What To Do When A Crown Comes Off

As we all know, crowns only come off when your dentist is closed or out of town! I’m going to show you what you should do and the best possible ways to recement your crown until you are able to get back into your dentist.

First things first… Don’t just stick that crown back on just yet! We need to do a little detective work to figure out what the correct thing to do is. Is this a temporary or a permanent crown? If it’s a temporary crown, you definitely want to get it back on as soon as possible. Without the temporary crown, your tooth can shift slightly and cause the permanent crown to not fit correctly. Skip the rest of this article and head right down to the section on “recementing the crown”.

**WARNING** A loose crown is easily swallowed. This won’t hurt you but it costs a lot more to have a new crown made than to have your old one recemented. If you’re not able to get it stable with my recommendations, don’t leave it in place. Leave it off until you’re able to get to the dentist.

Detective Work for Permanent Crowns

If it is a permanent crown you’re going to want to take a look at both the crown and the tooth. First take a look at the crown. Is it hollow inside? There shouldn’t be any filling material inside of it, except possibly a thin layer of cement (usually very white). If there are any bits of tooth, chunks of filling material, or a metal/fiber dental post, we’re in trouble. You’re either going to need a new crown or the tooth may not be able to be saved. You can try putting it back on but it likely isn’t going to stay. See your dentist as soon as possible.

 Here is an example of a porcelain fused to metal bridge. The dark grey area is the metal which has porcelain covered over it. Most older crowns (more than 10 years old) will look like this. Try and remove any additional cement that is stuck inside the crown before putting it back on.

  Many newer crowns are made entirely of porcelain materials. This is what they usually look like. You’ll want to be more careful with these types of crowns as some of them can be very brittle. Carefully try to remove any additional cement that is inside the crown before trying it back on.

Now let’s look at the tooth if you can. Again the tooth should be relatively clean, or have a thin layer of cement (usually white) all over it. If the tooth is obviously decayed (large hole or a significant amount of soft brown tooth structure) you can try putting the crown back on but it most likely won’t stay. This is another situation in which you should see your dentist as soon as possible.

If the crown and teeth both look good to you, you’ve got much better chance of being able to keep the crown on until you can see the dentist.

Temporarily Recementing Your Crown

**Read / watch all the instructions! Getting it to stay on is going to be hard enough if you do it all right and much much harder if you don’t!**

For the quick version, check out my video on how to do it. If you need more detail, check out all my information below the video…

There are multiple options for temporarily recementing your crown until you can see the dentist. Before you recement it, you’re going to want to try and clean off your crown and tooth as best you can. If any cement is still in place try and flake or peel it off. You’re going to struggle to get it back in place if you all the cement is still in place. If the tooth hasn’t had a root canal, it is likely going to be somewhat sensitive when you are cleaning it. This pain should only occur when you touch the tooth, breathe air on it, drink liquids, etc. If it is hurting all on it’s own constantly or is severe pain, you’ve likely got a more serious problem than just needing the crown recemented.

Practice placing the crown back in the right place. When you bite down with it in place, it should feel like your normal bite. If your bite feels “high” the crown likely isn’t all the way down or in the right place. Once you feel comfortable putting it back in, its time to find a temporary material to “recement” the crown with.

There are a couple of options for materials you can use. They have varying effectiveness and none will work nearly as well as the material your dentist will use. Let’s take a look at what you can use and how effective each one is…

• Temparin or a similar material sold in drugstores for re-cementing crowns
• Fixodent denture adhesive
• Toothpaste
• Corn starch or flour and water mixture.

I did some borderline scientific testing to see how effective each material was. I was actually kind of surprised by the results. This is why we test things!

Here is my testing set-up. The tooth model is in the middle attached by orthodontic elastics to metal poles on either side. The different adhesives were placed inside the crown, the crown was placed on the model, the material was let to set up for 5 minutes, and then I pulled the crown straight upwards slowly to remove it (it is usually vertical forces that cause a crown to come off all the way… lateral forces mostly work to break the seal of the cement). The elastics provided more and more force the further up I pulled the crown. The graphite marked on the paper how far I was able to pull up the crown before it came off.

Now this is what your tooth will generally look like after it has been prepared for a crown. The crown will fit right down over top of it, and will only fit in one very specific orientation.

Whatever material you use, you’re only going to want to use a thin layer of material. If you put too much in you won’t be able to get the crown to go down all the way. This is exactly how much I like to use.

I seated the crown all the way onto the model and some excess squeezed out of the sides (important). I then waited 5 minutes for the material to set up before testing.

Moment of Truth

I took each individual test and marked them on one single piece of paper for comparison. As you can see, the Temp-bond used by your dentist wins by a long margin. The best at home product you can use though is Temparin. If you do decide to use Temparin make sure and read below for specific instructions on using it or it won’t work as well! The instructions on the kit will mess you up if you follow them directly. Bringing up second place were toothpaste and fixodent. Last was the corn starch or flour and water mix (which performed much more poorly than I expected).

Let’s take a look a the individual materials I used. The first I tested was the typical temp cement that dentists use. Temp-Bond. As expected it provided very good retention.

Here is corn starch and water. Notice how it is soft and slightly runny but still mostly holds it’s shape. Definitely not great retention but could work in pinch if you’ve got nothing else.

Fixodent. Now this is normally used to keep dentures in place but again can work in a pinch. The big thing to keep in mind with fixodent is that you’ll need to bleed the tube first if it is new. The first little bit that comes out is really watery and won’t work as well. Fixodent worked much better than the corn starch mixture.

Toothpaste. I used Colgate Total but you can use pretty much anything you have on hand. It is the perfect consistency so you just have to put some in the crown and put it on. It had almost identical retention to the Fixodent.

Now our winner for best at home product! Temparin. It comes out of the tube looking like a piece of chalk. The directions say to place a little in the crown and push it down on the tooth. The material as it comes is WAY too hard to do this with! You will never get the crown to go all the way down. Trust me, I tried many times. I’m pretty sure an elephant could step on it and it still wouldn’t go all the way down. Take a small piece of it and mix it with some water until it is a similar consistency to toothpaste… a soft paste that holds it’s shape. It will work well for you like this. As an added benefit Temparin has some ingredients that will help soothe your tooth and reduce sensitivity.

So to recap. Try the crown in to make sure it goes all the way down. Dry the tooth and the crown. Get your adhesive (use the most retentive material you can get your hands on) and place it in the crown. Put the crown on the tooth and bite down gently to make sure the crown goes all the way down. Once you’ve got the crown in place, clean up the material that squeezed out the sides and you’re done. Take it really easy on the tooth and avoid anything sticky or chewy until you see your dentist.