Dr. Michael Sinkin, D.D.S.
Dr. Sinkin's Blog: The Dental And The Incidental

What to do if your Tooth Cracks or You Lose a Crown

June 30th, 2011 by

Dental mishaps and emergencies happen every day and obviously it is important to contact your dentist immediately if you have sudden severe pain, a swollen face, swollen gums, a loose tooth, or tender gums—as these are signs of an infection or an acute abscess.

But what if it’s a weekend? Or you’re out of town? Or your dentist is unreachable? Has something like this ever happened to you?

Scene l – Pain that Halts you in “Mid-Chew
It’s Saturday night and you’re in a restaurant with friends, or perhaps on a date, when suddenly you bite into something unexpectedly hard (like an olive pit in your salad) and are jolted by a sharp wince of pain that halts you in “mid-chew!” The sensation continues with waves of aftershocks (think about stubbing your bare-footed toe on a block of concrete) until finally the pain retreats and you realize, “My tooth is broken!”

Scene ll – You Lose a Crown or Filling
You’re on vacation with the family and pass an old-fashioned candy store when you spy something you haven’t seen since childhood: Charleston Chews! You can’t resist and buy a bag. With your first bite….oh no! A crown has been pulled off your tooth or a large filling has abandoned your molar from the warmth embrace of gooey chocolate taffy.

What do you do?

5 common dental emergencies and what you can do until you can see a dentist:

1. Chipped Tooth

  • With NO Pain: Chipped teeth often have jagged, sharp edges that love to grab your lip, cheek or tongue. Using an      emory board, gently smooth the rough edges of the tooth.
  • With Sensitivity to Cold, Sweets and Heat: Often when teeth first chip or break, they are very sensitive to touch and temperature. This usually fades over time and frequently applying Sensodyne toothpaste to the affected area can bring relief.

2. Broken Teeth or Lost Fillings
There are numerous products available in the dental aisle of your local pharmacy that can help:

  • Dent Temp: Whether you use the premixed version or the powder and liquid place it in the tooth’s void and pat it with water to harden the material. Bite into it while it’s still soft and scrape away excess material with a toothpick.
  • Dent’s Toothache Gum: Soften the gum in your mouth, and place on the affected tooth. If a pharmacy is no where to be found, a piece of sugarless chewing gum, preferably sweetened with xylitol, can be molded into the sensitive area to protect it. A softened piece of household candle wax can also be hand molded and pressed into place.
  • Sensodyne or Flouridated Toothpaste: Coat your tooth with the toothpaste, and cover the area with softened candle wax or chewing gum.
  • In the case of the broken tooth I mentioned above, if you just broke off a significant portion of your tooth and if the tooth has a large filling, there’s a good chance the filling is secure. If the tooth fragment has broken off completely, the initial pain will often fade and you can continue your meal remembering to avoid cold, sweets and extreme heat. If the tooth breaks and your dangling cusp is being held in by your gum, go to the restroom with your ice water. Place a piece of ice against the gum where the tooth is loose for 30 seconds, being careful not to put the ice directly on the tooth. Your gum will be numb enough that you will be able to gently and painlessly remove the loose broken piece of tooth dangling by a thread (like a baby tooth that’s ready to go). If your gum bleeds a bit, bite on a tissue or paper towel for a few minutes and the bleeding should stop.

3. Dislodged Cap or Crown

  • Clean and dry both your tooth and the cap or crown. Place a dab of Fixodent or Polygrip into the cap or crown and put it in place. Tap your teeth together. If you’re out camping, a loose slurry of flour and water can be used instead. Your cap or crown will only stay in place temporarily, so it is important to see your dentist immediately.

4. Dislodged Porcelain Laminate

  • Try placing the veneer back on your tooth in the proper position. When you’ve got the hang of it, carefully place a DAB of crazy glue inside the dried restoration and push into place. Excess cement can be wiped away with nail polish remover. Remember, just a little dab will do it!

5. Irritated and Tender Gums, Canker Sores and Inflamed Wisdom Teeth

  • Rinse your mouth with Listerine or a warm salt-water rinse by swishing vigorously. Do not gargle. An anesthetic salve like Ambesol can also be applied for quick relief.

Remember, all these solutions are for temporary relief only, so CALL YOUR DENTIST (me!) IMMEDIATELY.

My patients know that I can always be reached by calling 212-685-3040: if the office is closed, listen to the message and you will be given my cell number.

 

DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature.  Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.

 

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DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.

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95 Comments on “What to do if your Tooth Cracks or You Lose a Crown”

  • lynda ellis October 20th, 2012 9:50 am

    my crown has snapped clean off flat top of crown and flat tooth surface no pain no decay on tooth. Could I just have this stuck back

  • Michael Sinkin October 21st, 2012 7:34 am

    I dont think so. Sounds like you fractured your tooth and the crown came off with it. Look inside your crown…Is it hollow or is there tooth. If the latter, you snapped your tooth off. You will most likely need a new crown. If the tooth in your mouth doesn’t hurt, well that could be a good news/bad news situation. I’m glad you don’t have pain but the tooth may have had root canal OR you MAY need it. Dont worry.

  • Matty November 24th, 2012 10:58 pm

    I broke a piece off of my back tooth, and it is a large piece. It is sensitive to cold and is really scaring me. Will my tooth get infected if I can’t see a dentist until Monday?!? I grind my teeth at night, and I’m wondering if this has weakened the tooth?!?

  • Michael Sinkin November 25th, 2012 1:28 pm

    First things first…calm down. You will not get an infection nor will you develop an unremitting toothache. The problem you are describing is very common and while you will need to see your dentist to address your broken tooth, you can wait until after the holiday weekend. More than likely, you cracked off part or all of the inner (tongue side) cusp of one of your molars or bicuspids. The tooth probably already had a large filling which weakened the remaining structure.
    I wouldn’t be surprised if the filling is still in place and the piece that broke off is/was unsupported tooth. The sensitivity that you feel is because the tooth is “alive” and the freshly exposed dentin is naked to the elements. Cold sensitivity, aside from jagged edges, is the most common complaint of a freshly broken tooth.
    Until you see your dentist, place sensodyne toothpaste on the exposed tooth. This will help to reduce the unpleasantries of cold stimulus. Usually the thermal sensitivity dissipates as salivary proteins coat the tooth. You will probably need a crown or an onlay to restore your tooth properly. In the meantime, enjoy the rest of the holiday and what remains of Thanksgiving leftovers.
    By the way, you may want your dentist to evaluate your nocturnal grinding…sounds like you vould benefit from a nightguard.

  • Dorothy December 20th, 2012 5:04 pm

    A couple years ago I had a root canal then 3 of my wisdom teeth were removed. My dentist told me that while taking my wosdom teeth out my second to last top molar cracked and part of my tooth chipped off. I didn’t have the time or money so I never got a crown for it. One day while eating an apple almost half my tooth broke off. Now years later I have to constantly have a toothpick near by because food is always getting stuck in the gap. Today my filling on the cracked tooth started becoming unhardened. I can feel part of my fillings moving around but it won’t fall off. My left side of my nerves are sensitive. However I cannot get to a dentist till after new years because I’m going out of town. I’m worried that the filling may fall out or if I chew on it I will experience more pain. What should I do because I haven’t been to a dentist in a while and will be away for almost 2 weeks?

  • Michael Sinkin December 21st, 2012 8:07 am

    Your story is not uncommon. Unfortunately it sounds like you have put your tooth and comfort in jeopardy by procrastinating for so long. The most common reason for a tooth that has had root canal to break and even fracture to the point that it must be extracted is not having it properly restored. In your situation, it was having the tooth crowned. Since “root canaled” teeth don’t have a nerve, pain or extreme sensitivity did not drive you to taking care of your molar in a timely manner. Essentially you have a hollow tooth that had broken and the temporary filling is disolving and displaced. Get yee to a dentist asap. If your tooth splits down the root, you will most assuredly lose your tooth and may actually develop a painful abscess. When a patient of mine has limited time and funds, I often make a temporary crown to protect the tooth until a permanent crown can be made. This is a very economical way to preserve the tooth and avoid the dental mishap you now must deal with. Good luck.

