The First 30 Minutes: Immediate Steps After Losing a Filling or Crown
Step 1: Remove the Restoration from Your Mouth
Step 2: Inspect the Crown or Filling
- Is it a Crown? If a crown came off, is it mostly hollow? Is it intact, or does it look like there’s a piece of your natural tooth stuck inside it? An intact crown might be able to be re-cemented. If the crown is broken or has tooth structure inside, it’s a sign of a more significant problem like underlying decay or a tooth fracture .
- Is it a Filling? A lost filling will look like a solid chunk of material, either silver (amalgam) or tooth-colored (composite). It cannot be put back in, but its size can give you an idea of how large the hole in your tooth is.
Step 3: Rinse Your Mouth Gently
Step 4: Assess Your Pain Level
- No Pain or Mild Sensitivity: If the tooth isn’t hurting, that’s a good sign. The dentin (the layer beneath the enamel) is exposed, but the nerve-filled pulp is likely still protected. You may feel some sensitivity to air or temperature.
- Sharp or Throbbing Pain: If you are experiencing significant pain, it’s a sign that the dentin is highly sensitive or, in more severe cases, that the pulp is exposed or inflamed. This elevates the urgency.
Step 5: Call Your Dentist Immediately
- Which tooth it is.
- Whether it was a filling or a crown.
- If you have the crown and if it appears intact.
- Your pain level.
At-Home Care: Protecting Your Tooth Before Your Appointment
For a Lost Filling
Temporary Filling Material
- How to Use It: First, make sure the tooth is clean and dry. You can use a small piece of cotton to gently dry the cavity. Take a small amount of the temporary material, roll it into a ball, and press it gently into the hole. Bite down carefully to ensure it’s not too high and doesn’t interfere with your bite. The material will set over a short period.
- Important Note: This is strictly a temporary fix. It is not strong, will wear down quickly, and does not perfectly seal the tooth. It is only meant to protect the tooth and reduce sensitivity for a very short time.
Dental Wax
For a Lost Crown
If You Have the Crown and It’s Intact
- Clean the Crown and Tooth: Gently clean the inside of the crown with a toothbrush, and carefully clean the exposed tooth. Make sure both are dry.
- Use a Temporary Cement: Pharmacies sell temporary dental crown cement. Do NOT use super glue or any other household adhesive. Apply a small amount of the temporary cement inside the crown and carefully place it back onto your tooth, making sure it is aligned correctly.
- Check Your Bite: Bite down gently but firmly. If the bite feels high or “off,” remove the crown, clean it, and try again with less cement. Excess cement will squeeze out the sides; wipe this away.
- Denture Adhesive as an Alternative: If you cannot find temporary crown cement, a small dab of denture adhesive (like Fixodent or Poligrip) can also work to hold the crown in place for a few hours.
If the Crown is Broken or You Don’t Have It
- Protect the Tooth: The prepared tooth will be sensitive and have a rough texture. You can cover it with temporary filling material or dental wax to reduce sensitivity and prevent it from shifting.
- Be Extremely Careful: A tooth prepared for a crown is not meant to withstand chewing forces on its own. It can easily fracture. Avoid chewing on that side of your mouth entirely.
What NOT to Do: Common Mistakes to Avoid
DO NOT Use Super Glue or Household Adhesives
- It’s Toxic: Household glues contain chemicals that are not meant to be in your mouth and can damage the tooth and surrounding gum tissue.
- It Causes an Improper Fit: You will never be able to seat the crown perfectly with super glue. Even a microscopic misalignment can throw off your bite, leading to jaw pain, damage to opposing teeth, and potential fracture of the crowned tooth.
- It Makes Professional Repair Impossible: Once super glue sets, it’s incredibly difficult for a dentist to remove the crown without destroying it and potentially damaging the underlying tooth. What might have been a simple re-cementing procedure will now automatically require a new, expensive crown.
DO NOT Ignore the Problem, Even if It Doesn’t Hurt
- Risk of Shifting: Your teeth are held in place by their neighbors. When a crown or filling is missing, the adjacent and opposing teeth can start to shift into the empty space. This can happen surprisingly quickly. If the teeth shift, the original crown may no longer fit, and a new one will be needed.
- Risk of Fracture: The remaining tooth structure is weakened. Biting down on something hard can easily cause the tooth to crack or fracture, potentially below the gum line. A simple filling replacement could turn into a situation requiring a crown, a root canal, or even an extraction.
- Risk of Decay and Infection: The exposed dentin is much softer than enamel and more susceptible to decay. Bacteria can quickly lead to a new cavity or, if the pulp is nearby, a painful infection and abscess .
DO NOT Chew on the Affected Side
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Why Do Fillings and Crowns Fall Out? Understanding the Cause
New Tooth Decay
Biting and Chewing Forces
Failure of the Dental Cement
Trauma or Injury
Poor Oral Hygiene
Age of the Restoration
Professional Treatment: Restoring Your Tooth at Infinite Dental Wellness
- Assessment: We will check for any new decay and ensure the tooth is structurally sound.
- Cleaning: The area will be numbed, and any remaining old filling material and new decay will be removed. The tooth is then thoroughly cleaned.
- New Filling: A new filling will be placed. We often use tooth-colored composite resin, which is bonded directly to the tooth for a strong and aesthetic result. If the filling was very large, the tooth might now be too weak for another filling. In this case, a more protective restoration like an onlay or a full dental crown may be recommended.
- Re-cementing the Original Crown: If the crown still fits well, the underlying tooth is healthy, and your bite is correct, we may be able to simply re-cement it. This is the quickest and most cost-effective solution. We will thoroughly clean the tooth and the inside of the crown before bonding it back into place with permanent dental cement.
- Fabricating a New Crown: A new crown will be necessary if: The old crown is damaged or no longer fits properly.
- There is new decay on the underlying tooth that needs to be removed, changing its shape.
- The tooth itself has fractured. The process involves preparing the tooth, taking a new impression, and creating a new custom crown that fits perfectly and restores your bite.