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My Crown Fell Off. Can You Glue It Back On?

This is such a common question in my office. Every single week, I see patients who present themselves with a crown in their hand…actually, it usually in a little plastic bag… and ask me our lead question for this week. I never know the answer until I examine the patient and possible take an x-ray. My computer repair person has taught me that when something unexpected happens on a computer to ask, “what has changed recently?” The same applies to our unglued crown. Have we started a new diet? Are we under stress and clenching our teeth? Did we just have teeth extracted which resulted in a changed eating habit? The questions can go on and on. I am trying to determine the reason for the loosening of the crown.

Age of the crown is also a factor. The older the crown, the greater the likelihood that the cement started to weaken. If this is all there is, then placing new cement or dental glue will allow me to put the crown back in. The tooth needs to be examined and in the case of an old crown to see if decay is present on the tooth where the cement weakened. I want to be very clear about the previous point. Crowns can not decay, only teeth can decay. So if the underlying tooth gets a cavity, then the existing crown will no longer fit and falls off. If this is the case, I can’t just glue the crown back on. A new crown is needed to cover and aid in protecting the tooth in that area where the decay was presetnt. This decay caused leakage under the crown and the ultimate loosening of the crown.

I just saw a patient last week who asked me to replace a lost crown. She told me that when she tries to put it back in it does not stay. After examining the crown, I saw immediately that the tooth has actually fractured inside the crown. This was due to no back teeth and heavy chewing in the front of her mouth, where her crown was So much pressure was brought to bear on her tooth that it broke and of course the crown then fell out. This is why, there was no way to glue that crown back in the mouth because there was nothing left to hold it.

In cases like that, we have a couple of options. One choice is to remove the tooth and replace it with an implant or permanent bridge. Unfortunately, this is sometimes the only option. If there is a little left of the tooth, I can move the gum away from the tooth and give the tooth more structure to serve as a base for the new crown. So, in this case, the actual tooth does not have to be removed, but a new crown is necessary. I can usually provide a provisional crown for the patient so at least they have a repair to function and provide a tooth for them. I have saved many teeth this way. This is an adaptation of an older technique, which many people are not willing to take the time or spend the effort to do this and save the tooth. Extraction is always easier, but not necessarily appropriate. Also the patient is missing a tooth and has no replacement in comparison to saving the tooth. Schools today, don’t really teach this and many doctors are not even aware of the possibility. This is why, when you present me with a crown in your hands, I have to judge all of the possibilities for repair. Determining the cause and the health of the tooth will drive my decision. If all looks good, I just clean the inside of the crown and the tooth, and glue the crown back in. The next time that something breaks loose or comes off, please call me at 440.951.7856. I will do my best to put you back together as simply and as quickly as possible.

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