  • Nigel February 7th, 2013 3:24 pm

    I have just lost a crown, it’s come off on one piece and left a rough, short stumpy tooth behind. Trouble is in 8 days time I am due to go on a 3 week overland safari through Uganda and Rwanda, the last place I want to be with tooth pain (it doesn’t hurt now). Is it likely a dentist could fix it in a week? Will polygrip hold for 3 weeks? Is it too much of a risk to go?

  • Michael Sinkin February 7th, 2013 4:14 pm

    Hi Nigel, Your dental problem does not appear to be catastrophic It sounds like your crown became “unglued”. Get ye to a dentist asap to have it recemented. If you wait too long your crown may not fit properly because teeth can move and your gum can grow over your tooth. Worse case scenario…glue it yourself. But! Be aware you will have to keep reapplying the Polygrip and brush the stump when the crown is out. Play it safe-see a dentist and have a good trip. – Dr. Sinkin

  • Nigel February 7th, 2013 5:05 pm

    Calming advice given so quickly is hugely appreciated, many thanks.

  • Elizabeth February 8th, 2013 1:31 pm

    I just want to thank you for your tips above. I cracked my tooth but the filling is still intact and the cracked piece is still intact. I will dry den Temp until i can get to my dentist on Tuesday. THANK YOU SO MUCH!!!!!!!!!!! I have extremem dental phobia and was having a panic attack, but now i know there is something I can do until my appointment. Thank you again! I wish I lived close so I could be a patient

  • Michael Sinkin February 10th, 2013 8:31 am

    Hi Elizabeth, Glad I could be helpful. Let me know when you move to NYC…We’ll leave the light on.

  • Skip March 1st, 2013 2:06 am

    Hi, about six months ago I had a root canal and a crown placed on the molar. Well tonight ,while indulging in a box of Whoppers, I felt a strange crunching and much to my surprise my crown broke in half partially exposing the tooth underneath. It does not hurt so I am wondering if its okay if I can’t make it to the dentist for a few days.

    Thanks!

  • Michael Sinkin March 1st, 2013 7:55 am

    Dear Skip,
    No need to panic. Until you can get to your dentist, favor the other side while chewing and be mindful that the other half of your crown that is still in place could be dislodged. Don’t want to swallow or aspirate a wayward piece of porcelain. Brush the tooth as normal but stay away from the floss.
    Nothing like a dental mishap to ruin the experience of malted milk balls which happen to be a personal favorite of mine. The good news is that your “root canaled” molar was protected by the crown. Were it not, you might have seriously damaged your tooth. Your crown may had an internal defect that created a point of weakness. Whoppers are not that hard. I would encourage you to ask your dentist to consider placing a porcelain fused to gold crown on your other molar. It has all of the beauty porcelain offers with the underlying strength of gold…no metal will show. A word of caution….no frozen milky ways. Good luck. – Michael Sinkin

  • Skip March 1st, 2013 8:51 pm

    Thanks for the information Dr. Sinkin, you relieved some of my concerns. My tooth feels fine, a little sensitive, but I have an appointment to see my dentist on Monday. I was honestly a bit surprised that this happened given that the crown is relatively new. It also was a bit strange because it came apart in pieces and everything I read on the internet seems to be about a whole crown following out. Oh well..thanks again!

  • Kristi March 2nd, 2013 8:03 am

    I swallowed by temporary crown last night at dinner. I don’t know how it happened but it did. It’s Saturday morning and I have nothing on the tooth site. My dentist office does not have an emergency line and I don’t know if today is one of their Saturday office days. Should I out anything on the tooth in place of the crown until Monday when I can get my permanent crown put on? My crown is in, I was supposed to have it put on next week. Thanks

  • Michael Sinkin March 2nd, 2013 11:54 am

    Bummer. If you are adventurous, you can look for the temporary crown when it passes (I know it sounds gross) but if it were a permant crown I would encourage you to look for two reasons First, a crown is expensive to just flush away. Second, you want to make sure it passes; people with conditions like diverticulitis are at risk for a serious problem if the crown gets lodged in there intestine.
    If you do find it, clean it thoroughly with soap and water and rubbing alcohol and place it back on your tooth with a denture adhesive like Fixodent or Polygrip.
    Short of that, be careful not to chew on that side. If the tooth did not have root canal, it will probably be sensitive. Avoid very cold, hot, sweet or acidic foods. Favor chewing on the other side and keep your tooth clean. Brush with warm water and use a desensitizing toothpaste like Sensodyne.
    Monday is not that far away so yu shouldn’t have any problems with the new crown fitting. Occasionally the gum will overgrow around the base of the prepared tooth so your dentist may have to get you numb to properly seat the crown. I like to place the permanent crown in with temporary cement if the tooth as been uncovered for any length of time to ensure long term comfort.
    Enjoy your weekend and let me know how you make out. -Michael Sinkin

  • Chris March 25th, 2013 8:09 pm

    I have what I believe is composite over my front 2 teeth. A piece came off when I was chewing. It fits perfectly back in place. I looked for dental cement in my local pharmacies but they don’t carry it. How can I reattach the piece of composite back to my tooth either permanitily or temporarily until I see my dentist? Would things like poligrip work?

  • Michael Sinkin March 26th, 2013 6:14 am

    What I am about to suggest is what I would do to my own tooth as a temporary measure only. If you are dexterous and very, very careful, I would carefully place a small dab of “crazy glue” on the dislodged piece of composite and precisely place it from whence it came. Practice placing it before applying the glue (tiny amount). Use acetone (nail polish remover) on a gauze pad to wipe off excess glue. Be careful not to cement your finger to your tooth! See your dentist as soon as you can get an appointment.

  • Kathy June 17th, 2013 4:45 pm

    My dentist is out of town until June 25th. I have an appointment on the 26th to have a permanent crown put on an upper tooth. My problem is the temporary crown fell out 2 days ago so I used over the counter dental stuff to glue the crown back on. Yesterday while eating the crown broke in two.
    With my dentist gone, what should I do?

  • Michael Sinkin June 18th, 2013 12:33 pm

    Dear Kathy,
    Bummer. If you can, try to see a dentist who will be able to make a new temporary crown for you and keep your tooth protected.If you don’t, the gum may overgrow and your tooth may move making the fitting appointment more difficult. If your tooth did not have root canal treatment, I would imagine that it’s quite sensitive. A new temporary would cover it and make you more comfortable. In the mean time, brush it but don’t chew on it. If you can’t find a dentist, be careful not to damage the tooth and give your dentist the heads up on Monday. The new crown might not fit well enough to be placed on your tooth and he’ll need to make a new temporary and take a new impression. I would think your dentist has someone covering his office in case of an emergency such as yours. Call his office. Good luck.

  • Kathy June 18th, 2013 4:30 pm

    The tooth did have a root canal so I am not having sensitivity.
    The molar behind this tooth is also scheduled for a crown. It was my understanding that my next appt was to prepare this second tooth for a crown, give it a temporary then set both crowns at a 3rd appointment (I misstated in my earlier message about when the permanent crown would be seated) I need to be out of town tomorrow so Thurs June 20th would be the soonest I could schedule an appointment. Should I still see another dentist? I do not have insurance and this is all getting expensive.

  • Michael Sinkin June 20th, 2013 10:32 am

    Dear Kathy,
    Based on your update, there is no urgency. Be careful not to chew on your uncovered tooth and brush normally. Your dentist will be able to take care of everything at your scheduled appointment.

  • Kathy June 20th, 2013 12:01 pm

    Thank you Dr. Sinkin! You have put my worries to rest!

