A temporary crown is a provisional covering placed over a prepared tooth that is waiting to receive a permanent dental crown. This protective cap, typically made from acrylic resin, acts as a necessary barrier while the final restoration is custom-fabricated in a dental laboratory. Its primary function is to shield the underlying, exposed tooth structure, known as the dentin, from the environment. This prevents significant sensitivity and guards against damage or bacterial entry during the waiting period. Understanding the immediate steps to take if a temporary crown dislodges is essential for protecting the prepared tooth and ensuring the success of the final crown placement.
Immediate Steps to Take
If the temporary crown comes off, remain calm and immediately locate the crown. Carefully retrieve the restoration to avoid swallowing or losing it, as the dental office will likely want to re-cement the original piece. Once retrieved, gently rinse the crown with warm water to remove any debris or old cement, and inspect it for damage. Contact your dental provider right away, even if the office is closed, to inform them of the situation. The dental team needs to provide instructions and schedule an appointment for re-cementation as soon as possible. Keep the crown in a small, clean container or plastic bag for safekeeping until your appointment.
Protecting the Exposed Tooth and Preparation Site
If you cannot be seen by the dental office immediately, you may be instructed to attempt to temporarily re-seat the crown yourself to protect the exposed tooth. Begin by thoroughly cleaning the inside of the temporary crown and the prepared tooth surface, ensuring all remnants of old cement are removed. The crown must fit completely back into its original position; if it does not seat fully, do not attempt to force it.
To temporarily adhere the crown, only use materials specifically designed for this purpose, such as an over-the-counter temporary dental cement kit available at most pharmacies. Follow the product instructions, applying only a tiny amount of the material evenly inside the crown before gently pushing it back onto the tooth.
An alternative short-term solution, which is less secure, involves using a smear of petroleum jelly or even a small, sugar-free piece of chewing gum pressed lightly into the crown.
Never use household adhesives, such as superglue. These are toxic and can cause chemical burns to the soft tissues of the mouth. Superglue also hardens permanently, making it impossible for the dentist to remove the crown later without damaging the underlying tooth structure. If the temporary crown is lost or broken, cover the exposed, sensitive tooth with a small piece of sugar-free gum or dental wax until you can get professional care.
Potential Consequences of Leaving the Crown Out
Leaving the prepared tooth uncovered for an extended period exposes the underlying dentin, which is laced with microscopic tubules leading directly to the tooth’s nerve center. This exposure leads to severe dentin hypersensitivity, causing sharp, intense pain when the tooth is exposed to air or hot and cold temperatures. This discomfort indicates that the tooth’s pulp is unprotected and vulnerable to irritation.
A more serious consequence is the movement of the surrounding teeth, which can occur quickly, sometimes within just a few hours. The adjacent and opposing teeth may begin to drift into the space left by the dislodged crown. Even a slight shift will prevent the permanent crown from fitting correctly when it arrives from the lab, necessitating an entirely new and costly impression and fabrication process.
The prepared tooth is also at a higher risk for structural damage, as the temporary crown provides necessary support against the forces of chewing. The tooth margins, which are the edges of the preparation, are delicate and can easily chip or fracture without the protective cap in place. Furthermore, the exposed dentin is more susceptible to bacterial contamination and decay, potentially leading to infection.
Common Reasons for Temporary Crown Dislodgement
Temporary crowns are intentionally secured with a weak, non-permanent cement so they can be easily removed by the dentist for the final crown placement. This purposeful weakness is the primary reason for most dislodgements, as the cement is designed to hold the crown for only a few weeks.
The temporary nature of the adhesive makes the crown susceptible to being pulled off by sticky or chewy foods. Consuming items like taffy, caramels, or hard candies can grab the edges of the crown and overcome the cement’s retention strength.
Improper flossing technique is also a common cause, as pulling the floss up between the teeth can catch the edge of the temporary crown and pop it off. Dentists recommend gently pulling the floss out from the side of the tooth rather than snapping it upward.
The temporary crown may also dislodge due to uneven pressure from chewing or a pre-existing bite alignment issue. If the temporary crown is slightly too tall, it takes the brunt of the biting force, which gradually weakens the underlying cement. This constant, excessive pressure can accelerate the failure of the temporary bond.