Family Dentistry - Charlotte
2024 Lansing Road
Charlotte, MI 48813
Ph: 517-543-5230 Fax: 517-543-5011

 

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By contactus
January 22, 2012
Category: Uncategorized
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As I mentioned on our facebook page, I had a patient come to my office last week with a crown off. The crown loosened around Thanksgiving, but she held off from coming into the office due to finances and the hope that she would be getting dental insurance in the new year. First, I want to say that most crowns never loosen or come off. But, there are reasons why crowns come off. From my opinion and years of experience, I see crowns loosen for a couple of reasons. 1) There is decay beneath the crown and something as soft as bread pulls the crown off because the foundation or base underneath the crown is now not healthy and has become compromised. 2) An extremely hard, sticky candy was being chewed and it became stuck on the crown, and when the patient opened with resistance, the crown came off. 3) Sometimes, if there was little tooth left to begin with, the crown is relatively short when it is prepared, and this makes a crown's strength a bit less than a full length crown with more tooth structure remaining. 

Crowns gain their strength from two ways: the way the walls of the tooth are tapered/prepared by the dentist and also from the cement/bonding agents used to place the crown on the tooth. So, if there is little length to the walls of the tooth, there is less resistance to keep the crown from being dislodged. Luckily, the cements we use today are very strong and can often make up for short walls or differences in parallelism/taper. 

The point of this blog is to tell you what to do if you happen to be in the same situation as my patient  was last week. If you call our office as soon as your crown loosens or comes off, I recommend seeing you as soon as possible. We can track down the reason of why your crown came off by taking an x-ray to look for decay and by examining your remaining tooth to see if the crown can simply be re-cemented. If there is decay, it is likely that the existing crown will not be able to be re-cemented because we cannot cover up decay and hope it will go away. Decay just does not go away on its own. A new build up filling and crown will likely be needed. (Note: ALWAYS SAVE YOUR CROWN and bring it in to the dentist). 

If, however, there is no decay, and a jolly rancher just happended to catch the crown right and dislodged it cleanly, we often can re-cement the crown back in place. BUT, and that's a big BUT.....if you wait for a couple of months, like my patient did last week, the teeth shift and make it much more difficult to put the crown back on. This tooth, in particular, shifted forward and the crown no longer fit down around the tooth into its previous little compartment. I adjusted the contacts to enable the crown to seat better--after several adjusts--but then the bite (or occlusion as we call it dentally) did not come together as it once did. This led to an extensive adjustment on the crown which weakened the top chewing surface of the crown. Ultimately, I recommended we schedule her back for a new crown in the near future because this one was now so thin from all of the adjusting.  My patient told me if she would have known that this could have happened, she would have come in sooner. I told her I would "blog" about it in hopes of sharing my knowledge with others so they may be able to save some money and know what to do when and if  their crown comes off. 

It is hard to know what to do when something like this happens. But, I hope what you read above helps you understand the importance of acting quickly to avoid pain from underlying decay and to avoid paying more money by waiting longer to correct a problem. Finances are tight for many people right now, and our office understands that you want to get the best care for the least amount of money. By acting quickly and understanding WHY your crown came off,  you can make a choice of what to do once all of the options are presented to you by a dentist....and often this may save you time and money down the road. 

Submitted by Dr. Lisa Knowles

Dr. Knowles has had extensive training in emergency care from re-cementing crowns to re-positioning teeth that were knocked out or displaced from trauma. In the event of a dental emergency, we recommend a full examination for new patients to our practice. This begins with an appointment that includes x-rays, gingival and bone depth charting, oral cancer screening, and a thorough exam. For patients already in our practice, we offer immediate care, diagnosis and treatment. We hope you will not have to utilize our emergency services, but you can feel confident that Dr. Knowles will be there to help when needed. 

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