  • Dona bennett June 20th, 2013 4:55 pm

    Looks like I have cracked my filling . I was able to make an apt with the Dentist tomorrow at 130pm. The pain seems to have gotten worse, his staff said to tale Advil and use anbesol . Any other suggestions to get through the night?
    thanks
    Dona

  • Michael Sinkin June 21st, 2013 9:12 am

    Dona,
    So sorry I didn’t see this sooner. I wrote a blog about how to get relief fast http://www.michaelsinkindds.com/blog/5-ways-to-get-relief-for-a-toothache/. Hope you got thru the night ok.
    Michael

  • Clare mariott June 25th, 2013 10:26 pm

    I have one of my very front teeth break away the day before yesterday, just the bottom left hand corner of it-so that i can still see the back half of the tooth which looks fine. I am looking at a two week wait to get it repaired, is this going to result in losing the tooth? I am so grateful for you help.

  • Michael Sinkin June 26th, 2013 1:48 pm

    This a one of those situations where it’s hard for me to offer a sound piece of advice without seing your tooth. Several questions come to mind: Did your tooth have previous treatment such as bonding or bonded fillings? Does your tooth have a large cavity which weakened your tooth? Was your tooth healthy previously untreated and you had the misfortune to bite on something unexpectantly hard? I assume that you have no pain or sensitivity. The likelihood is that if you are very careful, your tooth is not at any great risk of being lost-but that doesn’t mean it is secure; especially if the tooth was compromised in some fashion before the piece broke off. What I don’t understand is why your dentist can’t see you sooner. I consider a lost or severely broken front tooth to be a circumstance in which I will make time to evaluate and treat (even if it’s a temporary measure until more definitive care can be done.)
    Call your dentist’s office and if the receptionist can’t accommodate you, ask to speak with the doctor. If you are out of town, find an emergency dentist to assess your condition. Good luck

  • Renee June 29th, 2013 9:05 am

    Add me to the long list of people who wish we were near enough to you Dr. Sinkin to become patients. The alleviation of anxiety and fear, and your calm, informative and compassionate demeanor goes such a long way. Yes, I am one of ‘those’ patients who’s crippling fear has always interfered with maintaining dental appointments with regularity. Leading me to my current problems! There are two. Both molars. Both root canals that had subsequently been crowned, one was temporary, the other permanent. A couple years ago leaving the dentist, newly proud of my ‘work,’ that I had had done, and managed to get through, I bit down, and heard/felt what was a tiny crack. That was the crown of course – at the time, I ignored it, the tooth looked fine, and I turned a blind eye. Of course you know the rest, the crown and entire tooth eventually dislodged/broke off completely when I ate something gooey I shouldn’t have one day. Odd thing is, I can stick it back in that spot and it doesn’t move unless i eat something like your example, a charleston chew on that side. My second problem is another molar on the right side, that had also been root canal’d, it had a temporary crown that I wore down to the quick, and now the tooth is gone except for a jagged edge sticking up. My questions is, I know I need to woman up and head into a dentist soon, but part of my problem is the fear factor and not knowing what they will do in these particular situations I’ve described. Plus, the judgement i worry about too. Can you give me a scenario for possible treatment options?

  • Michael Sinkin June 29th, 2013 8:09 pm

    Dear Renee,
    I am quite moved by your kind words and am sorry for your troubles. I regret that we are not in close enough proximity that I could personally help you. That said, I will try to allay some of your deepest worries by saying that it MIGHT not as dire as you fear (though admittedly, it’s not something you want to have happen.) It is possible that your tooth with the permanent crown may have fractured at or near your gumline in such a way that most of your tooth including its roots are intact. The part of the tooth that was mostly holding your crown broke away . (does your crown have tooth or filling material inside it?) That you can place the crown back makes me think that you might have enough tooth left to either refit it or have a new one made. It doesn’t sound like you had a post placed which may be why the tooth and crown broke away in the first place. It is encouraging that the crown stays in except when challenged by caramel-which you should not be eating!
    The tooth with the temporary crown appears to have decayed to the point where much of your tooth is just “gone.” It is possible that the decay has not compromised your tooth to the point where it can’t be saved and restored with a post/core and a permanent crown (which is what should have been done soon after the root canal was completed.)
    Sight unseen, l really can’t make a diagnosis. But, the sooner you address the situation, the better the chances of saving your molars. My advice….start by making a dental appointment for an evaluation only. Nothing to fear-just an x-ray and conversation. Information can be empowering. Don’t yield to your fears and make the worst case scenario (tooth loss) a self fulfilled prophesy. Get the facts. Take one step at a time. Let me know what you learn.
    And good luck.
    - Michael

  • Renee June 30th, 2013 3:26 am

    Thank you so much Dr Sinkin for such a prompt response! I will definitely do as you suggested and request a consultation first – in these kinds of situations for me personally, knowledge is not only power, but it definitely alleviates fear. Kind of like my being a white knuckle flyer for so many years until I actually learned about turbulence and what keeps the plane in the air, lol. To answer your question, the permanent crown (or maybe it wasn’t so permanent after all, I forget now – but it would have had a post if so, correct?) that I can lift completely out via something gooey, and fits firmly into place otherwise, does not have a post of course, and is filled with the filling material, not tooth. It almost appears as though I may have had some tooth around the perimeter, so she (dentist) put filling material in, and the crack that I heard not too long after leaving the dentist, was probably that thin perimeter bit of tooth that just cracked at the gum line. Then again there’s no broken edge of tooth, it just fits neatly in. Odd. I will definitely make my consultation appt Dr Sinkind, I feel much better already. I’ll keep you posted also! My sincere thanks – talk to you soon!

  • Lyn Anderson July 17th, 2013 10:45 am

    Hi there,
    I have just returned from my dentist after having a filling, having looked I have found that it’s my back crown that has been filled and look’s as if it’s now at a slant and look’s misshapen. Is this normal and can you have a filling in a crown.

  • Michael Sinkin July 17th, 2013 3:22 pm

    To answer your last question in a word-yes. It is possible to have a filling placed on a tooth with a crown. Most commonly a “filling” will be placed in the biting surface of a crown to seal the access opening of a root canal treatment. Sometimes a patient can actually grind through the biting surface of a crown-especially if he or she bruxes at night. It is also possible to develop a cavity where the crown and tooth meet-technically we call that junction the margin of the crown but you can think of it as a seam. Placing a filling there will eliminate the cavity and preserve the crown. What you have described sounds like some sort of repair performed on the crown. Perhaps you broke off a wall of porcelain. In such a situation, bonding could have been performed to “restore” the broken piece. Of course bonding to a molar crown to replace a broken piece cannot anatomically correct (the sloped appearance you describe) because bonding is not strong enough to withstand the forces of chewing. I suggest you call your dentist and ask about your observations and initial reaction upon seeing it. He would know the what and why of what you are seeing.
    Best,
    Dr Sinkin

  • Christine August 11th, 2013 7:25 pm

    Dr. Sinkin-

    Evening. I find myself in a terrible predicament. My boyfriend and I have traveled from Denver, CO to Birmingham, AL for the next 2 days. Once we stopped for a bite, he took a big bite of his burger, only to encounter a piece of rock hard bacon, and either cracked or chipped his tooth (back, right bottom molar). This being the south (on a Sunday), we cannot find any emergency dentists open until tomorrow. We looked for the gum but they had no idea what we were talking about :-/. We have also tried aspirin, Aleve, Orajel, and a lost filling/ loose cap repair kit (has an applicator and some putty that states it would take away the pain).

    What else can we do? His pain is quite severe.

    Thank you for any help

    Christine

  • Michael Sinkin August 12th, 2013 11:21 am

    These things seem to happen at the worst of times. The temporary filling material was your best bet for topical relief of pain. Make sure you cover as much of the broken tooth’s void as possible. If the nerve of the tooth is exposed or irritated, the sedative in the filling may take some time to work. If not, pain medication is your boyfriend’s best option. I don’t particularly like Alleve because of dose restrictions, but it can help. Assuming no allergies, try taking an extra-strength Tylenol….but no alcohol. You can try warm salt water rinsing as well. Good luck.

