A filling or crown that comes loose while you are eating is often gone before you realise it, and most of the time it has simply been swallowed. A small piece of filling or tooth usually travels through the gut and out without any trouble. Two things matter more: making sure it went down the food pipe and not the windpipe, and getting the damaged tooth covered again.
First, check your breathing
The one situation that needs urgent help is an object that has gone into the airway instead of the stomach. Signs that something may have been inhaled include:
- a coughing or choking fit at the moment it happened, or coughing that keeps going
- wheezing or noisy breathing
- shortness of breath or chest pain
- a change in your voice
If anyone is struggling to breathe, call 000. If breathing settles but you had a coughing fit when the piece disappeared, see a doctor or go to an emergency department the same day. An inhaled object does not always cause dramatic symptoms straight away, and adults in particular may have mild symptoms or none at first. A narrative review of foreign body aspiration in dental clinics (Huh, Journal of Dental Anesthesia and Pain Medicine, 2022) notes that X-rays or a CT scan are used to find the object and that removal often needs a bronchoscopy, a camera passed into the airway. Left untreated, an inhaled object can lead to complications such as infection.
If you can breathe, talk and swallow normally and there was no coughing, the piece most likely went into your stomach. See a doctor if a cough, wheeze or chest discomfort develops over the following days.
A swallowed filling usually takes care of itself
Fillings, crowns and fragments of tooth are small and mostly smooth, and dental materials are made to sit in the mouth safely. Once swallowed, small blunt pieces like these normally pass naturally in a bowel motion. There is no need to make yourself vomit, take laxatives or search for the piece, and you can eat and drink as usual.
See a doctor promptly if, over the next few days, you notice:
- stomach pain that is getting worse or will not settle
- vomiting
- blood in vomit or in a bowel motion, or black bowel motions
- pain or difficulty when swallowing, or a feeling that something is stuck in your throat or chest
Larger or sharp-edged items, such as a dental bridge or a partial denture with metal clasps, are a different matter. If one of those has been swallowed, contact a doctor straight away rather than waiting for symptoms.
The tooth left behind is the real job
With the swallowed piece out of the way, attention turns to the tooth it came from. A tooth that has lost a filling or a chunk of itself has a hole or sharp edge where food can pack in. The exposed dentine underneath is softer than enamel and can be sensitive to cold, sweet or biting. If the gap is left open for weeks, decay can develop in it and the remaining walls of the tooth can crack.
Book in with your dentist within a few days, sooner if the tooth is painful. In the meantime:
- chew on the other side
- keep brushing the area gently so food does not sit in the hole
- a temporary filling material from a pharmacy can cover a sharp edge for a short time, but it is not a repair
- if a whole crown has come off and you still have it, keep it in a container and bring it with you
Our guides to a broken filling and a loose adult tooth cover related problems in more detail.
What the dentist will look at
The dentist or OHT will first ask what happened, including whether there was any coughing, so that an inhaled piece is not missed. They will then examine the tooth to see how much is left, whether there is decay under where the filling was, and whether the remaining tooth is cracked. An X-ray may be taken.
Small losses can usually be repaired with a new filling. If a large part of the tooth has broken away, a crown or onlay may be suggested to hold it together, and if the nerve has been affected, other treatment may be needed. The dentist will explain the options and check your bite afterwards so the repair does not feel high.
When it is a whole tooth
Swallowing an entire tooth usually happens after a knock to the mouth. A swallowed tooth cannot be put back, so the focus moves to checking the socket, the neighbouring teeth and the jaw for other injuries. If a tooth has just been knocked out and you still have it, follow the steps in our guide to knocked-out tooth first aid and see a dentist immediately, because a replanted adult tooth has the best chance when it goes back in quickly.
Common questions
My child swallowed a baby tooth. Is that a problem?
Swallowing a loose baby tooth is common and the tooth normally passes without trouble. Watch for any coughing or breathing difficulty, and see a doctor if either occurs.
Can I wait for my next check-up?
It is better not to. A few days is fine if you are comfortable, but an open tooth can decay or crack if it is left for weeks.
If you have lost a filling or part of a tooth, Lumi Dental offers emergency appointments, so the tooth can be checked and repaired. See our general dentistry page to arrange a visit, or check our current offers.
This article is general information and not a substitute for an individual dental assessment. If you have any breathing difficulty, seek emergency medical care immediately.
