Dental crowns are long-lasting dental restorations. If you have a crown, you have likely had it for a while, and you’ve come to think of it as just another one of your teeth. It looks, functions, and feels like your other teeth. So when your dental crown falls out, it can be a bit of a shock.
What do you do? Here’s a comprehensive guide to dealing with a dental crown that’s fallen out.
What to Do When a Crown Falls Out
When your dental crown falls out, don’t panic! It’s not necessarily a sign that there’s a major problem, and there are easy steps to deal with the problem. Note: these are steps for dealing with a crown falling off a tooth. The recommendations are similar for losing a crown from a dental implant, but ignore step 5.
1: Get the Crown (and Any Pieces) Out of Your Mouth
As soon as you know a crown has fallen out of place, get it out of your mouth, along with any pieces that might have broken off. You don’t want to swallow them. If you do swallow a dental crown, though, it will most likely not cause a serious problem–the crown will pass through your digestive tract.
2: Clean the Crown and Tooth
Most dental crowns fall off when you’re eating, so take the time to clean food and debris from the crown. Also clean the tooth gently: just rinse with water or brush gently without toothpaste.
3: Examine the Crown and Tooth
Once you’ve gotten the crown and tooth cleaned, examine them for damage. The crown should be hollow and look like the same uniform material inside (no broken pieces of tooth attached). The edges should be smooth all around–jagged edges might indicate the crown broke.
Look at the crowned tooth as best you can. It should have a regular shape, typically with a shelf around the edge where the crown fits. The regular smooth shape indicates the crown came off cleanly, without breakage or decay underneath.
Don’t be surprised if the revealed tooth looks dark in color–it’s probably the dentin you’re seeing, which can be yellow, brown, or gray. Check the tooth for sensitivity by sucking in air over it.
Try the crown on the tooth. Note the fit to tell your dentist.
4: Contact Your Dentist
Next, contact your dentist to schedule an appointment. Based on what you tell them about the crown and tooth, they might consider the situation an emergency and try to get you in immediately. Or they might see this as routine and schedule an appointment for the near future–a few days or even a week is not unusual.
5: Protect the Tooth
If you don’t have a dental appointment immediately, you should take steps to protect the tooth until you see your dentist. Follow any instructions your dentist gave you, but if you didn’t get instructions, here are some common methods of protecting an exposed tooth.
Replace the crown: If the crown fits and the tooth and crown are both undamaged, you can try cementing the fallen crown back in place with temporary dental cement you can get at the drugstore. Never use any kind of glue to put a crown back in. Unless it says it’s for dental use, it’s not safe for your tooth or for you.
Coat the tooth with dental cement: If the dental crown or tooth is damaged or you can’t get the crown to fit, you need to coat the tooth to protect it. Temporary dental cement works well for this.
Coat the tooth with orthodontic wax: Another solution for coating a tooth is orthodontic wax. You might have some around the house from past orthodontic treatment or you can find it at a drugstore. You might have to recoat often if you use this method.
Practice good oral hygiene: Keep your mouth clean with regular oral hygiene. Ideally, the tooth should be coated, but take special care to keep it clean, but also don’t overbrush.
Why Crowns Fall Out
Dental crowns are supposed to be permanently cemented in place, so why do they fall out? There are several reasons why they can fall out:
Dental cement is very long-lasting, but it can and does fail. The good news is that when this happens, it’s easy to cement the crown back in place!
Decay under the Crown
Ideally, a dental crown should create a tight seal with the tooth underneath, providing protection to the entire tooth above the gumline. However, sometimes there’s a leak and bacteria can get under the crown, decaying the tooth underneath. Or perhaps your gums recede, exposing the unprotected part of the tooth.
Usually, the dental crown protects the tooth from trauma, but sometimes trauma (or, even more rarely, normal bite force) can cause the tooth to crack underneath the crown. Sometimes the crack starts or extends into the tooth root.
Dental crowns are usually made of very strong materials, but sometimes they break. The crowns that are most likely to break are old porcelain crowns and porcelain-fused-to-metal (PFM) crowns. Metal crowns and advanced ceramic crowns fracture much less often.
Can a Crown Be Put Back in?
Whether we can put a crown back in or not depends on why it fell out. If it fell out because the cement failed, we almost certainly can put it back in by simply re-cementing it. Other causes of lost crowns (decay, cracks, or broken crowns) mean the crown will have to be replaced.
In the case of decay or a cracked tooth, we might not be able to put a new crown on top. We might have to extract the tooth because it’s too damaged or unhealthy.
Options for Replacing a Dental Crown
If you need a new dental crown, there are several options for replacing them.
CEREC Same-Day Crown
The best way to replace a lost crown is with CEREC, which can make a new crown for you in one appointment. CEREC crowns are attractive, durable, and convenient. Replacing a crown is an inconvenience–why make it more inconvenient than it needs to be? In fact, if your old CEREC crown broke, but your tooth isn’t damaged or changed, we can just make a new one for you and have it waiting when you come in.
Lab-Made Ceramic Crown
You can also replace your lost crown with a lab-made ceramic crown. These can also look beautiful and may be very long-lasting. The main problem is that you will have to wear a temporary crown and come back for a second appointment. Temporary crowns are notorious for falling out or failing before the permanent replacement is ready, but this is still a good option.
These crowns were developed on the simple idea that they would look as good as a ceramic crown, but be as durable as a metal crown. The reality is often the opposite. However, in some cases, this might be the right choice for you.
You can also opt to have a metal crown made. These don’t look as attractive as ceramic crowns, but gold crowns do still have the best survival record. You will still need to wear a temporary crown, but perhaps it’s worth it for the potential to have a much longer-lasting dental crown.
Have You Lost a Crown in Las Vegas?
If you’ve lost a dental crown in the Las Vegas area, Dr. James B. Polley is one of the area’s leading experts in reconstructive dentistry. Please call (702) 873-0324 today for an appointment to get your dental crown replaced.