  • Juliet grayson August 15th, 2013 7:48 pm

    I am on a 6 week holiday in usa ( i live in britain). My bottom left hand molar (3 from the back) which has had root canal, the crown (and pin) came off and I swallowed the tooth. There is no pain.
    1) is it ok to leave the gap for 5 1/2 weeks until I get home to my dentist, or do I need to do something
    2) will the teeth either side move in the 5 1/2 weeks until I get home
    3) if i went or emergency dental treatment ( i think i have insurance) what could the dentist do??

    Thanks for your advice

    Jg

  • Juliet grayson August 15th, 2013 8:31 pm

    Sorry, realised I wrote bottom in last question, the tooth is missing from the TOP left hand side, 3 from the back.
    Jg

  • Michael Sinkin August 16th, 2013 10:37 am

    Juliet,

    I’m more concerned about the swallowed crown than I am about your tooth. Generally crowns will pass through your GI system uneventfully and come out in your stool. You want to make sure it passes. (That’s right, you’re on poop patrol.) Especially since the post went down the tube with the crown.

    Healthy people as well as people with a variety of gastrointestinal conditions; diverticulosis, Crohn’s syndrome, colitis, to name a few, may run into a problem with a wayward post and crown. Don’t panic, just watchfully wait.

    As far as your tooth is concerned, don’t worry. You will need a new crown when you return to the United Kingdom. You had root canal so you won’t have tooth pain. Be mindful for swelling of the gums but, otherwise, brush your “tooth” and enjoy your vacation. If any abdominal distress occurs, seek medical care.

  • Tammy Ginn August 18th, 2013 12:13 pm

    i have a crown on my lower incisor with another crown second molar back and a bridge between. About three weeks ago I started having tooth pain in that area, that continued to worsen to the point of going to the ER. Was prescribed something for the pain and amoxicillan 875 bid. Three days ago while eating pound cake of all things, my crowns/bridge fell out. I no longer have dental insurance, live in a different state than before, am in severe pain and my jaw is swelling. Dont know what to do. feels like a nerve is exposed. The ground down teeth are both black in color. Is that the way they were prepared before crowning? HELP

  • Michael Sinkin August 21st, 2013 10:04 am

    Dear Tammy,
    Not having dental insurance doesn’t change your dental state-you must see a dentist.( I suggest you read my recent post about the negative impact the economy has had on dental care…l share some helpful insights about your financial concerns.)
    If your dental description is accurate, you need to see a dentist for immediate care. There are many ways to address your obvious lack of teeth (some quite affordable) after the more immediate crisis is stabilized. From what you described, your previous bridged was destined to fail (an incisor and a molar as sole supports for such a large span bridge is not well engineered.) Do some homework, ask for recommendations and find a caring dentist who can help you.

  • Sherri August 24th, 2013 8:41 am

    I lost a crown on a tooth that had a root canal. My dentist said that the tooth had cracked below my gumline, and recommended that I have the tooth extracted, then get an implant or bridge. I made an appointment with an oral surgeon for the extraction, but it’s not for another 3 weeks. Is it OK to wait that long? What precautions can I take to keep the root clean and to prevent infection?

  • Vanessa Price August 25th, 2013 11:31 am

    Of all the days for a major dental issue…Sunday afternoon as I prepare to start a new job tomorrow!!! My 8 yr old son has had silver crowns on some of his back teeth since was 4 years old. Just now, he came in and told met the “silver top” came off one of them, and he has it in-hand. It happens to be a tooth closer to the front teeth on the bottom row. I don’t think it is time for it to “fall out”, but considering I just ate and am very queasy otherwise regarding teeth (sorry!), I cannot look at it, without risking fainting!! I did look from afar and he says the tooth is smaller than the others (from the crown I’m assuming) and that it does not hurt. I’m planning to save the crown and perhaps try to get him in for repairs tomorrow afternoon or later this week. My question is: will this exposed nubbin cause pain (my mouth is throbbing just thinking about it)?? Is there some other consequence if I don’t take him first thing tomorrow morning, and wait later in the week when I can somewhat safely ask to leave work early?? Insurance is not an issue, timing is!! Thank you in advance, Doctor!!

  • Michael Sinkin August 26th, 2013 11:44 am

    Dear Sherri,

    No worries. Just keep the area clean. Your tooth had root canal so sensitivity won’t be an issue. If you develop any swelling, call your dentist. Rinsing with Listerine is an added measure to prevent bacterial build-up.

  • Michael Sinkin August 27th, 2013 10:49 am

    Dear Vanessa,

    Based solely on what you just told me including the most important fact that your son is not in distress, I think he’ll be just fine until you can get him to the dentist. He has a stainless steel crown on his baby tooth and may very well have had a “baby tooth root canal.” I can’t diagnose by email but I think you can take yourself out of panic mode and make an appointment as soon as you can arrange it. I suggest you call his dentist of record for further reassurance. Good luck with the job.

  • Vanessa Price August 27th, 2013 11:09 am

    Thank you, Dr. Sinkin! You are very right….he is not in pain and says it is “starting to feel just like the other teeth” to avoid a trip to the dentist ;) , but I have contacted his pediatric dental team and we are now on the “wait list”. They expressed that this not an emergency per se, but something they want to look at pretty soon. I’m sure we’ll get in later this week.

    What a nice service you offer….thanks again!

  • Rani February 24th, 2014 4:43 am

    Hi. I was eating and out of no where a piece of my back tooth-which I think is a molar-came off. It was quite a big piece. I can feel a sharp bit when I brush my tongue over the tooth. The worst thing is I’m on vacation in a remote part of Asia and can’t get to a dentist for nearly 2 weeks. I’m freaking out a bit as I don’t want to get an infection etc. do you have any suggestions? Also should I brush the tooth?

  • Michael Sinkin February 25th, 2014 9:59 am

    Dear Rani,
    These sort of dental mishaps always seem to occur at the most inconvenient time. RELAX! From what you describe, including the lack of pain or swelling, you are probably at very low risk of infection, unless you break your tooth even more which speaks to the importance of avoiding eating on this side. You probably had a large filling or restoration that weakened the remaining tooth and you just happened to bite on it in such that a piece broken off. I don’t believe you will have any problems while you are away. Brush as normal, use warm water if sensitive, and don’t floss so as not to dislodge anymore tooth or filling. A piece of sugarless gum placed against the tooth may spare your tongue from additional insult if it’s getting sore. Enjoy your trip.

    Dr Michael Sinkin

  • LeAnn C March 28th, 2014 5:42 am

    I’ve had a cavity in one of my bottom right bicuspids. I could see the black spot(cavity) getting worse but didn’t have dental insurance until recently. Tonight I bit into a hard cracker and almost half of the tooth on the tongue side broke completely off. There’s no pain or swelling, but the soonest appointment I could get with a dentist is five days from now. Will I be alright until then? Will I have to have the entire tooth removed??

  • Michael Sinkin March 28th, 2014 6:25 am

    Dear LeAnn,
    I can’t begin to tell you how common your predicament is. Sight unseen, I can’t make a diagnosis, but I Would venture an educated guess that you will be okay for the next 5 days. From what you describe, assuming that the remaining tooth structure is intact, I do not think you will need the tooth extracted. Most likely you will need a crown and possibly root canal. If the tooth has extensive decay below the gum, you may need what called a crown lengthening procedure ( a type of gum surgery). If the tooth is beyond restoration, a dental implant should be considered but I’m jumping the gun. By the way, your decision to avoid care because of your lack of insurance will end up costing you more out of pocket dollars and more time in the dental chair. Good luck.

