It can be both painful and unsettling to have a crown come loose or fall out due to age, but in most cases, it can be successfully replaced provided that it is not damaged in the removal process.
Because the underlying tooth has to be shaped to allow the crown to fit over it precisely, a loose crown that allows the tooth to get eroded by acid and bacteria in the mouth may result in the tooth dentin becoming exposed and making your tooth sensitive to hot and cold drinks. This could constitute a dental emergency depending on the severity of the pain.
So it is important that you visit your dentist as soon as your crown feels loose or falls off to determine whether it can be replaced.
But why would the dental crown fall off?
1. Tooth decay
The crown itself is not prone to tooth decay, but the natural tooth underneath is. The decay usually forms near the gumline at the point where the crown meets the natural tooth. Depending on the severity of the decay, your dentist may choose to save the crown or replace it. Still, the decay must be removed and the resulting cavity filled. If the crown is in good condition, it can be replaced on the tooth, or a new crown made.
2. Consumed too many sticky items
Sticky foods are generally harmful to restored or replaced teeth. Eating too many chewy foods such as toffees can cause the crown to loosen gradually until it eventually falls off. Fortunately, the damage can be easily fixed by simply sticking the crown back on the tooth with cement.
3. Weakened cement bonding the crown to the tooth
The crown is made from hard materials that can tolerate years of biting and chewing forces. However, the cement holding it to your teeth is a weak point that can cause the crown to come loose over time, and ultimately fall off. This problem can be fixed by cementing the crown back onto the tooth.
4. Weakened natural tooth structure
Crowns are typically placed on strong, healthy teeth. But preparing a tooth for the crown destroys a portion of the healthy tooth structure. If the capped tooth is severely worn down, such that there isn’t enough space for the crown to be properly cemented, then the crown won’t last as long as it should. This is usually a problem with the molars.
5. Breakage of the crown due to trauma or heavy grinding/clenching
As strong as the crown material may be, it is also susceptible to excessive forces that can break it and cause it fall off the tooth. Usually, the damage starts with a small crack that gradually extends until the crown weakens enough and falls off.
Frequently Asked Questions
Who do crowns need to be replaced?
Some of the circumstances that may require the replacement of old crowns include:
- Cracked or broken crown
- Discolored crown
- Decay forming on the margins of the crown
How does a dentist remove a crown to replace it?
If you need a crown replacement, then the first step is removing the old crown. Unless it fell off on its own, the old crown can only be removed by cutting it into sections and isolating the pieces from your natural tooth, which means that it cannot be reused after removal. Dental adhesive can also be used to weaken the dental cement used to bond the crown to the tooth. This procedure is carried out under local anesthesia, with your tooth and gum tissue numbed, so you won’t experience any pain.
After crown removal, the remaining tooth structure will be disinfected, prepared and reshaped before making an impression of the tooth in order to obtain the tooth’s new dimensions for fabricating the new crown. The crown is typically fabricated in an off-site dental lab, so a temporary acrylic crown will be fitted in the meantime. The permanent crown will be fitted in another appointment, meaning that you need at least 2 sessions for crown replacement.
When can a crown not be replaced?
It is uncommon for a crown to not be replaced. But if an excessive amount of tooth structure was removed in the preparation phase, such that the remaining tooth cannot support a tooth cap, then your dentist may opt for other ways to build up the tooth, perhaps by applying layers of composite resin material and hardening it gradually to develop enough tooth structure. Afterwards, a crown may be fitted. In some cases, your dentist may need to consider other dental treatments to restore your smile.
Can a permanent crown be removed?
A temporary crown can be easily removed with mild adhesive to allow placement of a permanent crown. But if the permanent crown is compromised due to chipping, breakage, decay, or any other situation that necessitates crown replacement, it can still be removed using a strong dental adhesive to weaken the cement used to bond the crown to the tooth.
How much does it cost to replace a crown?
The cost of crown replacement varies depending on your location and reason for replacement, but it should be around $1,000. This cost can be fully or partially covered by your dental plan if the replacement happens at least 5-8 years from the date of initial crown placement.
How to reduce the risk of crown replacement
To avoid problems with either the crown or the underlying tooth that may lead to dental crown replacement, it is important that you take good care of your teeth, restorations, and/or replacement. Habits such as chewing on ice, biting your nails, opening bottles with your teeth, and grinding or clenching your teeth can also cause the crown to come loose or fall off. So, avoid such behaviours and talk to your dentist about wearing a night guard.
Proper at-home dental care and regular check-ups can help to identify any problems with your teeth or restorations before they become emergencies. For professional advice on how to care for your dental crowns or other restorations, please contact our office to schedule a meeting with the dentist.
