Dental crowns serve as tooth-shaped caps that restore a decayed, broken, weak, or worn-down tooth, covering the entire visible portion above the gum line. They are designed to be durable, often lasting between 5 and 15 years with proper care, and sometimes even longer. While crowns offer a reliable solution for damaged teeth, they can sometimes become dislodged. Although instances of crowns falling out are relatively rare, it is a fixable issue that can occur.
Why Crowns Become Dislodged
Several factors can contribute to a dental crown becoming dislodged. One common reason is the failure of the dental cement used to bond the crown to the tooth. Over time, saliva and chewing forces can degrade this cement, weakening the bond. Improper application of the cement during initial placement can also result in a less secure attachment.
New decay forming beneath the crown is another frequent cause. Even with a crown, the underlying tooth remains susceptible to decay, which can compromise the tooth structure supporting the crown and cause it to loosen. Physical trauma or injury to the mouth, such as biting on hard foods or experiencing an accident, can also apply enough force to dislodge a crown.
A crown that does not fit properly from the outset may also fail to adhere securely. This can occur due to inaccurate impressions taken during preparation or errors in laboratory fabrication. Constant wear and tear from chewing, grinding, or clenching teeth can gradually weaken the crown or underlying tooth structure, leading to dislodgement over many years. Insufficient natural tooth structure to provide a strong foundation can also make a crown more prone to becoming loose.
Immediate Actions When a Crown Falls Out
If a dental crown becomes dislodged, carefully retrieve it. Rinse the crown gently with water to remove debris, then store it in a safe place, such as a small plastic bag or container. The dentist might be able to reattach it, so avoid swallowing the crown.
Inspect both the crown and the exposed tooth for any visible damage. The tooth underneath may be sensitive or painful due to exposed nerves and tissue. For temporary comfort, some pharmacies offer dental cement to temporarily reattach the crown, or dental wax can cover the exposed tooth and reduce sensitivity. Toothpaste can also serve as a temporary adhesive if dental cement is unavailable.
Contact a dentist as soon as possible to schedule an appointment for re-cementation or replacement. Until the dental visit, avoid chewing on the affected side and opt for soft foods to prevent further damage or discomfort. Bringing the dislodged crown to the appointment allows the dentist to assess if it can be reattached or if a new crown is necessary.
Maintaining Crown Longevity
Maintaining good oral hygiene is important for the long-term durability of dental crowns. Regular brushing twice a day with fluoride toothpaste and flossing once daily helps prevent plaque buildup around the crown’s base. Decay can still develop around the edges or underneath a crown if proper hygiene is not maintained. Using a soft-bristled toothbrush and non-abrasive toothpaste can help protect the crown’s surface.
Dietary considerations also play a role in preventing crown dislodgement. Avoiding hard foods like ice cubes, nuts, or hard candies can prevent chipping or cracking. Sticky foods such as caramels or chewing gum should also be avoided, as they can pull on the crown and loosen its bond. Chewing on tough meats or using teeth as tools can also exert undue stress on the crown.
Routine dental check-ups are important for professional cleaning and to allow the dentist to inspect the crown for any issues. These regular visits help identify and address potential problems early, such as marginal gaps or decay, before they become more significant. Addressing parafunctional habits like teeth grinding (bruxism) and clenching also contributes to crown longevity. Wearing a custom-made nightguard can protect crowns from excessive pressure during grinding, which can lead to wear, microfractures, or loosening of the cement bond. Prompt attention to any discomfort or changes with the crown can help prevent further complications.