A dental crown is a tooth-shaped cap placed over a damaged or weakened tooth to restore its shape, size, strength, and appearance. When the crown comes loose or falls off, the underlying tooth structure, often called the “stump,” becomes exposed and vulnerable. Addressing a dislodged crown quickly is important because the exposed tooth tissue is susceptible to pain, temperature sensitivity, and further damage. Ignoring the issue can also cause surrounding teeth to shift, preventing the crown from fitting correctly when you see a dentist.
Immediate Actions When a Crown Comes Off
The first step upon noticing a dislodged crown is to safely retrieve it to prevent swallowing or inhaling it. Gently rinse the crown with warm water to remove debris or old cement residue. Inspect the crown for any cracks, chips, or fractures, and check the exposed tooth stump for sharp edges or visible decay. Store the crown in a clean, small plastic container or bag to protect it until you can bring it to your dentist.
Gently clean the exposed tooth stump using a soft-bristled toothbrush and warm water, avoiding irritation to the surrounding gum tissue. The underlying tooth may feel sensitive to air or temperature changes, so avoid chewing on that side of your mouth. To prevent injury to your cheek or tongue until reattachment, cover any sharp edges of the tooth with a small piece of orthodontic wax.
Step-by-Step Guide for Temporary Reattachment
For a temporary fix, purchase an over-the-counter temporary dental cement kit from a local pharmacy. Before applying the adhesive, the exposed tooth and the inside of the crown must be as dry as possible, using a clean cotton swab or gauze. Apply only a minimal amount of the temporary cement inside the crown, focusing on the area that contacts the top chewing surface of the tooth.
Carefully position the crown over the tooth stump, ensuring it is correctly aligned and fully seated, which may involve a slight rocking motion. Once aligned, bite down gently and slowly to press the crown into place without disturbing the cement layer. After seating the crown, remove any excess cement that squeezed out around the edges using floss or a damp cotton swab. This home repair is strictly a short-term measure and does not replace professional recementation by a dental professional. Never use household glues, such as superglue, as they are not biocompatible, can be toxic, and will make professional reattachment difficult or impossible.
Preparing for the Dental Visit and Professional Solutions
Contacting your dental office immediately to schedule an appointment is a priority, as the temporary fix is not a permanent seal against bacteria and decay. The dentist will perform a thorough assessment of the dislodged crown and the underlying tooth. This examination typically involves visual inspection, tactile probing, and possibly taking X-rays to check for decay or structural damage beneath the crown margin.
If the crown is structurally intact and the underlying tooth is healthy and has sufficient height, the dentist will likely be able to recement the existing crown. The professional process involves meticulously cleaning all residual cement from both the crown and the tooth stump before applying a stronger, long-lasting dental adhesive. If the crown is damaged, or if significant new decay or a fracture is found, the existing crown cannot be reused. In these cases, the damage must first be treated, and then a new impression will be taken to fabricate a replacement crown.
Why Crowns Fail
Crowns are designed to withstand years of normal function, but their failure is most often caused by issues that affect the seal between the restoration and the natural tooth. A frequent reason is the development of secondary tooth decay, which forms at the margin where the crown meets the gum line. This decay erodes the supporting tooth structure, compromising the fit and causing the crown to loosen and detach.
Another common factor is the degradation of the dental cement itself, which can slowly wash out over time due to constant exposure to saliva and temperature fluctuations. Trauma, such as biting down on a hard object or receiving a blow to the mouth, can physically dislodge a well-fitting crown. Excessive or chronic biting forces, often associated with teeth grinding or clenching (bruxism), can also weaken the cement bond and lead to crown failure.