A dental crown is a custom-made cap covering the entire visible portion of a damaged tooth above the gum line. Crowns are made from durable materials like porcelain, ceramic, or metal. While crowns are built for resilience, they can break, chip, or come loose due to trauma, decay, or wear. When a crown is compromised, the underlying natural tooth structure loses its protection, creating an urgent need for professional dental care to prevent further damage or infection.
Immediate Steps for a Broken Crown
The first action upon discovering a broken or dislodged crown is to remain calm and immediately contact a dental professional for an appointment. If the crown has come off completely, gently retrieve it and store it safely in a clean container, as the dentist may be able to reuse it. Avoid scrubbing the crown or using harsh cleaners; simply rinse it with water.
If the exposed tooth or surrounding gums feel sensitive or have sharp edges, gently rinse the mouth with warm salt water to cleanse the area and soothe irritation. For temporary protection of jagged edges, a small piece of dental wax or sugarless gum can be placed over the rough area to prevent injury to the cheek or tongue. Avoid chewing on the damaged side to prevent further fracture. Over-the-counter pain relievers can manage discomfort while waiting for the dental appointment.
How Dentists Assess Crown Damage
When you arrive at the dental office, the dentist’s primary focus will be an assessment to determine the extent of the damage to both the crown and the underlying tooth. This process begins with a detailed visual examination, checking for fractures, chips, cracks, and assessing the crown margins. The dentist will also probe the area where the crown meets the gum line to check for plaque buildup or potential recurrent decay, which is a common cause of crown failure.
The assessment includes taking dental radiographs of the affected area. This imaging allows the professional to view the underlying tooth structure, the supporting bone, and the root. X-rays are especially helpful for detecting decay beneath the crown that may have weakened the tooth, or for identifying a fracture in the tooth itself. The information gathered from the visual and radiographic inspection dictates whether a repair or a full replacement is the appropriate course of action.
Professional Treatment Options
The treatment chosen by the dentist depends on the initial assessment of the crown and the underlying tooth’s condition. If the crown is fully intact but has merely dislodged, the dentist can often re-cement it. This process involves thoroughly cleaning both the internal surface of the crown and the prepared tooth structure to remove old cement and debris. A specialized, strong dental cement is then applied, and the crown is seated under pressure, restoring its function.
If the crown has a minor chip or a small fracture, a full replacement may not be immediately necessary. For these localized issues, the dentist may perform a repair using a tooth-colored composite resin. This material is bonded to the damaged area, shaped to match the crown’s contour, and then hardened with a specialized light. While this bonding procedure is quick and preserves the original crown, it may not be as durable as the original material and is typically reserved for small cosmetic or structural flaws.
A full crown replacement is necessary when the original crown is severely fractured, the fit is compromised, or if significant decay or damage is found in the underlying tooth. The dentist removes the damaged crown and prepares the underlying tooth structure again to ensure optimal retention. Impressions are then taken of the prepared tooth and surrounding teeth, which are sent to a dental laboratory to fabricate a new, custom-fit crown.
While the permanent crown is fabricated, a temporary crown is placed to protect the vulnerable tooth. Once the new permanent crown returns from the lab, the dentist removes the temporary one and precisely fits the new restoration. The new crown is checked for fit, bite alignment, and esthetics before being permanently bonded to the tooth, utilizing a strong adhesive for long-term stability.
Maintaining Dental Crowns
Proper care maximizes the longevity of a dental crown. Maintaining excellent oral hygiene is paramount, focusing particularly on the area where the crown meets the gum line, as plaque buildup here can lead to decay beneath the crown. Brush twice daily with a soft-bristled toothbrush and fluoride toothpaste, and floss daily to remove debris from around the crown’s edges.
Avoiding biting down on hard objects like ice, pens, or hard candies reduces stress on the restoration and prevents sudden fracture of the crown material. Sticky or chewy foods should also be limited because they can potentially pull on the crown and weaken the cement bond over time. Individuals who clench or grind their teeth should wear a custom-fitted nightguard to absorb forces that can lead to crown failure. Regular dental check-ups allow the dentist to monitor the crown’s fit and the health of the underlying tooth, addressing minor issues before they become significant problems.