A dental crown is a fixed prosthetic that completely covers a damaged tooth, restoring its shape, strength, and appearance. Crowns are bonded to the prepared tooth structure using specialized dental cement. If a crown comes loose or falls out, it requires prompt professional attention. The underlying tooth is now vulnerable to sensitivity, damage, and potential infection. This guide provides immediate first aid measures and explains professional solutions for addressing a dislodged crown.
Immediate Steps After the Crown Falls Out
Carefully retrieve the crown from your mouth to prevent swallowing or choking. Gently clean the crown with warm water, removing any visible debris or old cement from the interior. Inspect the crown for cracks or damage, then place it in a clean container or plastic bag to transport it safely to the dentist.
If you cannot see a dentist immediately, you may attempt a temporary reattachment to protect the exposed tooth structure. Over-the-counter dental cement, available at most pharmacies, is the best option for this temporary fix. Apply a minimal amount of cement inside the crown, orient it correctly over the tooth, and bite down gently to seat it firmly.
Never use household glues or other non-dental adhesives, as these materials can be toxic and cause irreversible damage. If temporary cement is unavailable, a small amount of petroleum jelly or toothpaste can act as a short-term adhesive, though these are less secure. Always contact your dental office immediately to schedule a professional appointment.
Protecting the Exposed Tooth
When the crown is removed, the underlying tooth structure (dentin) is exposed and highly susceptible to sensitivity. Dentin leads directly to the tooth’s nerve, causing sharp pain when stimulated by temperature or pressure. To manage this hypersensitivity, avoid consuming extremely hot, cold, or acidic foods and liquids.
Manage pain or sensitivity with over-the-counter pain relievers. Desensitizing toothpaste can also help, as these products block fluid movement within the exposed dentinal tubules. Chew food on the opposite side of your mouth to prevent undue stress on the fragile, prepared tooth.
Maintaining meticulous hygiene is necessary to prevent infection or decay, which progresses rapidly when dentin is unprotected. Gently brush the exposed tooth surface with a soft-bristled toothbrush and fluoride toothpaste. Rinsing the mouth with warm salt water can help soothe the gum area and reduce bacteria.
Common Reasons Crowns Fail
Crowns are robust restorations, but they can fail, and understanding the cause helps prevent future issues. The most frequent reason a crown becomes dislodged is the degradation or failure of the dental cement itself. Over time, saliva and chewing forces weaken the bond, leading to a compromised seal and eventual crown loosening.
A second common cause is the development of underlying tooth decay. Bacteria can infiltrate the margin where the crown meets the natural tooth, causing decay that changes the shape of the supporting structure. As the tooth is damaged, the crown no longer fits securely, causing it to loosen and fall off.
Physical trauma also plays a significant role in crown failure, often due to excessive biting forces or injury. Habits like teeth grinding (bruxism) exert immense pressure, leading to wear, fracture, or displacement. Biting down on hard or sticky foods can also generate enough force to pull the crown off the prepared tooth.
Professional Dental Repair Options
Upon visiting the dental office, the dentist will conduct a thorough examination of both the dislodged crown and the underlying tooth. If the crown is intact, the underlying tooth is healthy, and the cause was cement failure, the most straightforward solution is re-cementation. This involves carefully cleaning the old cement off both the crown and the tooth, applying a new dental cement, and bonding the crown back into position.
If the crown is damaged, fractured, or the underlying tooth has extensive decay, a new crown will be necessary. The dentist will first remove all decay and repair the tooth, potentially requiring a filling or root canal treatment. After the tooth is restored, new impressions or digital scans are taken to create a custom-fitted replacement crown.
While the new permanent crown is fabricated in a dental laboratory, which can take several weeks, a temporary crown will be placed to protect the prepared tooth. The final step involves removing the temporary prosthetic and permanently cementing the new, custom-made crown onto the prepared structure. This process ensures the long-term function and strength of the restored tooth.