  • Girish April 18th, 2014 12:23 am

    Hi Doctor,
    While eating groundnut,I have broken my bottom jaw teeth vertically,It may be around 25℅ or quarter of the teeth is broken and the broken part is very slightly movable but its intact due to support of next teeth. I have sensitivity feeling when I drink hot or cold liquid. As temperory measure by putting filling powder from local pharmacy shop will fix the problem ? because once I go back to India after 3 month I will fix the teeth.I don’t have dental insurance here.Currently pain is not there, only while I’m eating I’m getting the pain,Is my teeth is exposed to nerve ? Kindly advice.
    Badari

  • Michael Sinkin April 19th, 2014 8:13 am

    Hi Girish,
    I can visualize the problem as you so well describe. You are in quite the predicament in that 3 months is a long time to try and nurse the problem and your tooth and underlying nerve are oblivious to your insurance status. The loose fragment will most assuredly become dislodged leaving vital and sensitive tooth uncovered. If the nerve is exposed you will have no choice but to see a dentist ASAP. If the nerve is not exposed, the sensitivity may subside as the tooth surface is covered with salivary proteins. Your tooth powder or Sensodyne toothpaste can help by applying it to the tooth. I recommend that you find a dentist to evaluate your tooth. You may just need a simple bonding procedure to correct the the damage. In any event, you don’t want to be in the situation where you have a full blown toothache. Get yee to a dentist and good luck.

  • Dave April 27th, 2014 7:06 am

    Hi, How difficult is it to replace a crown on a root canaled tooth? The situation is that my wife chipped a crown on one of her upper front teeth and is needing to have it replaced. In fact both of her upper front teeth have crowns and both had root canals (with posts) 25 years ago. The dentist says that she needs to have both crowns replaced as they were connected in the back during the procedure 25 years ago. We worry that during the procedure to remove the old crowns the root canals will be damaged as we’ve read that teeth that have had root canals are very fragile. Thank you in advance.

  • Michael Sinkin April 28th, 2014 8:24 am

    Hi Dave.
    I understand your concerns but they are largely based on common misperceptions. While it is true that teeth that have had root canal treatment are more prone to fracture than teeth that have not been so treated, this does not mean that they are weak. That your wife’s front teeth have been fine for the past quarter of a century since being “root canaled” speaks volumes. The fragility of endodontically treated teeth has more to do with the consequences of not properly restoring them after root canal is completed. Generally teeth requiring root canal have lost much of their structural integrity because of the presence of large cavities, big fillings or trauma (which is why the nerve can become inflamed in the first place.) Root canal in itself does not necessarily weaken the tooth. If teeth with root canal are restored properly they can last a lifetime. However, that doesn’t mean that the crowns placed will last forever. Crown replacement is a common occurrence for any one of a number of reasons including porcelain fracture, gum recession, decay and poor esthetics. All things being equal, replacement of your wife’s crowns should be a straightforward experience leaving your wife with even prettier front teeth. (Porcelain cosmetics have vastly improved improved over the last 25 years.)
    I’m going to put myself out on a limb and conjecture that your wife’s original treatment was the result of trauma; hence, 2 crowns splinted together on teeth with root canal and posts. Assuming no other underlying problems besides chipped porcelain, your wife will not have the same dental experience that might be indelibly inscribed in her memory when she first broke her teeth. Removing crowns is an easy procedure. They are cut off, not pulled off. Tell her not to worry and let me know how it all works out.
    Dr. Sinkin

  • Chris April 29th, 2014 1:53 pm

    Hi Dr. Sinkin,
    My tooth #3 had a large amalgam filling for 15+ years. It was found to have had some decay under that filling so three weeks ago it was redrilled and replaced with a composite filling.

    About a week after the new filling being placed, I bit down on a piece of hard candy and began to feel bite sensitivity along with sensitivity to cold & hot. I returned to my dentist thinking maybe the filling had cracked.

    Upon X-rays and an exam, the dentist found that the tooth was cracked on the lingual side. However the pain was transient (not lingering, only with stimulus) and the dentist did not believe I would need a root canal and that the nerve pain could calm down. We did opt to restore the tooth with a porcelain crown. I have a temporary currently on the tooth while we await the permanent to come in.

    Since the crown prep 4 days ago, the temperature sensitivity is completely gone but I still can not bite down on the tooth without bite sensitivity. Especially if the piece of food is on the edge of the tooth closest to the tongue where the crack was/is.

    Is this normal to still have bite sensitivity with a cracked tooth covered by a temporary? I am purposely not eating on that side of my mouth so as to let the tooth “settle,” but I am wondering if the permanent crown will get rid of the bite sensitivity, too. Thanks in advance.

  • Michael Sinkin May 2nd, 2014 11:13 am

    Dear Chris.
    The sensitivity you are experiencing in the aftermath of your recent dental odyssey. …namely replacing a large amalgam filling of 15 years duration in a molar with recurrent decay, is not surprising. Clearly the hard candy cracked your tooth, but to what extent the damage is to the remaining tooth or nerve remains undetermined. It is possible that the trauma of 2 successive dental interventions as well as the candy injury has “excited” the nerve. Time may allow the inflammation to dissipate; however, there is a pretty good chance that your tooth will require further treatment. Root canal is certainly a distinct possibility. My suggestion is that when the permanent crown is ready have your dentist place it with temporary cement and take it for a test drive for several weeks or longer. If your tooth remains sensitive, root canal is the next step. I never permanently cement a crown on a symptomatic tooth. If the crown is truly all ceramic or porcelain and it remains sensitive, root canal through it will probably necessitate a new crown to be made. Because of the history of large fillings and the subsequent crack, crown preparation and sensitivity, I suspect root canal is in your future. (Not to worry…see my blog about painless root canal.) Good luck.

  • Ben May 31st, 2014 12:19 am

    I tried the garlic powder, the vanilla extract, the Red Cross remedy eugenal or whatever, nothing compares to the relief I got
    From Makers Mark Bourbon and some
    Cheap cooking whiskey I had on hand. Wish I would have tried it to sleepless nights ago. Unbelievable the difference whiskey
    Makes

  • Michael Sinkin May 31st, 2014 2:37 pm

    Hi Ben,
    Just curious, did you swallow the bourbon? Because that’s when you maximize the anesthetic effects of alcohol. But seriously, alcohol, as in ethyl alcohol not isopropyl (rubbing) alcohol, is an astringent. It desciates (super dries) the adjacent gum and tooth structure. The alcohol irritates the gum and “distracts” the pain center in the brain from the broken exposed tooth pain (Gate Theory of Pain).
    Alcohol also dries the tooth surface which can draw fluids out of the dentin channels that interact with the nerve endings inside your tooth (dental pulp).
    I hope you have since been to a dentist and had your dental problem addressed. Thanks for your input.
    Dr. Sinkin

  • Girish May 31st, 2014 3:20 pm

    Hi Doctor,

    7 days back my lower jaw molar teeth broke around 25% of the teeth. 75℅ is still intact. For initial 3-4 days I got some pain and slight fever and took pain killers and antibiotic. Now pain is not there as you suggested I have put sensodyne tooth paste to my teeth,it gave me some relief. Now I don’t have pain but whenever I drink cold water I feel the pain.
    Currently I’m abroad and having no dental insurence,I will be going back to my country in 3-4 months,Is it fine to wait till that time.I have some Temperory filling with shall I use it for now?
    Is there any chance of infection ?
    Thanks
    Giri

  • Toni June 24th, 2014 3:58 pm

    Hello,

    Whilst eating an apple tonight a tooth that had a failed root canal a while ago snapped completely on one side. I can move it inwards and it feels hollow on the other, (I assume the crown has now completely gone) but a slim part of my actual tooth is still attached to something on the other side. I have been wondering whether to: a) twist it off myself b) leave it and wait until I can go after being paid next Monday. Is waiting a silly thing to do? Is there anything I can do to protect it in some way until Monday or do I have to go straight away. Btw there is no pain, nerve not exposed.

