A dental crown is a tooth-shaped cap placed over a damaged tooth to restore its shape, size, strength, and appearance. Although crowns are durable, they can unexpectedly come loose or fall off. This common occurrence warrants prompt attention from a dental professional. Losing a crown is not typically a medical emergency, but delaying treatment can expose the underlying tooth to damage or infection.
Immediate Steps to Take
The first step is to locate the crown carefully and avoid swallowing it. Once retrieved, gently rinse the crown with warm water to clean off any debris, avoiding harsh cleaners that could damage its interior surface. Place the crown in a clean container or sealed plastic bag to keep it safe until your dental appointment.
The exposed tooth will likely feel sensitive to temperature changes or air, and its surface may feel rough or sharp. To protect the area, avoid chewing on that side of your mouth and stick to soft foods. You can manage temporary discomfort with over-the-counter pain relievers, and a warm salt water rinse can help keep the area clean and soothe the gums.
If you cannot see a dentist immediately, you can attempt temporary reattachment using an over-the-counter dental cement or adhesive found at most pharmacies. Apply a small amount of cement inside the crown and gently seat it back onto the tooth, biting down lightly to secure it. This solution is strictly short-term; a proper seal requires professional attention, and household adhesives must never be used. Call your dental office immediately to schedule an appointment, as most offices prioritize urgent issues like this.
Common Reasons Crowns Fall Off
The most frequent cause for a crown becoming dislodged is the failure of the dental cement bonding it to the tooth preparation. Over time, the constant forces of chewing, temperature changes, and saliva can degrade this bonding agent, weakening the adhesive seal. Once the cement bond is compromised, the crown can be pulled off by sticky foods or dislodged by biting on something hard.
A common culprit is the development of tooth decay beneath the crown’s margin. Even a crowned tooth is susceptible to new cavities, and decay forming around the preparation line erodes the underlying tooth structure. This loss of supporting material changes the shape of the tooth stump, causing the crown to lose its tight fit and fall off.
Excessive mechanical force can also lead to crown failure, even if the cement is sound. Habits like teeth grinding or clenching (bruxism) exert persistent pressure that stresses the crown and the underlying tooth. A sudden, traumatic impact or biting down forcefully on hard objects can fracture the crown or overwhelm the adhesive bond, causing the restoration to detach.
Dental Examination and Treatment Options
The dental examination focuses on two main components: the integrity of the crown and the condition of the underlying tooth. The dentist will inspect the crown for cracks, chips, or warping that could compromise its fit or function. They will also evaluate the exposed tooth for signs of new decay, fracture lines, or a loss of preparation height that might explain the failure.
If the crown is undamaged and the supporting tooth structure is healthy, the most straightforward treatment is re-cementing the existing crown. The tooth and the inside of the crown will be meticulously cleaned to remove old cement and debris. A new, durable dental cement will then be used to permanently re-bond the crown, which is often the quickest and most cost-effective solution.
Replacement is necessary if the crown is fractured, or if significant decay or a tooth fracture is discovered beneath it. The decay must be removed, and the tooth may require a new core buildup to provide a stable foundation. If a new crown must be fabricated, the dentist will take an impression, and a temporary crown will be placed to protect the tooth while the permanent restoration is being made.