A dental crown, often referred to as a cap, is a prosthetic device shaped like a tooth that covers and protects a damaged or weakened natural tooth structure. While a loose crown can be stressful, it is a common occurrence in dentistry and is typically fixable if addressed promptly. The primary goal is to protect the exposed natural tooth underneath and the crown itself until a professional dental appointment can be secured.
Immediate Handling: Remove or Leave the Crown?
If the crown is partially attached but unstable, avoid wiggling it with your tongue or fingers, as this can cause damage to the underlying tooth or the crown itself. If the crown is so loose that it presents a risk of being accidentally swallowed or inhaled, it should be removed gently. Try rocking it lightly with gentle pressure to see if it detaches easily, but stop immediately if you feel resistance or pain.
Once removed, clean the crown carefully by rinsing it under lukewarm water to remove any debris or food particles. Do not use harsh chemicals, soaps, or vigorously scrub the crown, as this could compromise its integrity. Place the cleaned crown in a small, clean container or sealed plastic bag to ensure it is not lost or damaged before your dental visit. An intact crown is much more likely to be re-cemented by the dentist, simplifying the repair process.
Temporary Stabilization and Pain Relief
After managing a loose crown, the exposed tooth is often highly sensitive to temperature changes and air. Over-the-counter temporary dental cement kits are available at most pharmacies and can be used to stabilize the crown in the short term. Use these only if the crown is undamaged and fits back onto the tooth easily. Before application, thoroughly dry the inside of the crown and the tooth preparation, perhaps using a piece of sterile gauze.
Apply a small amount of adhesive inside the crown, position it precisely onto the tooth, and gently bite down to secure the fit. This temporary measure is not a permanent solution and is only meant to protect the tooth for a day or two until a professional can reattach it with medical-grade cement. If the crown is damaged or does not seat properly, do not attempt to force it back on, as this could cause further harm.
For discomfort or pain, over-the-counter pain relievers like ibuprofen or acetaminophen can be taken according to the package instructions. Rinsing the mouth several times a day with warm salt water helps soothe irritated gum tissue and maintain cleanliness around the exposed tooth. Applying a small amount of clove oil, which contains the natural anesthetic eugenol, can also temporarily numb the sensitive area.
Protecting the Exposed Tooth Until the Appointment
Protecting the prepared tooth underneath is essential to prevent further damage or decay, whether the crown is stabilized or completely off. The prepared tooth structure is more vulnerable than natural enamel and requires caution until the crown is permanently reattached. Avoiding unnecessary pressure on the affected area is the primary step for interim care.
Patients should immediately switch to eating soft foods and chew only on the opposite side of the mouth. Sticky or hard foods must be avoided entirely, as they can pull the crown off or damage the exposed tooth. These include:
- Caramel
- Nuts
- Toffee
- Ice
Even if the crown is temporarily cemented, these dietary restrictions reduce the risk of dislodging it again.
Oral hygiene must continue, but with extra gentleness. Use a soft-bristled toothbrush and brush lightly around the area, being careful not to dislodge any temporary material. If flossing near the tooth, pull the floss out horizontally from the side rather than vertically, which could yank the crown loose.
Causes and Professional Repair Options
A crown typically becomes loose because the dental cement securing it has failed due to normal wear, temperature fluctuations, and constant chewing forces. Cement washout is the most frequent cause. Looseness can also signal a more significant issue, such as underlying tooth decay forming beneath the crown margins. This decay erodes the supporting natural tooth structure, causing the crown to lose its tight fit.
Trauma, such as a fall, or habits like heavy night grinding (bruxism), can put excessive force on the crown, weakening the bond. Other factors include an imprecise original crown fit or insufficient natural tooth remaining to hold the restoration. In some cases, a crack in the crown itself compromises its ability to remain securely bonded.
Professional Repair Options
The repair process begins with an examination, often including X-rays, to diagnose the cause of the looseness and assess the underlying tooth’s health. If the crown is intact and the natural tooth is healthy, the dentist can clean both surfaces and re-cement the existing crown using a durable, permanent adhesive. This is the simplest and quickest repair option.
If the dentist finds significant decay or if the crown is damaged, a more complex treatment is required. The decay must be removed and the tooth repaired before a crown can be placed again. If the existing crown is cracked or broken, a new impression will be taken to fabricate a custom replacement, and a temporary crown will be placed until the final restoration is ready.