    Thanks

    Female, 37

  • Michael Sinkin June 24th, 2014 7:54 pm

    You have given me quite a bit of information about your poor tooth. You mentioned a failed root canal (how do you know it failed?) And a lost crown? Then what you have left is a shell of a tooth that once supported the missing restoration and that remaining tooth is broken. No acute pain and no nerve because you had root canal. No gum swelling? I am guessing that it’s your back tooth; otherwise the cosmetic defect would have probably driven you to the dentist. I think that the loose fragment could probably be removed without too much distress but seeing your dentist is a must ASAP. You don’t want to develop an abcess. From your description, I fear you will probably lose the tooth. Keep the area clean and rinse with Listerine for added disinfection. Good luck. FYI…I really can only speculate on the situation based on your description. Get a professional evaluation.

    Michael

  • Mary June 27th, 2014 4:24 am

    Hi my tooth just fell out (it was a baby tooth) I can’t be sure but from memory I had the replacement adult fang removed about 10yrs ago because it grew through top of my gum I can’t get to dentis for another five days I’m hoping there is no risk off infection. It didn’t hurt wen it came out but it dosent look like all the root came out. Thanks

  • Kate June 29th, 2014 11:44 pm

    Hey there! So I’m very sorry to bother you so late. I was just eating steak leftovers and my crown came clean off. It is a temporary crown that was put in a week ago (while I wait for the permanent one). My actual tooth wasn’t damaged as far as I can tell, thank goodness! I also cleaned cleaned the temporary crown. Here’s my question for you.. When I brush my teeth, should I brush the stump that my crown fell off of? Will I still be able to eat until I see the dentist in a few days? I’m pretty freaked out over the whole thing. Any advice would certainly be much appreciated. Thank you!!

    -Kate

  • Ariana June 30th, 2014 8:58 pm

    Thank you!

  • Michael Sinkin July 2nd, 2014 8:36 am

    Hi Kate.
    Chewy steak can do it. Definitely brush the stump…use warm water and toothpaste. Don’t freak out as all seems fine and no damage apparently done to your tooth. Call your dentist and see if you can go in earlier to have the temporary re-cemented.

    Dr Sinkin

  • Michael Sinkin July 2nd, 2014 9:57 am

    Hi Mary,
    Not to worry. Baby teeth generally fall out in a more timely fashion relative to permanent tooth development. Over retained baby teeth are common in adults and sometimes last a lifetime. More ofter they go the way yours just did…they fall out. Risk of infection is unlikely. The lack of root is expected as baby teeth near the end of their functional life time, the roots resorb making way for the permanent successor. In your case, it sounds to me that you are a likely candidate for a dental implant.

    Dr. Sinkin

  • Bruce July 5th, 2014 4:38 am

    Can you please advise me doc, two days ago my crown broke off completely taking the nerve(stump) with it. I now have a bit of nerve at my gumline base. There is no sensitivity whatsoever. I have no dentist and am worried about possible infection. Will this need to be removed? could it serve for a implant denture?

  • Michael Sinkin July 5th, 2014 7:27 am

    Dear Bruce,
    That you have no pain makes me think that what you refer to as the exposed nerve (stump remnant) might actually be a portion of a root canal filling. Generally speaking, if the nerve were visibly exposed you would be much more distressed. Namely, your tooth would be extremely sensitive
    So assuming your did have root canal, I am less concerned about your developing an infection in the near term. It is possible that your tooth can be saved with a post and core buildup and a new crown- that’s assuming there is adequate tooth structure. If not, certainly an implant is an option. You need to see a dentist for an evaluation. In the meantime, enjoy the holiday weekend and be ready to make some calls first thing Monday morning. Based on your description, I think you will be fine for the next few days. If your condition changes (pain or swelling), you will need to seek out emergency care. Good luck.

    Dr. Sinkin

  • bruce July 5th, 2014 7:43 am

    Thankyou very much for your quick response, I will try to find a dentist.

  • kristel toomey July 11th, 2014 11:29 pm

    Dr. Simkin:
    Sincere apologies for contacting u at such a late hour. This request is actually on behalf of a friend. I believe he was told by his dentist that he has excellent htgiene but poor enamel due to genetics. This dentist had treated my frien’s mother occasionally + noticed that her enamel cross-hatch pattern was atypical + the pattern may + has weakened their teeth. My friend is 62, a raw vegan, eats quite well and brushes wth baking soda/peroxide + flosses after every meal along wth xtra brushing gently or rinsing wth raw honey. His moth is mostly full but they’re bits + pieces of his real teeth. Over time, they’ve broken after eating nuts etc. His dentist told him he has the gums of a teen. He had a tooth pulled a few months ago wth minimal pain + no swelling + no pain meds.
    Current problem. Last wk or so a piece of a crown chipped off. He said he planned to call to see his dentist since he noticed the rest of the crown was bit jiggly. but just a little while ago he was flossing and the rest of the crown popped out leaving part of the old tooth (it has a root canal) + a metal piece sticking out from that area. He called his dentist who told him he shuld hav come by when the piece xhipped off + best he can do is see him tuesday.
    He also had agreed late nxt wk to help his girlfriendd out on long island re her mom/a dr appt.
    I feel badly because he really does work hard to take care of his health + he tries not to get overly workeed up about this general problem wth his teeth but it seems as though in spite of taking every precaution, every year or so it seems like one more thg keeps happening wth his teeth. His dentist seems very competent + is always willing to do whatever he can to respect the wishes of my friend aftr reviewing the current problem,taking any necessary xrays and providing his professional feedback..
    I’m sorry this is rather long-winded but I’m wondering if u culd recomend a few alternatives under these circumstances such that he doesn’t hav to keep addressing one problem after another which do seem like he just got unlucky wth his enamel. He did hav 2 wisdom teeth capped wth steel and the specialist didn’t even use any glue, just the pressure of the steel agaiSnst the wisdom teeth and strangely enough, it’s been almost 25 years wth no prob wth those teeth. Also he said it seems that it doesn’t matter what current highest quality bonding material his dentist uses to address appropriate situations the bonding never really combines or sticks successfully wth his teeth.
    I know this is a rather spotty + fragmented request but I wish there were viable options my friend can consider so he doesn’t hav to experience a problem almost like clockwork every time he relaxes about his teeth or he has to go away (to long island). He wuld rather not hav all his teeth pulled + just get dentures or implants both of which are drastic, timme consuming + costly.
    Do u happen to hav any recommendations which I culd pass along to him? Ur website + professionalisM is a Godsend.
    Perhaps another time,now that I’ve stumbled onto ur amazing wwebsit accidentally, I can ask u about my boyfriend’s dental issues (he’s 59, doesn’t hav dental coverage, had football freak accident in HS –the other guy’s sneaker/shoe somehow got past his helmet + crushed a # of teeth on one side, lower jaw I believe + back then in a small town the local dentist just pulled the teeth out but now aftr trying bridges that don’t quite feel right, $30k worth of current reconstructive work including a titanium plate etc to avoid sinking of that area of his jaw which supposedly is going to result in major problems down the road for him but he doesn’t hav the $ to do this nor does he want to get involved wth a dental plan involving this kind of debt..very stressful..so he just let’s it be for now..times r tough financially..:((not to mention my own (got hit by a van head on in 2007, cleared by drs at ER but wthin 2 years + thereafter, started a long processs of chippd teeth which eventually get to point of pulling..I didn’t saue. Was too busy taking care of my elderly mom + just. Grateful that drs cleared me via tons of xrays, at that time..currently on disability, have severe fibromyalgia etc)
    I know..geez this sounds like major bad karMa but bottom line is dental care is. Very costly + it’s hard to get reliable, solid dentists/specialists wthout major expenditures..I’ve tried going the dental school route myself but I hate to say that I would never recommend NYU (and I grduated from there wth a BAY…again sorry for the discoMbobulated email..hopefully u have the gist of my request..any and all feedback is welcome + greatly appreciated. Have a good evening. U sound like a truly wonderful combination of genuine professional who is equally gifted wth a big caring heart/very impressive “bedside manner”, if u will..cheers, kristel

