A dental crown is a custom-made, tooth-shaped cap placed over a damaged or weakened tooth structure. This restoration is designed to encase the entire visible portion of the tooth. Its primary purpose is to restore the tooth’s shape, size, strength, and function, often after a root canal or when a large filling is insufficient. When a crown breaks or falls off, it leaves the underlying tooth vulnerable and exposed.
Assessing the Urgency
Determining the immediate need for professional care depends entirely on the symptoms and the physical condition of the mouth. A true dental emergency requires immediate attention, often outside of regular office hours, to prevent severe health complications or permanent damage. Signs that necessitate this rapid response include uncontrolled bleeding from the site, which suggests soft tissue trauma, or any evidence of infection, such as facial swelling or a fever.
Severe, debilitating pain that cannot be managed with over-the-counter medication also qualifies as a true emergency, as this can indicate exposed nerves or a fracture extending into the tooth’s pulp. If the broken crown leaves a sharp, jagged edge that is cutting the tongue, cheek, or gums, immediate care is required to prevent significant soft tissue injury.
In contrast, an urgent situation requires prompt care, ideally within 24 to 48 hours, but does not present an immediate threat to overall health. This includes a crown that has fallen off intact without significant pain or bleeding. Minor chipping, where the exposed edge is smooth and causes no soft tissue irritation, also falls into this category. Although the exposed tooth is sensitive and susceptible to further damage, the lack of severe symptoms allows for scheduling during normal business hours.
Immediate Steps for Temporary Relief
While waiting for the dental appointment, several practical steps can manage discomfort and protect the exposed tooth. Carefully locate and retrieve all pieces of the crown, including the main cap if it came off intact, and place them in a clean, secure container. These fragments can help the dentist assess the failure and determine the best course of action.
To manage sensitivity or minor pain, a warm saltwater rinse can be performed to gently clean the area and reduce inflammation. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be taken according to package directions to minimize discomfort until professional treatment is available. Avoid chewing or applying pressure on the side of the mouth where the crown is missing or damaged.
If a sharp edge remains on the remaining tooth structure or the broken crown, cover it to prevent soft tissue damage. Dental wax, found in most pharmacies, or a piece of sugar-free chewing gum, can be molded over the rough area to create a smooth barrier. If the crown fell out intact, temporary dental cement kits are available at drugstores for short-term re-cementation, though this is only a temporary measure.
Professional Treatment Options
Upon arriving at the dental office, professional treatment begins with a thorough examination to determine the cause of the failure and the condition of the remaining tooth structure. The decision to repair, re-cement, or fully replace the crown is influenced by the extent of the damage, the remaining integrity of the underlying tooth, and the material of the original restoration.
If the crown is intact and the underlying tooth is healthy, the dentist will clean both surfaces and use a permanent dental cement to re-bond the crown into place. For minor chips or cracks, especially those involving porcelain or ceramic, a simple repair can be performed using a tooth-colored composite resin, known as dental bonding. This method is quick but may not be as durable as a full replacement for extensive damage.
Full replacement becomes necessary if the crown is fractured beyond repair, if there is significant decay in the underlying tooth, or if the tooth structure itself is compromised. This process involves preparing the tooth again, taking a new impression, and fitting a temporary crown to protect the area while the new permanent crown is fabricated in a dental laboratory. The new crown may be made from materials like porcelain, ceramic, or metal alloy, depending on the tooth’s location and the required strength.