If your dental crown comes off and the underlying tooth appears dark, it can be concerning. This common dental issue requires understanding immediate steps and potential reasons for discoloration and dislodgement.
What to Do Right Away
If your dental crown comes off, remain calm and locate it. Handle it carefully to avoid further damage. Gently rinse the crown with water.
Once cleaned, store the crown safely in a clean container until you can see your dentist. If the exposed tooth feels sensitive, over-the-counter temporary dental cement or sugar-free gum can sometimes be used to temporarily reattach the crown, but this is a short-term solution. Avoid chewing on the affected side of your mouth and stick to soft foods. Contact your dentist promptly to schedule an appointment.
Understanding a Discolored Tooth
A tooth underneath a crown might appear dark for several reasons. One common cause is dental decay, where bacteria can seep under the crown, especially if the seal is compromised, leading to cavities that manifest as dark spots. This decay can weaken the tooth structure and progress unnoticed.
Another reason for dark discoloration can be the presence of old amalgam (silver) fillings beneath the crown. Amalgam contains metallic components that can stain the tooth structure over time, making it appear dark or grayish. This staining is usually harmless but can be visually concerning.
Discoloration can also indicate a necrotic, or “dead,” tooth, where the pulp has died. This can happen due to trauma or untreated decay, leading to internal bleeding and tissue breakdown that causes the tooth to turn yellow, gray, or black. External staining from certain foods, drinks, or medications can also contribute to tooth discoloration. Only a dental professional can accurately diagnose the specific cause of the discoloration.
Reasons a Crown Comes Off
Dental crowns are designed to be durable, but they can occasionally become dislodged for various reasons. A frequent cause is the weakening or failure of the dental cement that bonds the crown to the tooth. Over time, this cement can degrade due to factors like saliva, chewing forces, or if it was not applied correctly during the initial placement.
Underlying tooth decay is another significant factor. Even with a crown, the natural tooth structure underneath remains susceptible to decay, especially if bacteria infiltrate gaps between the crown and the tooth. As decay progresses, it can compromise the tooth structure that supports the crown, causing it to loosen and eventually fall off.
Physical trauma, such as a blow to the mouth, or habits like grinding and clenching teeth (bruxism), can exert excessive pressure on the crown, leading to its dislodgement. Additionally, chewing on hard or sticky foods can put undue stress on the crown, potentially pulling it off. A crown that does not fit perfectly can also contribute to its dislodgement. If the crown was not precisely crafted or fitted to the tooth, or if there is insufficient healthy tooth structure remaining to support it, the bond may not be strong enough for long-term retention.
What to Expect at the Dentist
Upon visiting the dentist, a thorough examination will assess the situation. This typically includes a visual inspection of the exposed tooth and crown, as well as dental X-rays. X-rays are crucial for identifying hidden issues such as decay underneath the crown, infection, or problems with the tooth’s root or surrounding bone structure.
Based on the diagnosis, the dentist will discuss treatment options. If the crown and underlying tooth are healthy and intact, and the main issue was cement failure, the existing crown might be cleaned and re-cemented. If significant decay is present, or if the crown is damaged or ill-fitting, a new crown will likely be necessary.
In cases of extensive decay or nerve damage, a filling or root canal might be performed before a new crown is placed. A root canal involves removing the infected pulp tissue to save the tooth. If the tooth is severely damaged and cannot be salvaged, extraction may be the last resort. The dentist will explain the most appropriate course of action to restore both the tooth’s health and function.