A temporary dental crown is a protective cap placed over a tooth that has been prepared for a permanent restoration. This interim covering, often made of acrylic or composite resin, serves multiple purposes while the custom-made permanent crown is being fabricated. It shields the sensitive tooth structure from bacteria and temperature changes, maintains correct spacing, and prevents the prepared tooth from shifting. Although secured with temporary cement, this crown can occasionally become dislodged prematurely, requiring immediate attention.
Identifying the Loss of a Temporary Crown
Recognizing that the temporary crown has fallen out often involves sensory and visual cues. The tongue is typically the first alert system, immediately detecting a sudden gap or a change in the contour of the tooth. The prepared tooth underneath is significantly smaller than a natural tooth and may feel rough or sharp to the tongue or cheek.
A dramatic increase in tooth sensitivity is another reliable indicator that the protective covering is missing. The exposed dentin is highly vulnerable to air, pressure, and temperature extremes from hot or cold foods and drinks. Visually, the temporary crown itself will be absent from its position.
Sometimes, the crown may be severely loose rather than completely gone, but the sensation of it shifting when biting should be treated similarly to a complete loss. The absence of the correct height and shape can cause the adjacent teeth to feel misaligned, affecting the bite. Even if the crown has not fully fallen out, a noticeable difference in the way the teeth meet signals a compromised seal that needs professional attention.
Immediate Steps When the Crown Comes Off
The first action upon realizing the temporary crown is dislodged is to carefully retrieve it to prevent accidental swallowing or inhaling. Once recovered, the crown should be gently rinsed with warm water to clean away debris or saliva. It is important to inspect the crown to see if it is intact or fractured, but even a damaged crown should be kept.
The loose crown should be stored safely in a small, secure container or zip-top bag until the dental appointment. The most important subsequent step is contacting the dental office immediately to inform them of the situation. Dental practices typically prioritize appointments for recementation, and they can provide specific instructions for managing the exposed tooth in the interim.
In rare cases where the crown is swallowed, the patient is usually advised to monitor for symptoms, as the object will likely pass naturally. If the patient experiences severe pain, swelling, or persistent bleeding around the tooth, seek emergency dental care. Attempting to reattach the crown with household adhesives like super glue should be avoided, as these are toxic and can cause significant damage.
Caring for the Exposed Tooth
Once the dentist has been contacted, the focus shifts to protecting the prepared tooth until the scheduled recementation appointment. The exposed tooth structure is sensitive and susceptible to irritation, so managing discomfort is a priority. Over-the-counter temporary dental cement, available at most pharmacies, can be used to attempt a temporary reattachment if the crown is intact, following the product’s directions.
If reattachment is not possible, covering the exposed tooth with a small amount of orthodontic wax can offer significant relief. The wax acts as a physical barrier against air and helps smooth out any sharp edges, protecting the soft tissues of the mouth. For pain management, over-the-counter anti-inflammatory medications, such as ibuprofen, may be taken according to package directions.
Maintaining careful oral hygiene is necessary to prevent infection without causing further irritation. Brushing should be done very gently with a soft-bristled brush, and flossing near the exposed tooth should be approached with caution or avoided entirely. Rinsing the mouth several times a day with warm salt water can help soothe the gum tissue and keep the area clean until the professional repair is made.
Dietary modifications are necessary to minimize stress on the tooth and prevent dislodging any temporary fix. Patients should avoid hard, crunchy, or sticky foods, such as caramel, nuts, or chewing gum. It is recommended to chew exclusively on the opposite side of the mouth until the temporary crown is securely reattached.