Hey, if the crown fits…
At Your Smile Dental Care, we recommend dental crowns when a weakened tooth needs added support and strength. And, although we used a special type of dental cement to permanently adhere the crown to the underlying tooth, dental caps have been know to fall off.
A dental crown may come loose or fall out for a number of reasons:
If it is not a dental implant crown, then you still have your natural tooth underneath the crown. Like your other teeth, it is still susceptible to cavities if you are not meticulous about your home care or in attending regular professional cleanings. If part of your tooth gets destroyed by dental decay, then the crown may no longer fit snugly around your tooth. Bacterial plaque and its damaging acid continues to seep in where this protective seal between the tooth and the cap has been breached, further destroying tooth tissue. As the tooth continues to break down, the crown will become loose and eventually fall out. Sometimes the crown even comes off with the tooth still inside. Usually still fixable, but it sure makes patients say, “Yikes!”
This is why dental visits are so important! Regular visits allow us to monitor the health and fit of your dental crowns so that we can catch problems before they become bigger issues – like losing a crown.
Don’t be surprised if you are not even aware that you grind or clench your teeth – most people aren’t! You may wake up with sore teeth and jaws, have loose teeth, have chips or fractures in some teeth, or experience tooth pain or sensitivity. The incredibly strong forces that are put on your teeth when grinding or clenching can cause dental crowns to become loosened or even chip/break. Dr. Sam Axelrod advises patients who clench and grind to wear a custom-made guard over their teeth at night for added protection. A nightguard will put your teeth into proper bite and protect your teeth and dental crowns from wear and damage.
3. Injury or Trauma
Some injuries can be so severe that a crown gets knocked right off a tooth. It may be that the dental crown was already loose and all it needed was a sudden jarring hit to knock it off!
4. Disintegrating Cement
Gradually, over time, the cement that holds the crown in place can break down and dissolve. This leaves the bond between the existing tooth structure and crown weak and the crown simply falls out. Again, you dentist will monitor the seal at your dental check-ups to ensure that the integrity of the cement is still intact.
What to Do…
It is understandable why most patients panic when their crown falls out. They know that their tooth is no longer protected by the crown and they may even begin to feel some sensitivity to hot and cold food, biting down, tooth brushing or breathing in air.
Take these 10 steps to increase the likelihood of saving your crown and tooth:
1. Wrap the crown in a piece of tissue or gauze then place it into a plastic container.
2. Do not attempt to clean off the crown or it may drop onto the floor or down the drain!
3. Rinse your mouth with warm water and spit out into a cup or bowl. This is done to ensure that there isn’t more pieces of tooth of crown in your mouth that you could swallow or aspirate. Retrieve any pieces you think may be a piece of tooth or crown and place in the plastic container.
4. Sometimes, your tooth is left with a sharp edge when a crown falls off. Do not try to file it down yourself! If you happen to have any orthodontic wax that is used for braces, you can place it over the sharp edge until you get to the dentist.
5. Never, ever “glue” your crown back onto your tooth. Not only is glue not safe in the mouth, but you make our job more difficult when we have to try to remove the “glued” crown without causing further damage to the tooth or surrounding teeth. Some patients have also been known to use sticky gums or foods to “glue” a crown in place. Not only do you run the risk of the crown being lost or swallowed, you are providing food for cavity-causing bacteria to further damage your tooth.
6. Same goes for any temporary cements that can sometimes be found in pharmacies. Our concern is that any re-cementation would be very temporary at best and could still leave you at risk for swallowing, choking, aspirating or the crown falling out and being lost. Additionally, self-cementing could cause your bite to be off, which in turn, may cause complications and harm to other teeth. Use these drug store cements or denture adhesives at your own risk!
7. Rather than researching home remedies online or taking advice from friends or friends, call your dentist first. Only they can offer you the safest, “specific to you” advice on what you can do at home.
8. You can still eat, but should chew on the opposite side of the mouth from where you crown fell out. Choose softer foods and avoid those that are sharp or extreme in temperature.
9. As for brushing your teeth, you should try to keep the tooth that was crowned as clean as possible to avoid added irritation, food impaction and plaque/debris buildup. You will want to brush gently with a very soft toothbrush and rinse with warm temperature water.
10. See your dentist as soon as possible. Teeth move when they are not supported by adjacent teeth or biting against opposing teeth. Delaying treatment will cause your existing tooth to shift and your crown will likely no longer fit the new tooth position.
Swallowed or Aspirated Crown
What happens if you accidently swallow a crown?
Usually a crown is small enough that it just goes through the digestive tract without complication. However, there is always a risk that the crown can become stuck in the throat obstruction of the airway. You would begin immediate action as you would with any other type of choking. See here for Choking Victim instructions.
Aspiration is an entirely more serious matter than involves the crown being accidentally “breathed” into the respiratory tract during swallowing, coughing or hiccupping. In a case like this, you will need to be evaluated immediately at your local hospital emergency or the nearest urgent care with a radiology department. A chest x-ray will determine the location of the crown and the attending physician will arrange for prompt retrieval to prevent further complications.
If you have lost your crown or are facing any kind of dental emergency, please give us a call right away. At Your Smile Dental Care, Dr. Sam Axelrod and his team of caring professional will be happy to answer your questions and make all possible arrangements to help you.