You bite into something chewy, feel a hard piece rattle loose, and realise part of a tooth is now missing. In most cases this is a filling or a crown that has let go, and while it is unpleasant, it can usually wait a few days for a dental visit. What cannot wait is looking after the tooth that has just lost its cover.
The steps below are about the time between the moment it happens and your appointment: what to keep, what to cover, what to avoid, and which symptoms mean you should be seen sooner.
If it was a crown, keep it
A crown that comes off in one piece is worth saving. Rinse it gently under the tap, dry it, and put it in a small container or zip-lock bag. Bring it to your appointment. If the crown is undamaged and the tooth underneath is still healthy, the dentist can often clean both surfaces and cement the same crown back in place, which is usually quicker and far cheaper than making a new one.
A filling is different. Once it falls out it cannot be reused, so there is nothing to keep. The tooth simply needs to be protected until it can be refilled.
Pharmacy cement is a stopgap, household glue is not
Most pharmacies sell temporary dental cement or temporary filling material. Used as the packet describes, it can cover a hole left by a filling, smooth over a sharp edge, or hold a crown on for a short time. It is designed to wear away, so think of it as a few days of protection, not a repair.
Superglue and other household adhesives are not made for use in the mouth. They can irritate the gum, seal bacteria under the crown, seat the crown at the wrong angle, and make it much harder for the dentist to clean off and re-cement properly. If a crown will not sit comfortably with temporary cement, leave it out and cover the tooth instead.
Looking after the exposed tooth at home
The inner layer of a tooth, the dentine, is more sensitive and more prone to decay than the enamel or restoration that was covering it. A few habits help in the meantime:
- Chew on the other side and avoid hard, sticky or very chewy foods.
- Keep brushing twice a day with fluoride toothpaste, gently around the gap, so food and plaque do not sit in it.
- Keep sugary food and drinks to mealtimes.
- Avoid very hot and very cold food and drink if the tooth reacts to them.
For sensitivity, a toothpaste for sensitive teeth dabbed onto the exposed area with a clean finger and left there can help, which is also the self-care advice given by NHS 111 Wales. Over-the-counter pain relief, taken as directed on the packet, is reasonable if the tooth aches. Clove oil on a cotton bud may numb a tooth briefly, but it can irritate the gum, so use very little and keep it off the soft tissue.
Leaving it for weeks usually makes the repair bigger
A tooth without its filling or crown is weaker than it looks. Decay can progress in the exposed dentine, and a thin wall of tooth can crack under normal chewing. A gap that could have been refilled can become a tooth that needs a crown, a root canal or an extraction. Even if nothing hurts, it is sensible to book in within days rather than weeks.
Pain, swelling or fever mean you should be seen sooner
Call a dentist promptly if you notice:
- severe, throbbing or worsening pain, especially pain that keeps you awake
- swelling of the gum, face or jaw
- a fever, a bad taste or pus near the tooth
- a sharp broken edge that keeps cutting your tongue or cheek
These can point to an infection or a deeper fracture. Facial swelling that spreads, or swelling that affects your breathing or swallowing, needs urgent medical care.
What the dentist works out at the appointment
The visit starts with a look at the tooth and usually an X-ray. The main questions are whether there is new decay under the old restoration, whether the tooth has cracked, and whether the nerve is healthy. The answer decides the fix:
- a new filling, if the tooth is sound and the gap is a manageable size
- re-cementing the existing crown, if both the crown and the tooth underneath are in good shape
- a new crown, an inlay or onlay, if too much tooth is missing for a filling to hold
- root canal treatment first, if decay or a crack has reached the nerve
Crowns often come loose because the cement has broken down over many years, decay has formed at the edge, or a sticky food has pulled on an already weak seal. The dentist will look for the cause so the same thing is less likely to happen again. Our guides to crown materials and white and silver fillings explain the options in more detail.
On cost, re-cementing a crown that is still in good condition is usually a much smaller fee than replacing it. As a typical market range only, a new crown in Australia commonly costs about $1,500 to $2,500. That is a general guide, not a Lumi fee or a quote. For our current offers see the current deals page, or book a general dental appointment and you will usually receive a written treatment plan, often by email.
Common questions
Can I push my crown back on without cement?
It may sit there briefly, but it can easily be swallowed or inhaled, especially while sleeping. Use pharmacy temporary cement, or keep the crown safely in a container until your appointment.
Does re-cementing a crown hurt?
Usually not. If the tooth underneath is healthy, it is often a short appointment, and many people need no anaesthetic for it.
I swallowed the crown. What now?
A small crown that has been swallowed usually passes without harm, but let your dentist know. If you have coughing, wheezing or trouble breathing afterwards, it may have been inhaled, and you should seek medical care straight away.
If a filling or crown has come out, the team at Lumi Dental in Melrose Park can check the tooth, find out why it happened and talk you through the options. Book a visit or get in touch and we will find a time.
