My Crown or Filling Fell Out. What Should I Do?

A crown or a filling just came out, maybe while you were eating, maybe while you’re away from home. It usually looks worse than it is. Here’s what to do right now, why it shouldn’t wait long, and what decides whether the same crown can go back on.

If your crown came off

• Keep the crown. Put it in a small plastic bag so it doesn’t get lost. It doesn’t need milk or water.
• If it goes back on easily, you can put it back. Temporary cement from the dental aisle of a pharmacy will hold it for a few days. Clean the inside of the crown first, and check that it seats all the way down and your bite feels normal.
• If it doesn’t go back on easily, leave it off. Don’t force it, and don’t try to bite it into place.
• Don’t use superglue. It isn’t safe in your mouth, it can damage the tooth underneath, and it often turns a quick re-cement into a much bigger repair.
• Chew on the other side until it’s been seen.

Why it shouldn’t wait

A crown is made to fit one tooth in one position. Once it’s off, the teeth around it can start to move into the space, and the tooth it covered can move too. Wait too long and the crown won’t fit anymore, even if nothing else is wrong with it. Then a quick re-cement becomes a new crown.

The tooth underneath was shaped to make room for the crown, so it’s also more exposed than it was. If it doesn’t hurt, that doesn’t mean it can wait weeks. Call us soon.

Can the same crown go back on?

Often, yes. If the tooth underneath is sound and the crown still fits, we can usually clean it up and cement the same crown back on. That costs a lot less than a new one.

First we look at the tooth and decide whether it needs an X-ray. A crown usually comes off for a reason, and we want to know what it is before we put it back. If it came off because of decay at the edge or a broken tooth underneath, we’ll show you what’s going on and talk through what the tooth needs. More on crowns.

When part of the tooth came out with it

Sometimes there’s a piece of tooth stuck inside the crown. Whether the tooth can still be saved depends on how much tooth is left in your mouth. If there’s enough to build on, it can often be rebuilt, usually with a root canal and a post. If the tooth can be saved, it often needs a new crown, because the old one was made to fit the tooth before it broke. When there isn’t much left, it’s a real discussion: is saving it realistic, or is an implant the better option? My tooth broke: what to do, and how it gets fixed. Root canal or pull it? How to decide.

If a filling fell out

Keep the area clean, chew on the other side, and get it seen soon. A filling that falls out leaves a hole where food and bacteria collect, and the tooth around it is usually more sensitive than it was.

A filling that comes out is often a sign the tooth needs more than a new filling. If the new filling would take up more than about half of the tooth’s biting surface, a crown or an onlay usually lasts longer. Crown or filling? How we decide.

If it was a temporary crown

A temporary crown is only meant to protect the tooth until the permanent one is ready, so it’s held on with weaker cement on purpose. If yours came off, call the office that made it. Until then, the same advice applies: put it back on if it goes on easily, with temporary cement from a pharmacy, and leave it off if it doesn’t. Don’t leave the tooth uncovered for long, because a permanent crown is made to fit the tooth exactly where it is now.

Visiting Las Vegas?

We often see visitors whose crowns came off while they were here. Call us. You don’t need to be a patient already. We’ll look at the tooth, take an X-ray if it needs one, and tell you whether the crown can go back on. How to reach us, and what to do after hours.

Call 702-734-0776. You don’t need to be a patient already.

General education, and not a substitute for an exam.

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