A dental crown detaching from a tooth can be concerning, especially when it reveals a discolored tooth. This is a common dental issue. Understanding the reasons for detachment and discoloration helps in seeking timely professional care.
Immediate Steps When Your Crown Falls Off
If your dental crown falls off, first locate it. If intact, gently rinse it with warm water to remove any debris and store it in a clean, safe container, as your dentist may be able to reattach it. Then, gently clean the exposed tooth and the surrounding area with warm water and a soft-bristled toothbrush.
The exposed tooth may be sensitive to temperature changes or pressure. To manage discomfort, you can take over-the-counter pain relievers or rinse your mouth with warm salt water. As a temporary measure, you can purchase dental cement from a pharmacy, or use a small amount of toothpaste or sugar-free gum inside the crown before gently placing it back on the tooth. This temporary fix helps protect the exposed tooth until you can see a dentist.
Contact your dentist as soon as possible for an appointment. Even if there is no pain, the exposed tooth is vulnerable to further damage, decay, or infection. Until your appointment, avoid chewing on the affected side and stick to soft foods.
Common Reasons Crowns Detach
Dental crowns can detach for several reasons. One common cause is the degradation of the dental cement or adhesive used to bond the crown to the tooth. Over time, this cement can weaken due to normal wear and tear, saliva breakdown, or if it was not applied correctly during the initial placement.
Underlying tooth decay is another frequent culprit. Even with a crown in place, the natural tooth structure beneath it remains susceptible to decay. Bacteria can seep into tiny gaps at the crown’s margin, weakening the tooth structure that supports the crown, causing it to loosen.
Physical trauma or injury to the mouth can also dislodge a crown. Habits such as teeth grinding (bruxism) or clenching exert excessive biting forces, which can lead to detachment. An improper fit, either from inaccurate impressions during fabrication or changes in tooth structure over time, can also result in a loose crown.
Understanding Tooth Discoloration Under a Crown
When a crown detaches, revealing a discolored tooth, several factors can contribute to this appearance. New decay forming on the underlying tooth is a concern.
Another reason for discoloration could be old filling material. If the tooth previously had an amalgam filling, the metallic components can leach into the dentin, causing the tooth to appear dark or grayish. Residue from old dental cement, which may have darkened, can also contribute to discoloration.
The natural color of the underlying tooth might be darker than the crown. Discoloration could also indicate a necrotic pulp, meaning the tooth’s nerve has died, leading to a darkening of the tooth structure. External stains from food, drinks, or tobacco might accumulate around a compromised crown margin.
Professional Dental Care and Treatment Options
Upon visiting the dentist after a crown detaches, a thorough examination is performed. The dentist will visually inspect the tooth and often take X-rays to assess the extent of any damage, decay, or infection beneath the crown.
If the crown is intact and the underlying tooth structure is healthy, re-cementing the old crown is often the simplest solution. The dentist will clean both the crown and the tooth, remove any old cement, and then bond the crown back in place with strong dental adhesive. However, if the crown is damaged or the underlying tooth has significant decay or structural issues, a new crown fabrication may be necessary. This involves preparing the tooth, taking new impressions, and then creating a custom-fit crown, which may require multiple appointments.
In cases where decay has reached the tooth’s pulp, or if an infection is present, root canal therapy may be required before a new crown can be placed. If the tooth is severely damaged and cannot be saved, extraction might be necessary. Following extraction, options like dental implants or bridges can be considered to replace the missing tooth.
Maintaining Your Crown and Oral Health
Maintaining good oral hygiene is fundamental to the longevity of dental crowns and overall oral health. Brushing at least twice daily with fluoride toothpaste and flossing once a day helps prevent plaque buildup and decay around the crown’s margins, where it meets the natural tooth.
Regular dental check-ups and professional cleanings are also essential. These visits allow the dentist to monitor the crown’s condition, detect any early signs of wear or looseness, and address potential issues before they become severe. Avoiding hard, sticky, or overly chewy foods can prevent undue stress on the crown.
If you grind or clench your teeth, especially at night, discussing a custom-fitted nightguard with your dentist can protect your crowns and natural teeth from excessive forces. Promptly addressing any sensitivity or changes in your crown’s fit is advisable.