Dental Crown is a tooth shaped artificial structure that is placed on the top of reduced tooth in order the restore the original shape, size and strength of the tooth. Depending upon the necessity dental crowns can be of various types:
All Metal Crowns: These crowns are made of metal and are generally preferred for posterior most teeth. They can withstand high masticatory forces. The major drawback of metal crowns is that they can’t be used for anterior teeth.
Porcelain fused to metal: As the name suggests, these crowns are a combinations of porcelain and metal. They are not as strong as all metal crowns and thus can undergo chipping or breaking off. These types of crowns can be used for both anterior and posterior teeth.
All Resin crowns: They have very less strength and are thus more prone to wear and tear and fractures.
All Ceramic Crowns: These crowns camouflage natural tooth and thus can be used in patients requiring crowns for anterior teeth or patients with metal allergies. Their drawback lies in their low strength and due to this only they are not the first choice of treatment for posterior teeth.
Under the following conditions we require a dental crown:
Grossly carious tooth: In case of grossly carious tooth that has undergone filling, the tooth requires a crown. The main reason is that due to excess loss of tooth structure, there are chances of filling to get dislodged and thus doctors recommend crown under such conditions.
Cracked Tooth: Sometimes cracked tooth is also advised to undergo capping in order to prevent further infection.
During prosthodontic purpose: In case of dental bridges, the healthy tooth can be carved and thus can be given a bridge.
Tooth discoloration: In case of tooth discoloration also crowning is done. All Ceramic crowns are preferred under such conditions.
Dental Implants: To cover dental implants, crowns can be given.
So, these are the etiological factors when we require dental crowns but the game doesn’t ends here. Patient’s need to take special care of their crowns others wise there can be a failure which may lead to crown dislodgement.
Here are the reasons when crown can get dislodged from the oral cavity.
Poorly Fitting Crowns
The main reason of loose fitting crowns is poor restoration work and due to this the chances of crown dislodgement increases many folds.
Carious decay underneath the tooth
When the caries hasn’t been removed effectively and properly by the dentist and the crown in fitted above it. Due to this the tooth continues to decay thereby making crown lose and thus dislodging it. Under such conditions, the dentist should be informed about the thing and the re-treatment should be started immediately.
Not enough tooth structure to hold upon
Crown requires sufficient amount of tooth structure, so that it can snuggly fit into it but if the tooth structure is not enough then it can cause crown to come out easily of the oral cavity.
When the crown isn’t fitted properly and there is micro leakage occurring. Due to this the external moisture contaminates the cementing material that bonds tooth structure with the crown and thus leads to crown dislodgement.
Getting the crown made from a cheap lab to save few bucks can be a major cause behind crown dislodgement. These labs don’t usually look into the details like recommended crown tooth interface of 20 to 200 microns etc. So, either the crowns have over bite or under bite. Due to these reasons, crowns don’t fit into the oral cavity and comes out.
Last but not the least, trauma like fall from the floor, got hit on the crown etc. can be a reason behind crown loss.
Inform the dentist: The first thing to do is to inform your dentist regarding the dislodgement of the crown. Schedule an appointment with him as soon as possible.
Examine the crown: If the crown has come out then examine it carefully to see if the tooth structure is also attached to it or not. If the tooth structure or part of it is attached to the crown then you need to schedule an emergency dental visit as it can’t be reattached using a temporary cementing material.
Seat the crown using temporary cement: If the crown doesn’t have any tooth structure attached to it then visit any chemist shop and get the temporary cementing material. You can use that to re-attach the crown to the tooth surface.
Take the crown carefully and clean it using anti-bacterial wash and let it dry. Also clean the tooth using a cotton swab and isolate it using cotton. After the crown has dried put a cementing material carefully into it (fill half of the crown). Then insert the crown carefully into the tooth and let it seat properly. After this, bite on a gauge piece gently for at least two minutes. Then floss the area in downward direction.
NOTE: This is just a temporary procedure. You need to visit a dentist to get the crown permanently fixed.
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