Dental crowns are custom-made, tooth-shaped caps that fit over a damaged or weakened tooth, essentially restoring its shape, size, strength, and appearance. They serve multiple purposes, including protecting a weak tooth from breaking, holding together a cracked or worn-down tooth, covering a tooth with a large filling, or supporting a dental bridge or implant. These restorations are crafted from various materials like porcelain, ceramic, metal alloys, or a combination, designed to blend seamlessly with your natural teeth. While dental crowns are designed for durability and can last many years with proper care, they can sometimes dislodge unexpectedly.
The Immediate Sensation When a Crown Falls Off
When a dental crown dislodges, the immediate sensation can range from no pain to significant discomfort or sensitivity. The intensity of pain often depends on the condition of the underlying tooth. If the tooth beneath the crown is healthy, you might experience only mild sensitivity to temperature, air, or pressure. However, if the tooth is decayed, damaged, or has exposed nerves, the sensation can be quite painful.
This pain occurs because the underlying dentin, a layer beneath the enamel, becomes exposed. Dentin contains millions of microscopic tubules that connect to the tooth’s pulp, where nerves reside. When these tubules are exposed, external stimuli like hot or cold temperatures, air, or even touch can cause fluid movement within them, triggering nerve responses and leading to a sharp, short pain. The surface of the tooth may also feel sharp or rough, which can irritate the tongue or cheek.
Steps to Take When a Crown Dislodges
If a dental crown falls off, the first step is to carefully retrieve the crown and handle it gently. Inspect it for any damage or debris, and if it is intact, clean it thoroughly with warm water. You should then store it safely in a small container or plastic bag to bring to your dental appointment.
To manage any temporary discomfort and protect the exposed tooth, you can rinse your mouth gently with warm salt water to help keep the area clean and reduce bacteria. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help alleviate pain or sensitivity. Avoid attempting to re-cement the crown with household glues or non-dental adhesives, as these can contain harmful chemicals and cause further damage.
For temporary reattachment, if the crown is undamaged and fits properly, you can use an over-the-counter dental adhesive or temporary dental cement, available at most pharmacies. Apply a small amount to the inside of the crown and carefully position it back onto the tooth, biting down gently to ensure a secure fit. If temporary reattachment is not possible or the crown is damaged, covering the exposed tooth with dental wax or sugar-free gum can provide protection until you can see a dentist. It is important to contact your dentist promptly, even if there is no pain, to prevent further issues like decay or infection.
Why Crowns Fall Off and Dental Solutions
Dental crowns can dislodge for several common reasons:
- Deterioration of dental cement: Saliva and chewing forces weaken the bond over time.
- Underlying tooth decay: Decay beneath the crown weakens the tooth structure and compromises stability.
- Trauma: Biting hard objects or a blow to the face can dislodge a crown.
- Teeth grinding (bruxism): Excessive pressure from grinding gradually loosens the crown.
- Improper fit: Inaccuracies in the impression or changes in tooth structure can loosen the crown.
During a dental visit, the dentist will assess the tooth and dislodged crown to determine the best course of action. Options include re-cementing the existing crown if it is in good condition and the tooth is healthy. If the crown is damaged or there is significant decay, a new crown may be necessary. Severe decay or nerve damage might require a root canal before a new crown. Maintaining good oral hygiene and avoiding hard or sticky foods can help prolong your crown’s life.