerve. When rinsing, use lukewarm water or a gentle warm saltwater solution, as extreme temperatures can trigger sharp pain in the exposed tooth.
If you recovered the crown, clean it carefully before taking it to the dental office. Gently rinse the crown with warm water to remove any debris or old cement, but avoid scrubbing or using harsh cleansers that could cause damage. If residual cement remains inside, you can try to remove it using a toothbrush or a paperclip, ensuring the inner surface is clean for potential re-cementation.
Protecting the Tooth Until Your Appointment
The exposed abutment is prone to sensitivity and potential shifting. The loss of the crown exposes the dentin, causing hypersensitivity to air, pressure, and thermal changes. Temporarily avoid very hot, cold, sweet, or acidic foods and chew on the opposite side of your mouth to mitigate discomfort.
The best temporary solution is to use an over-the-counter dental cement kit, which is specifically designed for this purpose and available at most pharmacies. To apply, clean the crown, dry the abutment tooth as much as possible, apply a small amount of the cement inside the crown, and gently seat it back onto the tooth in the correct orientation. After placement, bite down lightly to ensure proper alignment, and remove any excess cement that squeezes out.
If temporary cement is unavailable, a small amount of sugar-free gum, petroleum jelly, or even denture adhesive can be used in a pinch to help hold the crown in place. These methods are less secure and should only be used as a last resort to stabilize the crown and protect the underlying structure until you can get professional help. If the crown is damaged or lost, you can cover any sharp edges on the remaining tooth with soft dental wax to protect your cheek and tongue.
Scheduling Urgent Dental Care
Contact your dental office as soon as possible, ideally within 24 to 48 hours of the crown falling off. The underlying tooth can shift position surprisingly quickly without the crown to hold the space. If the tooth shifts, the permanent crown may no longer fit, necessitating more complex and costly procedures.
When you call the office, be prepared to provide specific information about the situation to help the staff determine the urgency of your appointment. You should tell them whether you have the crown, if it is intact or broken, and if you are experiencing any pain, swelling, or extreme sensitivity. If the crown is undamaged, the dentist will likely clean the abutment and the crown, then re-cement it using a professional dental adhesive.
If the crown is broken or the underlying tooth has significant new decay, the dentist may need to prepare the tooth again and take impressions for a brand-new crown. In this case, a temporary crown will be placed to protect the tooth and maintain the necessary spacing until the permanent restoration is ready. Waiting too long before seeking professional care increases the risk of further damage, decay, or even the need for a root canal.