A dental crown is a fixed prosthetic restoration, essentially a cap cemented onto a prepared natural tooth to restore its function, strength, and appearance. When a crown feels loose or emits an unpleasant odor, it signals that the protective seal has been compromised. This situation requires prompt professional attention because it exposes the vulnerable tooth structure underneath to the harsh environment of the mouth, risking extensive decay or infection.
Understanding the Causes of Looseness and Odor
Looseness is typically caused by the failure of the dental cement that holds the crown securely onto the underlying tooth structure. Over time, the luting agent can gradually dissolve or wash out due to the constant pressure of chewing and oral fluids. This mechanical failure creates a microscopic gap between the crown’s inner surface and the natural tooth. This space allows for microleakage, permitting saliva, food debris, and oral bacteria to seep into the interface, where they become trapped and decompose. The resulting bacterial growth and the release of volatile sulfur compounds produce the unpleasant odor and taste. If the gap persists, bacteria attack the exposed natural tooth material beneath the crown, leading to secondary decay. The crown’s failure to seal the tooth means the protective barrier is gone, allowing decay to progress quickly and weaken the remaining tooth structure. Trauma, teeth grinding, or biting on hard objects can also accelerate the breach by fracturing the cement or the tooth itself.
Immediate Steps for Managing a Loose Crown
Contact your dentist immediately to schedule an assessment, as a loose crown is considered a dental emergency. While waiting for the appointment, avoid chewing or biting down on the affected side to prevent further damage to the exposed tooth. If the crown comes off completely, carefully remove it from your mouth to avoid swallowing or aspirating it. Gently clean the inside of the crown and the underlying tooth surface using a soft toothbrush and warm water. Store the crown safely in a clean container until your dental visit. Never attempt to re-fix the crown using non-dental adhesives, such as household super glue. These glues are toxic, can permanently damage the tooth and gum tissue, and make it nearly impossible for the dentist to re-cement the crown properly. If the tooth is sensitive, temporary dental cement is available at most pharmacies and can be used as a short-term measure to temporarily re-seat the crown.
Professional Assessment and Repair Options
The dentist will conduct a thorough clinical examination and take X-rays to assess the condition of the crown and the underlying tooth. X-ray images are crucial for detecting decay or structural damage hidden beneath the crown. The assessment determines the appropriate course of treatment. If the underlying tooth is largely intact and healthy, and the crown is undamaged, the dentist can clean both and re-cement the existing restoration with fresh dental adhesive. This is the simplest solution when the primary issue was cement washout. If the examination reveals significant secondary decay, a structural crack, or damage to the crown, a more complex intervention is necessary. In cases of extensive decay, the dentist must remove compromised tooth structure and rebuild the tooth before placing a new crown. If decay has reached the pulp chamber, a root canal procedure may be required first. The crown will need complete replacement if the original restoration is compromised or if the underlying tooth structure has changed too much for the old crown to fit securely.