Short answer: When a crown falls out, rinse it, keep it in a closed container, avoid chewing on that side and see a dentist as soon as possible. Crowns usually come off because of decay underneath, dissolved cement or insufficient tooth structure. If both the crown and the tooth are sound, in most cases the crown can be recemented; if there is decay or a fracture, it needs to be replaced. Household glues should not be used.
You felt something hard in your mouth while eating and realized it was your crown. Although this is annoying, it is usually not an urgent danger and can generally be resolved when the right steps are taken. Rather than panicking because your crown fell out, the most important steps are to keep the crown safe, avoid irritating the tooth and reach your dentist quickly. In this article we explain why crowns fall out, what to do when it happens, whether it can be recemented, when it needs to be replaced and how this can be prevented.
Why do crowns fall out?
Crowns usually fall out because decay develops in the tooth underneath, the cement dissolves over time or the tooth has lost enough sound structure to hold the crown. A crown is fixed onto the tooth with a special cement; anything that weakens this bond can cause the crown to loosen.
The main causes are:
- Decay under the crown: Plaque that builds up at the crown margins near the gum can lead to decay over time. As the decay progresses, the tooth structure the crown sits on weakens and the crown can no longer stay in place. This is one of the common causes of crowns coming off.
- Dissolved cement: Over the years, the cement can dissolve due to chewing forces and the oral environment.
- Insufficient tooth structure: In very short or heavily broken-down teeth, the crown's retention may be reduced.
- Sticky and hard foods: Sticky foods such as caramel, chewing gum or Turkish delight, or hard objects, can dislodge a loosened crown.
- Teeth clenching and grinding: Constant, intense forces can strain both the crown and the cement.
- Trauma: Falls, impacts or sports injuries.
- Broken post in root-canal-treated teeth: The piece inside the root that supports the crown (the post) may have broken or come loose; in that case the crown can fall out together with the post.
My crown came off – what should I do? What to do with a crown that has fallen out
The first thing to do when a crown falls out is to keep it safe so it doesn't get lost and to book an appointment with your dentist as soon as possible. Until you reach your dentist, these steps can guide you:
- Find and keep the crown: Gently rinse the crown with water, dry it and put it in a small container with a lid or a clean bag. Do not brush it or scrape it with a hard object.
- Check your mouth: Gently rinse your mouth with lukewarm water. You can feel with your tongue whether there is a broken piece or a sharp edge on the tooth.
- Call your dentist: Explain the situation and bring the crown to your appointment.
- Avoid chewing on that side: The exposed tooth may be more sensitive and fragile.
- Manage sensitivity: Avoid very hot, very cold and sweet foods and drinks. If needed, you can use a pain reliever your dentist recommends.
- Keep up your oral care: Gently clean the exposed tooth with a soft brush as well; plaque buildup can weaken the tooth further.
What not to do
- Do not glue the crown back with household adhesives. Products such as super glue can be harmful to oral tissues, fix the crown in the wrong position and damage the tooth; they are also difficult to remove later.
- Do not leave the crown loose in your mouth. There is a risk of swallowing or inhaling it, especially while sleeping.
- Do not postpone your appointment for long. The exposed tooth may shift, decay or break over time, which makes it harder to reuse the crown.
Temporary dental cements sold in pharmacies can be considered a short-term solution when you can't reach a dentist right away. However, it is advisable to consult your dentist before doing this. If you accidentally swallowed the crown and have no difficulty breathing or coughing, it usually passes through the digestive tract; you should still let your dentist know. If you have shortness of breath, persistent coughing or wheezing, the crown may have entered the airway and you should go to the emergency room.
Can it be recemented?
If the crown is intact, fits the tooth well and the tooth underneath is healthy, in most cases it can be recemented. The dentist first carefully examines both the crown and the tooth.
The main points evaluated when deciding on recementation are:
- Whether the crown has cracks, fractures or chipped porcelain
- How well the crown margins fit the tooth
- Whether the tooth under the crown has decay, a fracture or loss of structure
- Whether the tooth has enough sound structure to support the crown
- The soundness of the post in root-canal-treated teeth
- The condition of the gum and the tissues around the root
If these conditions are suitable, the tooth and the crown are cleaned, cement residue is removed and the crown is fixed in place again. If necessary, an X-ray is taken to evaluate the root and surrounding tissues. With bridge-type crowns, the other teeth the bridge is attached to also need to be checked, because when one abutment of a bridge loosens, decay may have progressed unnoticed underneath.
When replacement is needed
If decay has developed under the crown, the crown is damaged or the tooth can no longer provide enough support, a new crown needs to be made. In such a case, treatment may typically include these steps:
- Removing the decay: The decayed tissue in the tooth is cleaned out.
- Root canal treatment if needed: If the decay has reached the tooth's nerve, root canal treatment may be performed.
- Reinforcing the tooth: If a lot of structure has been lost, a filling or a post and core may be placed to create a solid base the crown can hold onto.
- Preparing the new crown: The tooth is reshaped, an impression is taken and a temporary crown is placed until the new crown is ready.
When the tooth is too damaged to be saved, extraction followed by an implant, a bridge or other prosthetic options may be considered. Options for the new crown, such as zirconia or porcelain-fused-to-metal, are decided together with your dentist based on the tooth's position and your expectations. As the fee depends on the procedures required, it is provided in writing after the examination.
Prevention
The key to preventing a crown from falling out is protecting the tooth under the crown from decay and not overloading the crown. These tips can help extend the life of your crown:
- Clean the crown margins well: Brush twice a day with fluoride toothpaste, paying special attention to the margin where the crown meets the gum.
- Clean between your teeth every day: If you have a bridge, clean underneath it with special floss or interdental brushes.
- Be careful with sticky and very hard foods: Especially with older crowns, avoid chewing gum, caramel and ice.
- If you clench or grind your teeth, wear a night guard.
- Don't use your teeth as tools: Opening packages or bottle caps, or biting your nails, can damage crowns.
- Go for regular check-ups: Decay and loosening that start at the crown margins can be resolved with simpler methods when caught early.
You can find frequently asked questions about crowns and other prosthetic treatments on our frequently asked questions page.
If your crown has fallen out, come in for an examination
If your crown has fallen out or feels loose, keeping the crown and booking an appointment as soon as possible improves the chances of saving your tooth. At our polyclinic in Park Oran Ofis in Çankaya, the crown and your tooth are examined together, and we clearly explain whether the crown can be recemented or needs to be replaced.
Frequently asked questions
Can I glue a crown that fell out back in myself?
Gluing the crown with household adhesives is not recommended; these products can damage oral tissues and cause the crown to be fixed in the wrong position. Temporary dental cements sold in pharmacies can be used for a short time when you can't reach a dentist right away. However, you should consult your dentist before doing this and get examined as soon as possible.
How long can I wait after a crown falls out?
After a crown falls out, it is advisable to see a dentist as soon as possible, preferably within a few days. The exposed tooth may become sensitive or break, or the neighboring teeth may shift. These changes can make it harder to reuse the crown.
I swallowed my crown – what should I do?
If you have no difficulty breathing, coughing or wheezing, the crown usually passes through the digestive tract; you should still let your dentist know. If you have shortness of breath, persistent coughing or chest discomfort, the crown may have entered the airway. In that case, go to the emergency room without delay.
My crown is loose but hasn't fallen out – what should I do?
A loose crown may indicate that the cement underneath has dissolved or that decay has developed. It is advisable to avoid chewing on that side and to avoid sticky foods, and to get examined soon. Early intervention improves the chances of preserving the tooth and reusing the crown.