  • Michael Sinkin July 12th, 2014 9:11 am

    Dear Kristel,
    Wow! Where do I begin? I feel your exasperation and appreciate the dental quandary you and your friends are experiencing. You covered so much territory in your email that it is impossible for me to give you specific advice. Suffice it to say that an objective and thorough evaluation for each of you is in order. Your description of the problems while quite detailed leave me with many clinical questions that need to be answered before I could possibly over a recommendation. A history of repeated catastrophes makes me wonder if some other underlying problem is contributing to your friend’s situation (aside from “defective” enamel.) That he has cosistently had to deal with dental emergencies makes me think that a different perspective is needed. Sometimes one’s focus on the problem at hand obscures the bigger picture. It’s like being able to distinguish the forest from the trees. Certainly the notion that if one tries the same approach over and over again why would you expect different results. As for you and your boyfriend. …again a thorough evaluation is necessary before I could possibly offer guidance.
    I certainly understand the the daunting expenses associated with comprehensive dental care, but an accurate diagnosis is paramount to finding a solution. There are many approaches to proper care. It’s not one size fits all. Once the problem is understood, careful planning and a staged treatment approach can make the financial burden less overwhelming.
    Dr . Sinkin

  • Nikhil July 18th, 2014 2:33 am

    It is 2:32 in the morning and I bit on something that cracked my tooth a little opened and I’m scared cause it’s hurting and everyone’s sleeping.

  • Michael Sinkin July 18th, 2014 1:54 pm

    Hi Nikhil, So sorry to hear about your tooth. Get yourself to your dentist asap. If you don’t have one, go online and type in “emergency dentist.” Good luck!

  • nicole July 27th, 2014 9:19 pm

    Hi there, it is Sunday evening and while I was eating dinner, I felt a strange crunch and upon inspection I see that my bottom back molar on the left side has a corner of it that is loose. I will be going to the dentist first thing inthe morning but I was hoping you could tell me if you think my tooth will need to be extracted. This tooth has a big ugly dark colored filling from a root canal 15 years ago that has turned the rest of the tooth a horrible gray color. The tongue side of the molar has one corner that is missing and now one corner cracked and loose, the other side is intact. My teeth are crowded on the bottom as it is would it be better to just have it removed? Thank you I appreciate any advice you might be able to give me.

  • Michael Sinkin July 30th, 2014 8:45 am

    Hi Nicole,
    By the time you get this response, you probably will have already seen your dentist. However, I am more than happy to share my thoughts about your dental description. It sounds like you had a molar root canal without having a proper restoration such as a crown or onlay placed to protect your weakened tooth from fracture. In fact, it appears from your narrative that you had the riskiest and least protective of fillings placed in a post root canal tooth, namely a silver amalgam filling. While I have nothing personally against silver fillings, they do expand and contract over time causing leakage by the tooth/filling interface. This is especially true with large ones. Having such a large filling placed in a molar following root canal is a prescription for disaster. The blackand gray color is a sign of such leakage and the cracking is evidence of the lack of protection of your tooth.
    I cannot say whether your tooth is beyond repair or not. A crown might still be a viable solution. Extracting your 2nd molar because your front teeth are crowded will most likely not improve the situation. Good luck to you.

    Dr. Sinkin

  • Mary July 30th, 2014 12:07 pm

    I swallowed my temporary crown. My dentist has not yet made a final impression – waiting for root canal work to be finished on this tooth. Will he be able to take a proper impression? Will the shape of the permanent rely on trial and error?

  • Jessica July 30th, 2014 3:43 pm

    Last night when I was eating chips, I felt a sharp pain in my tongue and when I run my tongue over my molar I felt something sharp. Looking in the mirror I saw a little part of an old filling broke off, which left a little hole, and sharp exposure. Is there anything I can do temporarily to fill in the hole until the 1st of September when my I can afford to go to the dentist? Nothing hurts except for the molar being sharp and cutting up the side of my tongue, which is causing me pain when I eat or drink when I swallow because my tongue moves against the sharp edge of the molar. Thanks in advance.

  • Michael Sinkin July 30th, 2014 8:20 pm

    Dear Mary,
    Not to worry, at least about the permanent crown fitting. You want to get a new temporary on as soon as possible to protect your tooth from potential damage and to keep the inside of your tooth sealed against contamination. Brush your prepared tooth as normal and make an appointment.
    Dr. Sinkin

  • janel lasker July 31st, 2014 11:28 pm

    Hello I was just wondering if you had any advice as I am currently going on vacation in a few hrs and have a very long drive. Basically i was just at my dentist last week to have a aggravated tooth that had a root canal done, it was hurting into my ear and the gum was very inflamed,my dentist said it had a seam where food was getting in and he would fill this he figured It would take care of the problem well now it is still hurting even when I don’t eat,but what’s really odd is that is my very last tooth on upper left hand side and now the opposite upper on right became really sensitive and now gum is sore and inflamed almost like its touching the inside of my cheek and it happened like out of nowhere. I am taking antibiotics he gave me just in case and using salt water, but I’m so scared because I’ll be five states away with two children and Im all ready in pain. I’m so worried I’ll get an infection or I all ready do. Help Please

  • Michael Sinkin August 3rd, 2014 7:57 am

    Dear Janel,

    Sorry to hear of your dental woes; especially the timing with your vacation. Your taking antibiotics prescribed by your dentist should probably alleviate any concerns for serious infection. That said, if your symptoms don’t improve in 48 hours, you should call your dentist for advice. Remember. ..48 hours.
    Enjoy your vacation.
    Dr. Sinkin

  • Julie August 11th, 2014 2:45 pm

    Hello Doctor

    I wish you were my dentist!

    A large white filling just came out leaving a massive hole (this was a large filling). Jagged edges but no pain. My dentist can’t see me for two weeks. What should I do in the meantime please? I’m guessing when I see him it’ll be a crown as he did warn me it was a huge filling.

    Many thanks
    Julie.

  • Michael Sinkin August 12th, 2014 10:32 am

    Dear Julie,
    Two weeks???
    Can’t he see you sooner for some dental first aid? Anyway, there is an over the counter product called dentemp. It is a temporary dental filling material made for this very problem. Easy to use. Just follow the instructions and be sure you aren’t allergic to any of the ingredients. Oil of cloves and zinc oxide are the main ones. Good luck.
    Are you sure your dentist can’t see you sooner it wouldn’t take long to tide you over. If he’s on vacation , I would imagine he has arranged for emergency coverage. Good luck!
    Dr. Sinkin

  • Leah August 14th, 2014 3:03 pm

    Hi Dr. Sinkin,

    I had a root canal done and had a crown put in over two years ago (with a crown lengthening done). For the last few months I’ve been having a foul smell coming from it. This week I started feeling it coming loose. It just came out and it has a portion of my tooth attached to it (I have a hollow middle and one outer portion of my tooth left). What can I do to help protect the small portion of my tooth left as my dentist can’t see me until tuesday. Do you think I will need an extraction done or will a crown still be a possibility?

    Leah

  • Michael Sinkin August 15th, 2014 12:04 pm

    Dear Leah,

    It’s clear to me that the foul odor/taste that you were experiencing was the result of your crown’s cement seal being broken. This could have happened for any one of a number of reasons but the bottom line is that once the seal was disturbed, bacteria was getting under the crown….hence the smell. The fact that you had crown lengthening performed indicates that initially there wasnt enough tooth structure to grab onto. From your description, it doesn’t appear that you had a post placed after the root canal was completed. What you have left of the tooth – the hollow portion and residual walls may be restorable with a new crown or perhaps even using the crown that came out. It all depends on the state of the now naked tooth. If significant damage was done, you may lose the tooth.

    In the mean time, keep your tooth clean, brush as normal and don’t chew with it. Good luck.]

