A temporary dental crown is a provisional restoration that covers a prepared tooth while a permanent crown is being fabricated in a laboratory. This interim cap is typically made from acrylic or composite resin and secured with temporary dental cement, which is intentionally less adhesive than a permanent bond. The temporary crown protects the exposed, sensitive underlying tooth structure, maintains correct spacing, and preserves appearance during the typical two-to-three-week waiting period. Although temporary crowns are meant to withstand normal chewing forces, the weaker cement means that fracture or complete dislodgement is a common event requiring immediate attention.
Immediate Steps Following the Break
When a temporary crown breaks or falls out, immediately retrieve all pieces to prevent accidental swallowing or aspiration. After securing the fragments, gently rinse the mouth with warm water to clear any debris or loose cement. A warm saltwater rinse is beneficial as it helps soothe gum tissue and maintain a clean environment around the exposed tooth.
Next, visually assess the situation to determine the next steps for protection. Check the exposed tooth for sharp edges or if the underlying structure, called the preparation, is fully exposed. If the crown is intact or only slightly chipped, you may be able to re-seat it temporarily. If it is fractured into many pieces, store them safely in a container to show the dentist.
Addressing Sensitivity and Discomfort
Losing the temporary crown exposes the dentin, the layer beneath the enamel, which contains microscopic tubules leading directly to the tooth’s nerve. This exposure causes a sharp increase in sensitivity to air, temperature changes, and pressure. To manage this discomfort, take an over-the-counter anti-inflammatory pain reliever, such as ibuprofen or acetaminophen, following the package directions.
Using a desensitizing toothpaste containing ingredients like potassium nitrate can help calm the exposed nerves by blocking pain signals. Dab a small amount of this toothpaste directly onto the exposed tooth surface before bed and leave it undisturbed to maximize its effect. Also, avoid consuming foods or liquids that are extremely hot, cold, or acidic, as these stimuli can trigger intense pain in the unprotected tooth.
Protecting the Exposed Tooth Structure
The most important step is placing a temporary barrier over the prepared tooth to prevent further damage and bacterial contamination until a dental appointment can be secured.
Re-seating the Crown
If the crown is still in one piece, it can often be re-cemented using an over-the-counter temporary dental cement kit available at most pharmacies. Clean and dry the inside of the crown and the tooth preparation as much as possible. Place a thin layer of the cement inside the crown and seat it firmly over the tooth.
Emergency Coverage
If commercial dental cement is unavailable, a small amount of petroleum jelly or thick toothpaste can be used as a makeshift adhesive to hold the crown in place temporarily. These household items are much less secure and should only be used as a last resort. The crown must be removed before eating or sleeping to avoid inhalation.
If the temporary crown is lost or too broken to re-use, cover the exposed tooth with dental wax or a small piece of sugar-free gum. This masks any sharp edges and provides a mild buffer against the oral environment. Under no circumstances should non-dental adhesives, like super glue, be used, as they are toxic, damage tissue, and complicate professional re-cementation.
Next Steps: Contacting Your Dental Office
Contacting the dental office immediately is crucial because the exposed tooth is vulnerable to decay, fracture, and shifting, which compromises the fit of the permanent crown. When calling, clearly communicate if the crown is lost, chipped, or if you are experiencing severe symptoms like throbbing pain, swelling, or bleeding, as these indicate higher urgency. Dental offices prioritize re-cementing a dislodged temporary crown because the exposed tooth can shift within a few days, preventing the permanent restoration from fitting correctly.
If the incident occurs outside of normal business hours, the practice likely has an emergency protocol or a number for urgent consultation. Even if you successfully placed the crown back yourself, you must still attend a professional appointment as soon as possible to have it properly cleaned and re-cemented with a fresh adhesive. Until the appointment, chew exclusively on the opposite side of the mouth and maintain gentle oral hygiene around the affected area.
Understanding Why Temporary Crowns Fail
Temporary crowns are designed to be provisional, and their failure results from the materials and adhesive used. They are made from less substantial materials, such as acrylic resin, which are not as strong as the ceramic or metal alloys used for permanent restorations, making them susceptible to cracking or chipping. The dental cement is deliberately weakened so the dentist can easily remove the temporary crown without damaging the prepared tooth when the permanent one is ready.
Failure is often caused by external forces or fit issues:
- Chewing sticky foods like caramel or hard items such as ice or nuts.
- Constant pressure from teeth grinding, known as bruxism, which prematurely weakens the temporary seal.
- A slight imperfection in the initial fit or a high spot in the bite, which puts undue stress on the restoration during chewing.