A crown coming off is startling, usually happens while you are eating something perfectly ordinary, and feels considerably more dramatic than it is. If your crown fell out, what to do next is fairly simple, and the most important instruction is one about what not to do.
Do not reach for the glue.
On this page
- What to do straight away
- Why household glue ruins everything
- Why crowns come off
- Looking after the tooth until you are seen
- What happens at the appointment
- Can it just be re-cemented?
- How urgent is it?
- In summary
What to do straight away
- Find the crown and keep it safe. Rinse it, dry it, and put it in a small container or an envelope, not loose in a pocket. In most cases it can be re-cemented.
- Check it is not still attached to part of the tooth. If a dark, hard piece is attached inside the crown, part of the tooth has come away with it, which is worth mentioning when you ring.
- Rinse your mouth gently with warm salt water.
- Ring your dentist and describe what has happened.
- Do not attempt to glue it back.
If you swallowed it, which happens more often than you might think, it will pass without harm. Ring us anyway, since a new crown will need making.
Why household glue ruins everything
Superglue is not manufactured for use in the mouth, and it is not safe in contact with oral tissues.
Beyond that, it causes two practical disasters. It sets hard inside the crown, which means the crown can no longer seat properly on the tooth, so a crown that could have been re-cemented in ten minutes often has to be remade entirely. And it prevents the tooth beneath being cleaned and assessed, so any decay there gets sealed in and continues quietly.
Temporary dental cement from a pharmacy is a different matter and is designed for exactly this situation. It is a reasonable stopgap for a day or two, particularly over a weekend, though it is not a fix.
Why crowns come off
Rarely because the crown has failed. Usually because of one of these:
- Decay in the tooth underneath. The commonest reason by a distance. The crown cannot decay, but the natural tooth at the margin certainly can, and as it does the crown loses its grip.
- Cement failure over time. Cement does not last forever, particularly on older crowns.
- Sticky food. Toffee and chewing gum pull with real force.
- Grinding, which stresses the bond night after night. Our post on the signs of night-time grinding may be relevant.
- Fracture of the tooth beneath, which is the more serious possibility and why the tooth needs examining rather than just re-cementing.
Looking after the tooth until you are seen
- Chew on the other side. The exposed tooth underneath is shaped down and relatively fragile.
- Avoid very hot, very cold and very sweet things, since the exposed dentine will be sensitive.
- Keep brushing the area gently. It still needs cleaning, perhaps more than ever.
- Use sensitive toothpaste if the tooth is uncomfortable.
- Do not delay too long, because an unprotected prepared tooth can allow neighbouring teeth to drift slightly, which affects how the crown seats.
What happens at the appointment
The crown is examined and so is the tooth beneath it, usually with an X-ray. That examination is the reason a proper appointment matters rather than a home repair: the crown coming off is often a symptom, and the tooth underneath needs assessing.
If the tooth is sound and the crown undamaged, it is cleaned and re-cemented, often in a short appointment and frequently without numbing.
If there is decay underneath, that is removed first and the tooth rebuilt before the crown goes back, assuming it still fits. If too much tooth has been lost, a new crown is needed, and occasionally the tooth needs root canal treatment first.
Where a new crown is needed, same day crowns can often be made and fitted in one visit, and our post on how they are made explains the process.
Can it just be re-cemented?
Often yes, provided three things are true: the crown itself is undamaged, the tooth beneath is sound, and no glue has been near it.
That last condition is entirely within your control, which is why this article keeps mentioning it.
A re-cemented crown usually serves well for years afterwards. Our post on how long a dental crown lasts covers what extends the life of any crown, and our page on crowns explains the treatment generally.
How urgent is it?
Prompt rather than emergency. A lost crown is not usually painful and rarely dangerous, so it does not warrant an out-of-hours call unless you are in significant pain or the tooth has fractured sharply.
But do not leave it for weeks. The prepared tooth underneath is vulnerable to decay and sensitivity, and the longer it goes uncovered the more likely it is that the original crown will no longer fit. Our post on what counts as a dental emergency explains how urgency is judged generally, and the NHS overview of crowns has further background.
In summary
Keep the crown safe, rinse your mouth, leave the superglue well alone, and ring your dentist within a day or two. Most crowns can simply be cleaned and re-cemented, provided the tooth beneath is sound and nobody has glued anything.
If yours has come off, ring us on 01255 422506 and we will get you in. Our post on when a filling is too big covers the related question of when a tooth needs more than a repair.
This article is general information rather than personal dental advice. Every mouth is different, so please speak to your dentist about your own teeth.
