A provisional, or temporary, crown is a short-term restoration placed over a tooth reduced in size to receive a final crown. Its primary purpose is to protect the exposed, sensitive inner tooth structure (dentin) from bacteria, temperature changes, and trauma while the permanent restoration is fabricated. The provisional crown also maintains the correct spacing and alignment of surrounding teeth, preventing shifting that could complicate the seating of the final crown. Furthermore, it restores the tooth’s appearance and allows the patient to maintain normal chewing function and aesthetics during the waiting period.
Removal of Excess Cement
The first immediate action following the successful seating and cementation of the provisional crown is the thorough removal of any excess dental cement. Temporary cements are designed to adhere just enough to retain the crown but still allow for easy removal at the next appointment. However, any cement that cures outside the margin, or edge, of the provisional crown poses a significant risk to the surrounding gum tissue.
This excess material acts as a physical irritant and creates a rough surface where plaque and bacteria accumulate rapidly. If left in place, this buildup can quickly lead to gingival inflammation (gingivitis), which may progress to localized bone loss. Dentists employ specialized tools, such as explorers, scalers, and curettes, to meticulously scrape away cement fragments from the crown margins and the gum line. Floss is also used interproximally to ensure no cement remains lodged between the teeth.
Verifying Fit and Function
Once the area is clean, the next step involves checking the provisional crown’s fit and its interaction with the bite. This verification process focuses on two major aspects: the marginal seal and the occlusion. The marginal seal is the precise fit between the crown’s edge and the prepared tooth structure near the gum line, which is crucial for preventing microleakage. A poor seal allows oral fluids and bacteria to seep under the provisional, potentially causing decay, sensitivity, or premature cement failure.
The dentist then evaluates the occlusion, which is how the provisional crown meets the opposing teeth when the patient bites down. This is done using articulating paper, a thin, inked paper that leaves colored marks on contact points. If the marks indicate “high spots,” the crown is adjusted and polished until the contacts are even. This ensures a comfortable bite and prevents excessive force that could dislodge the restoration or cause jaw muscle strain. Proper occlusal balance is important because an unstable bite can cause the provisional to fracture or loosen.
Essential Post-Procedure Care
The final step is providing detailed post-procedure care instructions, transferring responsibility for the temporary restoration’s success to the patient. Patients must avoid chewing hard, crunchy, or sticky foods, such as caramel or taffy, which can exert a pulling force and potentially dislodge the provisional. It is recommended to chew on the opposite side of the mouth whenever possible to minimize stress on the cemented restoration.
Maintaining meticulous oral hygiene is important, but the technique must be modified to protect the provisional crown. When flossing, patients should gently thread the floss down between the teeth and then pull it out from the side. Snapping the floss back up can catch the margin and dislodge the crown. If the provisional crown loosens or comes off, patients should keep the crown and contact the dental office immediately for recementation.
Emergency Recementation
In an emergency, or if the office is closed, the patient can temporarily reseat the crown. This can be done using a small amount of toothpaste or over-the-counter temporary dental cement to protect the prepared tooth until professional care can be arranged.