What to Do If Your Permanent Crown or Bridge Comes Off

It’s not common, but not unheard of, for a permanent crown and/or bridge to come off. Usually it’s not long after the procedure, before the cement has fully set.

A bridge is actually two crowns with a “tooth” attached in between. And either the crown or the “tooth” can come loose.

Why would it come off?

  • When the cement used wasn’t isolated properly, like with saliva getting into the cement somehow.
  • If the person with the crown clenches or grinds his/her teeth. This causes the teeth to flex a lot, and the cement gets loose.
  • If the bite isn’t set correctly. With this, the cement will break down because of repeated hitting of the cement seal.
  • If good eating habits aren’t followed, like if, after getting the permanent crown in, you go home and eat the wrong thing. Maybe chew on ice, or have sticky chocolate candy, or peanut butter crackers. Or even worse yet, bubblegum!
  • Lack of adequate retention for the crown and/or bridge. In other words there’s not enough original tooth above the gum line to hold onto. No less than 2 millimeters of tooth structure is needed above the gum line, all the way around the tooth. And it must be free of decay—which will compromise the seal. And lacking good oral hygiene, decay can get started and progress underneath the crown.

Crown lengthening, a form of gum treatment, can create adequate tooth structure for the crown. Another treatment that works well is orthodontic treatment. It also creates more tooth structure

Very rarely, a lack of retention can depend on how the natural teeth are prepared above the gum line. And that, if not done right, will affect how the crown or bridge fits on the natural tooth structure. And if the fit’s not good, it could come off, even though it’s cemented.

What if it DOES come off?

You’ll need to act quickly. The longer the crown and/or bridge is out, the more chance your surrounding teeth will shift—as well as the teeth they chew against. You don’t want that to happen!

Start by storing your fallen out dental work safely. It oftentimes can be cleaned up and re-cemented in place. But you could have a retention issue to be addressed. Or, on the off chance that the crown/bridge or the underlying natural teeth have been damaged in some way, you may have to undergo a completely new dental procedure to have it done all over again.

But in any case, get to your dentist as soon as you can!