When a dental crown falls off, it can feel alarming, but this is a common and manageable occurrence. A dental crown is a custom-made cap designed to cover a damaged or weakened tooth, restoring its shape, size, and strength. While these restorations are durable, the adhesive bond securing them to the natural tooth structure can fail over time. The immediate goal is to protect the exposed tooth and the crown until you can see your dental professional.
Immediate Care and Sensitivity Management
The moment you realize your crown is dislodged, safely retrieve it and contact your dental office immediately to schedule an appointment. Gently clean the crown by rinsing it with warm water, avoiding scrubbing or using harsh chemicals that could damage the porcelain or metal. Once cleaned, place the crown in a small, secure container for transport to your dental appointment.
Next, assess the exposed tooth, which is now missing its protective covering. The remaining tooth structure, known as the prepared tooth or abutment, may feel sharp or jagged, potentially irritating the soft tissues of your mouth. If the edge is sharp, purchase temporary dental wax from a pharmacy and gently press a small piece over the tooth to create a smooth surface.
An exposed prepared tooth often results in heightened sensitivity because the underlying dentin is no longer insulated. To manage this discomfort, avoid extremely hot or cold foods and beverages, as temperature changes can trigger sharp pain. Rinsing your mouth several times a day with a warm salt water solution can help soothe the surrounding gum tissue and keep the area clean.
For pain management, over-the-counter medications such as ibuprofen or acetaminophen can reduce discomfort and inflammation until you receive professional care. Chew food only on the opposite side of your mouth and consume softer foods to prevent further pressure or damage to the vulnerable tooth. This careful management minimizes the risk of injury or bacterial infection before your visit.
Safe Temporary Reattachment Methods
If your dental professional cannot see you immediately, you can attempt a temporary reattachment of the crown to protect the tooth structure. This requires purchasing a dental-specific adhesive or temporary filling material, which is widely available at most pharmacies. Never use household super glues or other non-dental adhesives, as these products are toxic to oral tissues and can permanently ruin the crown, preventing professional re-cementation.
Begin the process by ensuring both the inside of the crown and the prepared tooth are clean and completely dry. Use a cotton swab or tissue to gently dry the tooth and the inner surface of the crown, as moisture compromises the temporary adhesive bond. Next, apply a very small, pea-sized amount of the temporary dental cement evenly inside the crown.
Carefully seat the crown back onto the tooth in the correct orientation, which may require trial and error to ensure a proper fit. Once positioned, bite down gently for about one minute to press the crown fully into place and allow the temporary cement to begin setting. Floss carefully around the perimeter of the crown to remove any excess adhesive, pulling the floss out sideways rather than upward to avoid dislodging the crown.
This home fix is purely a short-term protective measure, as the temporary cement is not designed to withstand normal chewing forces. Avoid sticky, hard, or chewy foods, and continue to minimize contact with the temporarily secured crown until your dentist can permanently re-cement or replace it.
Dental Assessment and Permanent Solutions
Crowns most often fall off due to the failure of the dental cement, which naturally degrades over time from exposure to saliva and chewing forces. Recurrent tooth decay is another frequent cause, as bacteria infiltrate the margin between the crown and the tooth, weakening the underlying structure. Poor fit from the initial placement or excessive force from teeth grinding (bruxism) can also compromise the bond.
During your dental appointment, the professional assessment will focus on the health of the prepared tooth and the integrity of the crown. The dentist will use dental instruments and potentially X-rays to check for new decay or fractures beneath the restoration. If the underlying tooth is healthy and the crown is undamaged, the most common outcome is re-cementing the existing crown using a strong, permanent dental adhesive.
If new decay is discovered, the dentist will first remove the decayed tissue and rebuild the tooth structure to create a stable foundation. The original crown may then be re-cemented, or a new crown may be required if the prepared tooth’s shape has changed significantly. A complete crown replacement is necessary if the crown itself is cracked, fractured, or if the underlying tooth damage is too extensive for the original restoration to provide sufficient coverage.
To prevent future incidents, maintaining rigorous oral hygiene is necessary to prevent decay from undermining the bond. If bruxism is a factor, wearing a custom-fitted nightguard can protect the crown from damaging forces. Avoiding habits like chewing on ice or hard candies, and being mindful of sticky foods that can pull on the restoration, will extend the lifespan of the cement bond.