Understanding Crown Durability
A permanent dental crown is a cap placed over a damaged tooth to restore its shape, size, strength, and appearance. While designed for long-term use, “permanent” in dentistry means a durable solution, not an indestructible one. Even well-placed crowns can become loose or fall out over time. Crowns are made from various materials like porcelain, ceramic, or metal alloys and bonded to the tooth with specialized dental cements. Despite strong bonding agents, the interaction between the crown, bonding material, and tooth structure is complex, and various factors can compromise this crucial bond, leading to dislodgement.
Common Reasons for Dislodgement
New decay underneath the crown’s margins is a frequent cause of dislodgement. Bacteria can accumulate at the junction where the crown meets the natural tooth, leading to cavities that weaken the underlying tooth structure and compromise the crown’s foundation. This decay can erode the tooth, reducing the surface area available for the crown to bond to securely.
The bonding cement can also be a point of failure. Over time, the dental cement used to adhere the crown can degrade due to forces from chewing or exposure to oral fluids. Additionally, if the initial application was compromised, such as by moisture contamination during placement, the bond might not have been strong enough from the start.
Physical trauma or injury to the mouth can directly impact a crowned tooth, leading to dislodgement. A direct blow or impact can exert sufficient force to break the bond or even fracture the crown or the underlying tooth. Similarly, certain chewing habits contribute; regularly biting hard foods like ice or nuts, or sticky foods such as caramels, exerts excessive stress on the crown and its adhesive bond.
Habits like nail-biting, pen-chewing, or the involuntary grinding and clenching of teeth, known as bruxism, also place undue stress on dental restorations. The repetitive, forceful pressures from bruxism can weaken the crown’s bond or cause micro-fractures in the crown or the natural tooth. Furthermore, an improper fit during the initial placement or inadequate preparation of the tooth can create inherent weaknesses in the bond, compromising long-term stability.
Immediate Actions When a Crown Falls Out
If a permanent crown falls out, the first step is to remain calm and carefully retrieve it, if possible. Once located, gently clean the crown by rinsing it with water to remove any debris. Next, visually inspect both the crown and the exposed tooth for any signs of damage, such as cracks or fractures, before attempting any temporary measures.
For a temporary fix, you can use an over-the-counter temporary dental cement available at most pharmacies. Alternatively, a small amount of petroleum jelly or even toothpaste can serve as a very short-term adhesive to hold the crown in place until you can see a dentist. It is crucial to understand that these are only temporary solutions to provide immediate relief and protection, not a substitute for professional dental care. Never use household adhesives like superglue, as these can cause significant damage to the tooth and surrounding tissues, making professional repair much more difficult.
After temporarily re-securing the crown, or even if you cannot, avoid chewing on the affected side of your mouth. This prevents further damage to the exposed tooth, which can be sensitive and vulnerable to fracture or decay, and helps keep the crown in place if you’ve temporarily re-cemented it. Contact your dentist immediately to schedule an appointment. Prompt professional assessment and re-cementation or replacement are essential to prevent complications such as increased tooth sensitivity, further decay of the exposed tooth, or the shifting of adjacent teeth, which can complicate future restoration.
Maintaining Crown Stability
Maintaining excellent oral hygiene is fundamental to extending the life of a permanent crown and minimizing the risk of dislodgement. This involves regular brushing twice daily and flossing around the crown, paying particular attention to the gum line where the crown meets the tooth. Consistent hygiene helps prevent the accumulation of plaque and bacteria, thereby reducing the risk of decay beneath the crown.
Regular dental check-ups and professional cleanings are equally important. These appointments allow your dentist to monitor the integrity of the crown, assess the surrounding gum health, and identify any early signs of issues, such as decay or a compromised bond, before they lead to dislodgement. Addressing these concerns proactively can significantly prolong the crown’s stability.
To reduce stress on your crowns, it is advisable to avoid exceptionally hard and sticky foods that can exert excessive forces. Foods like hard candies, ice, or sticky caramels can pull on the crown or cause it to fracture. If you experience bruxism, or teeth grinding and clenching, discussing the use of a custom-fitted night guard with your dentist can provide substantial protection. A night guard helps distribute the forces evenly, safeguarding your natural teeth and dental restorations.
Avoid using your teeth as tools for tasks such as opening packages, biting nails, or chewing on non-food items. These habits can place unnatural and damaging stresses on your teeth and crowns, increasing the risk of dislodgement or fracture. If you notice any discomfort, sensitivity, or a feeling that your crown is loose, contact your dentist without delay. Prompt attention to these early warning signs can prevent more significant problems and ensure the long-term success of your dental crown.