A dental crown is a custom-made cap placed over a weakened tooth (due to decay, fracture, or a root canal) to restore its strength, shape, and appearance. Although durable, crowns can fail over time due to wear, trauma, biting hard foods, or cement deterioration. Understanding the severity of the damage is key to getting the right care. This guide clarifies when a broken crown is a true emergency and details the immediate steps you should take while awaiting professional treatment.
Classifying the Severity
A simple broken or lost crown is usually a dental urgency, requiring prompt attention within a day or two, but not an immediate trip to the emergency room. The primary concern is the exposed tooth underneath, which may be sensitive to temperature or pressure. A chipped crown can also create sharp edges that irritate the tongue or cheek tissue.
A true dental emergency involves symptoms that threaten overall health or could lead to rapid, irreversible damage if not addressed within hours. Seek immediate care if the crown failure is accompanied by severe, uncontrolled bleeding, or if you experience significant facial swelling that affects breathing or swallowing. Persistent, throbbing pain unmanaged by over-the-counter medication, or evidence of a jaw fracture following trauma, also signals an emergency. These symptoms suggest a deep infection or major physical trauma requiring immediate professional assessment, even if an urgent care facility must be used.
Immediate Steps for Home Care
If your crown has fractured or fallen off, carefully retrieve the piece and clean it gently with warm water, avoiding scrubbing. Store the crown in a clean container or plastic bag, as the dentist may be able to re-cement it. Do not try to force the crown back onto the tooth without temporary cement, as incorrect placement can cause further damage.
To manage discomfort or sensitivity from the exposed tooth, take over-the-counter pain relievers (such as ibuprofen or acetaminophen) following dosage instructions. Rinsing gently with warm salt water helps keep the area clean and reduces inflammation. Avoiding extreme temperatures in food and drink will also minimize sensitivity.
If the crown has created a sharp edge, use dental wax, sugar-free chewing gum, or petroleum jelly to cover the area and protect oral tissues. For a completely dislodged crown, you can attempt temporary reattachment using temporary dental cement, available at most pharmacies. Apply the cement inside the crown and seat it carefully back onto the tooth, biting down gently to ensure correct positioning before calling your dental office. While awaiting your appointment, adjust your diet to soft foods and avoid chewing on the affected side to prevent further damage.
Professional Repair Options
When you see the dentist, the first step is a thorough assessment, including X-rays, to determine the cause of the crown failure. The dentist will examine if the crown broke due to trauma, cement failure, or new decay underneath, which weakens the underlying tooth structure. The choice of repair depends on this assessment of the damage to both the crown and the tooth.
If the crown is intact and the underlying tooth is healthy, the dentist can clean the crown and the tooth preparation, then re-cement the existing crown using a stronger, permanent adhesive. For crowns with minor chips or hairline fractures, the dentist may use a tooth-colored composite resin to repair the damage through dental bonding. This technique is non-invasive and restores the crown’s contour and function.
A new crown is necessary if the existing one is fractured beyond repair, if there is extensive decay, or if the tooth structure is compromised. The process involves taking new impressions, placing a temporary crown to protect the prepared tooth while a permanent one is fabricated in a dental lab (typically taking about two weeks). If the failure exposed the tooth’s innermost part (the pulp) and caused infection, a root canal procedure may be required before the new crown is placed to ensure long-term health.