One of the biggest emergencies I see as a Dentist in Tigard, OR is “my crown or filling came off”. This is never convenient for the patient and always causes a lot of anxiety since crowns and dental fillings are perceived as permanent. There are several reasons why a crown or dental filling comes off and some of them might surprise you.
Probably the most common reason a crown or dental filling came off is because of Tooth Decay or Secondary Caries. This is when the tooth underneath the crown gets a cavity or decay. How does this happen you might ask or you might say but a crown can’t get a cavity. Well the tooth structure under and surrounding the crown is susceptible to decay just like any tooth and when it decays there is a loss of tooth structure. This is why oral hygiene, brushing, flossing, and regular dental checkups are so important. The cavity under the crown will weaken the tooth structure eventually causing the crown to loosen and fall off. Generally speaking thorough evaluation of the tooth structure is needed to evaluate what treatment is necessary.
Another common factor why crowns or fillings come off is because the Crown Breaks. Just like teeth break, dental crowns can break too. Generally speaking porcelain crowns break more frequently then gold crowns. Most of time the crown breaks because of the shear force exerted on the crown or hardness of the object being eaten. Crowns should never be used to open bottles or break hard objects. You should also be careful with certain foods especially when you have multiple crowns on your front teeth. If a crown breaks then if will have to be replaced.
Repeated Chewing of Sticky Foods over time can breakdown the cement that is holding the crown to the tooth. Now this usually happens when you have had the crown for a long time or you just got the crown and forgot to not chew sticky foods prior to the cement in the crown setting up. Often times if this happens a dentist can re-cement the crown back onto the tooth, but first a thorough evaluation of the tooth structure is needed. It is also important to eat sticky foods such as certain candies in moderation as this wear and tear can and will eventually cause a crown to come off.
Not as often but always a possibility is Faulty Cementation. Cementation is the process when the permanent crown is cemented on by the dentist. There are a variety of cements that dentists will use and sometimes it depends on the type of crown that is done. Also there have been huge advancements in the quality and strength of cements, so if you had a crown done 10 years ago the likelihood is that cement the dentist used on your crown is no longer being used or has been upgraded to a better cement. The process by which a crown is cemented to a tooth is very important. Some cements require a completely dry tooth, occasionally an air void can affect the cement, or sometimes the cement is not mixed properly. All of the
se can affect how well a crown is cemented to a tooth.
Last and probably not seen as often is Faulty Preparation of the Tooth by the dentist or dental lab. Precision and exactness is very important when a dentist prepares a tooth for a crown. However every case is different and a dentist sometimes has to make due with what is given. If there is not enough tooth structure then a dentist might have to evaluate if a dental crown is a possibility or if another procedure is required before doing a crown.
So what do you do if a Crown Falls Off or Becomes Dislodged? First of all don’t panic and don’t try and replace it yourself. If the crown comes off while eating be careful not to swallow it or aspirate it. This is another reason whey you should not try to replace it yourself. Call your dentist immediately and try not to eat on the tooth until it is evaluated. The prepared portion of the tooth is very fragile and can break very easy if chewing a hard food.
Remember there are a lot of reasons why a dental crown or filling comes out and your dentist will evaluate all of the possibilities.
Post written by Dr. Justin Marostica a Dentist for TenderCare Dental in Tigard, Oregon.