A dental crown is a custom-made cap placed over a damaged or weakened tooth, designed to restore its original shape, size, and strength. This protective restoration covers the entire visible portion of the tooth down to the gum line. While crowns are intended to be long-lasting, they are not permanent, and it is common for one to come loose or fall off. Failure often occurs when the permanent dental cement weakens or washes out over time. Other factors that compromise the bond include underlying tooth decay or excessive forces from teeth grinding and chewing hard foods.
Immediate Steps When the Crown Comes Loose
When a crown detaches, carefully retrieve it immediately to prevent swallowing or inhaling it. Gently rinse the crown with warm water to remove debris, handling it by the outer surface and avoiding the hollow interior. The exposed underlying tooth, which has been filed down, is often sensitive to air and temperature. Gently rinse this abutment tooth with warm salt water. Look closely at both the crown and the tooth for any visible fractures or signs of damage.
Contact your dental office right away to explain the situation and schedule an appointment. Store the crown in a small, clean container or zip-top bag to bring with you. Until you are seen by a professional, avoid chewing food on that side of your mouth to protect the exposed tooth from fracture or irritation. Do not attempt to use household adhesives or glues to reattach the crown, as these products are toxic and can cause damage.
Temporary Solutions Before Your Dental Appointment
If you cannot see your dentist immediately, temporary measures can protect the tooth and reduce sensitivity. Over-the-counter temporary dental cement kits are available at most pharmacies for short-term use. To apply this temporary fix, ensure the inside of the crown and the exposed tooth surface are clean and dry. Apply only a small amount of the temporary cement evenly inside the crown, avoiding overfilling it.
Gently place the crown back onto the tooth and bite down lightly to seat it fully, then remove any excess cement that squeezes out. This temporary material is designed only to hold the crown in place for a few days until professional care is provided. If the crown is lost or you are dealing with a sensitive tooth, cover the exposed structure with a piece of dental wax or petroleum jelly. These options create a barrier against temperature changes and food particles, minimizing discomfort until your dental visit.
How a Dentist Recements or Replaces the Crown
When you visit the dentist, the initial focus is a thorough assessment of the crown and the underlying tooth structure to determine the definitive treatment. The dentist checks the abutment tooth for new decay, structural cracks, or changes in shape using specialized instruments. If the crown is intact, the underlying tooth is healthy, and the fit is appropriate, the dentist cleans both surfaces meticulously. Recementing involves using a strong, permanent dental adhesive, such as a resin-modified glass ionomer or a resin cement, to create a durable bond.
If the crown fell out due to recurrent decay beneath the margin, the decay must be completely removed, which alters the tooth’s shape. In this scenario, the original crown will no longer fit properly, requiring replacement rather than recementation. The crown must also be replaced if it is fractured, visibly damaged, or if the original fit was poor. A new crown requires taking a new impression of the prepared tooth. The new custom restoration is then fabricated and permanently bonded in a subsequent appointment.