    Dr Sinkin

  • Cheryl August 30th, 2014 9:47 am

    This morning my temp dental implant came out. Since it is a holiday, the office is closed till Tuesday. The posts are still in. Will I damage anything by waiting a couple of days to get in to see the dentist?

  • Michael Sinkin August 31st, 2014 7:42 am

    Dear Cheryl,
    From your description, it sounds like your temporary crown or crowns came off the posts (which I assume are the abutments that are screwed into the actual dental implants.) If this is in fact what occurred, there is nothing to worry about except the inconvenience of missing “teeth.” Avoid chewing on the area as you don’t want to irritate the gum or possibly loosen the screws within the posts. Sight unseen, I can’t offer any concrete advice. If the situation is as I envision it and the posts are secure (not loose), and the temporary crowns are not damaged, you may be able to place them back using a denture adhesive like fixodent. The temporaries have to be clean of any debris or cement and you would first want to try placing them on the posts without the fixodent and see if they’re in properly. Be mindful that even with the fixodent, they are more likely to become unglued, so avoid chewing with them. If you are not comfortable doing this, put them in a safe place (not wrapped in tissue where you might accidentally throw them out) and wait until Tuesday. Happy Labor Day.
    Dr Sinkin

    DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day to day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.

  • Christine September 21st, 2014 3:21 pm

    Hi Dr I am really needing your reassurance. Tooth 18 was crowned a few years ago on recommendation of my dentist as it had such large fillings in it. Shortly after, this tooth infected and I needed a root canal which was done through a hole drilled into the crown. Nine months ago I was told there was decay under it so the crown was cut off, cavity treated, build up and post done and new crown placed. Recently I felt a weird sensation, but not really pain, when chewing anything hard or sticky and realized the tooth seemed to be “rocking” slightly. The dentist diagnosed the tooth is cracked and needs to be removed and replaced with an implant. He took an x ray and probed under the margin of the crown at my lingual gum line to make this conclusion. I am very upset and don’t want to lose my tooth! Should I ask him to actually remove the crown and re examine before extracting? I am so worried! Please help!

  • Susan October 6th, 2014 4:15 pm

    Hi
    Can anything be done to save my tooth
    I had a root canal filling and the tooth has
    fractured I have been told the tooth cannot
    be crowned but the filling as now fallen out
    and I can feel the hole but it surround by tooth
    Can’t some thing be done as I can’t afford a
    implant as suggested by my dentist
    Thank you for your time

  • Michael Sinkin October 7th, 2014 8:11 am

    Hi Susan,
    I am so sorry for your trouble. Obviously I cannot make a diagnosis as to the restorability of your tooth without an examination and x-ray. If your tooth has a vertical fracture, meaning that the root is split, it will most likely need to be removed. If the tooth is fractured below the gum-line and bone, the ability to save the tooth depends on how much healthy tooth remains and if necessary, what kind of surgery might be required to uncover sound tooth structure onto which a crown is fabricated. If an extraction is necessary, an implant is generally the ideal solution. From an economic perspective, it might be more cost effective to have the implant in the long run, especially if the prognosis of your tooth is so poor. Sometimes an implant can be placed and after integration occurs, 3-4 months later, a temporary crown can be made as a phased approach to help spread the costs over a longer period of time. Good luck.
    Dr. Sinkin

  • Tina October 16th, 2014 5:07 am

    hello,
    I am sure you have heard this before, but i was set up to go to a new dentist a week ago. My husband recently got a new job and we were waiting for the benefits to kick in before having a cracked crown with a possible root canal looked at. Unfortunately the right paperwork at his work wasn’t filled out and I had to cancel the appt. until the insurance kicks in. 2 weeks to a month I was told, so of course Murphy’s Law goes into affect and half of my crown falls off tonight leaving a stubble of a tooth that throbs occassionally and is sensitive to cold. I am rinsing with salt water after I eat anything to keep food out. But there is just no way on earth we can afford anything without insurance. What else can I do? Please help!

  • Michael Sinkin October 16th, 2014 6:52 am

    A bureaucratic slip up and you need professional help asap. Here’s my advice.
    Call the new dentist’s office and explain the situation. He should be able to render some “first aid” that will tide you over until the insurance kicks in. Such treatment should be modest in cost. Don’t be uncomfortable discussing fees. You will most likely need root canal and a new crown in a matter of weeks. I would expect him/her to be able and willing to help you now. If not, look for a different dentist. You need to be seen before you develop a severe toothache or an abcess. The circumstances being what they are, I’m sure you will get the help you need. Compassion should be one of the criteria for your soon to be doctor.
    Dr Sinkin

  • sue halling October 22nd, 2014 8:03 pm

    Hi
    this week I had felt my left check bone bothering me like a dull ach coming and going.My first thought was tooth absess but I felt all around my upper inner gum and felt nothing unusually. I have an inner ear condition that comes and goes with dull pain and my family dr has me on decongestants, floconasal spray and non drowsy claritan to keep it under control, Im 61 by the way and never had this problem till 2 yrs ago. No allergys.Its the ear tube that holds fliuds .Any how this weekend my check bone ached under my eye on left side , would come and go. I finally broke down on sun and started on 2 keflex x 2 a day .Immediately I was improving mon.i called office and they said continue 7 days. So I was happy. Well tonite Im nibbling at supper and I felt something on the upper left molar .The 3 or 4th tooth from the back. I took a dental floss pick and lightly felt around and could feel that the molar inner wall(tongue side ) moved some .I quickly left it alone as it is evening. I have a filling in the middle and im sure it is old and the tooth probably just gave away.The tooth is all there but Im fearing the inner tooth wall is fractured .And that tooth is allive but Im not hurting thank goodness.
    I left voice mail on phone to dentist .I hope to go see tomorrow.i usually have in the past years had a tooth removed at an oral surgeon and not with regular dentist. If they say come in the morning first thing Im trying to decide if he decides to send me to a surgeon should I not have any breakfast.In case I would be put to sleep .I dont remember if that type of surgery needs an empty stomach . It is always soemthing :)

  • Michael Sinkin October 24th, 2014 7:04 am

    I feel you may be jumping the gun. The tooth should be evaluated by a general dentist before any discussion of extraction takes place. Many broken teeth can be successfully restored. Good luck.

  • Billie October 26th, 2014 7:38 pm

    I just lost a crown with the middle of the tooth. Today is Sunday. Anything I need to do before going to the dentist?

  • Michael Sinkin October 26th, 2014 9:12 pm

    If you are not in pain and have no swelling just make a dental appointment as soon as possible. Good luck!

  • Valerie November 11th, 2014 10:15 pm

    Hi Dr. Sinkin,

    I got most of my answers from reading your replies, thank you. However, I do have a question. My back molar tooth has a crown that keeps falling out because there isn’t enough tooth structure to hold it (it’s like two flat surface cemented together). I have already spent $5000 on that tooth getting root canal, gum surgery for cementing the crown and getting a second crown by a different dentist etc. My new crown fell out again. Without going through “implant” or “post and crown” procedure, would the remainder of that tooth get infected with time (since the protective layer is gone)? And would my other teeth shift? What other alternative solution(besides pulling it) is there to protect what is left of that tooth, if any? I have had bad experiences with bridge and post in the past. Would onlay be an option?

  • Michael Sinkin November 13th, 2014 8:10 am

    I feel your frustration. Something is definitely amiss. I would love to see what’s going on because there is a definite disconnect between all the treatment modalities used to save your tooth (root canal, gum surgery, 2 crowns) and the final result. Your description of 2 flat pieces put together makes me think that your tooth lacks enough surface area to retain the crown. A post generally helps to achieve this by building up the tooth, but the opposing tooth may be too close when you bite down to allow for a proper and retentive crown prepation. You need another pair of dental eyes on your tooth. Some thing just doesn’t add up. Get a another opinion. Good luck!
    Dr. Sinkin

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