My Crown Fell Out! What Do I Do Now?
Crowns falling off while eating or drinking are a common concern and we’ve heard anything from coffee, to sandwiches, to Twizzlers, to nuts being the culprit. First things first, if you can call us, do! Typically, a crown that has fallen out can be a well managed situation until you can get to our office. If your crown or bridge has fallen out during normal business hours we will get you in that same day and get it back in place. Should your crown or bridge have fallen out during the evening or on a weekend, leave us a message and we will get you right in on the next business day to fix the situation. You can always contact Dr. Sami directly if necessary should you have any question or other concerns.
In the meantime, here’s some advice for what to do before you can make it to us.
First thing, if the crown is out of your mouth, take a look at it and your remaining tooth in your mouth. If your tooth broke and a piece is stuck inside the crown, it will be difficult for you to adequately get it back in place. There won't be much you can do without our help. While you may be able to get away with waiting a bit if this occurs on a back tooth, we realize this constitutes a cosmetic emergency if it happens with a front tooth. In that case call us right away and we will do everything we can possible to see you immediately and fix the problem.
If your crown came out and is totally hollow with no evidence of any major tooth breakage, follow this list of Do's and Dont's:
DO find the crown right away. If you accidentally swallowed it, it is strongly recommended to call a medical doctor immediately. While rare, there could be a chance it went down the wrong pipe. A chest x-ray is typically indicated to ensure the crown is in your digestive tract and not anywhere in your airway system (trachea or lungs).
DON'T use any type of glue as a temporary cement. I've had many patients attempt this. It is not recommended. If not placed onto the tooth properly, the crown and your bite will be extremely uncomfortable and cause a more urgent emergency to develop as pain will begin to set in due to an inaccurate bite. In addition you risk the possibility of having the crown cut off instead of simply reusing it since the glue can make it very difficult to remove without a drill.
DO keep your crown if you find it. The majority of the time the crown can simply be cleaned out and re-cemented back onto the tooth. However, if it fell out due to substantial dental decay or if the tooth fractured off, a new crown will be most likely required in addition to other possible treatments to save the tooth.
DON'T use temporary cement until you talk to us first. If necessary, clean the crown off and place it back onto the tooth without any cement. We may recommend using an over-the-counter cement that you can purchase from your local pharmacy or drug store to keep your tooth in place until we can see you. However, it's important to check with us first as you may have a unique situation in which temporary cement would be harmful.
If you cannot contact us right away and are in a mind, the safest bet is to use denture adhesive. You can apply a small amount of the denture paste into the crown and it will allow the crown to stick in place without any harmful affects to the tooth. In addition it will be easy to remove later.
DO use any necessary over-the-counter pain medications such as Tylenol or Motrin if necessary. If the tooth that had the crown on did not have root canal treatment, it is very likely that it will be sensitive to some capacity. This is normal and to be expected. In the vast majority of cases this does not mean there is an infection or bigger problem present. Take the medication as needed and as directed. Make sure you do not have any allergies or take any other medical conditions or medications that may possibly conflict with them.
DON'T eat anything that is too hot or too cold. If your tooth has not had a root canal, it is still alive and will be responsive to extremes in temperatures that will only irritate the nerve. Consuming food and beverages at room temperature is usually best. The same goes for chewing food that is hard or crunchy and applies a lot of pressure on the teeth. Stick to a soft and lukewarm diet until we can get the crown back on permanently.
DON'T put back the crown onto the tooth in order to eat unless you've been instructed to use over-the-counter temporary cement. You can eat without the crown in place and if necessary favor the opposite side. Placing the crown back onto the tooth will most likely only result in it loosening and dislodging again, risking further possibly of you accidentally swallowing it while chewing.
DON'T go to sleep with the crown in place unless it was secured in position with temporary cement. Placing the crown back onto the tooth without cement and going to sleep places you in serious risk of aspirating the crown should it loosen while you're asleep. It is safer to leave the crown out and wait to have us re-cement it in place.
Once at the office, we will evaluated the tooth and the crown. Depending on the condition of the tooth, we might need to take an x-ray. If both are found to be in sound clinical shape we will clean the crown out and re-cement it back in place. If we discover any areas of concerns around the fit of the crown or the clinical condition of the tooth, we will discuss these issues and make appropriate recommendations on how we can move forward with any necessary treatment you need.
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