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.


If you enjoyed this post, please consider sharing it:
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.

Related Posts:

226 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.


  • 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?

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

    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.

  • 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.
    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


  • 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


  • 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.

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


    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.

  • 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

  • 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 ?

  • Toni June 24th, 2014 3:58 pm


    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.


    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.


  • 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!!


  • 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

  • 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?


  • 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

    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

    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

    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

  • rhonda mcneill November 25th, 2014 6:28 pm

    My nerve us exposed I believe. It only hurts when I rinse with Listerine or try and brush it. Excruciating but other than that it doesn’t bother me. What can I rinse with that doesn’t burn?

  • Michael Sinkin November 25th, 2014 10:24 pm

    What you must do is get to a dentist before the pain becomes unrelenting or before you develop an abscess. If you must rinse, try an alcohol-free mouth rinse like Listerine Zero or better yet, warm salt water (1/2 tsp of salt in an 8 oz glass of warm water). The artificial sweeteners in over-the counter mouth wash can trigger a pretty severe pain response. Don’t delay. Any relief you get will only be temporary and Thanksgiving is 2 days away.
    Best of luck.

  • Terry November 26th, 2014 3:58 am

    Hello Dr. Sinkin,

    This blog is great and I think you do a great job at putting a lot of peoples’ fear and anxiety to rest when it is not needed. On to my question, about 30 years ago a was hit by a baseball bat in the mouth which resulted in cracked teeth, root canals, shaved teeth, and crowns on my top two front teeth (as well as 3 on the bottom but those I am not concerned about at the moment). Tonight while taking a bite of food the tooth under one of the top crowns snapped off at the gum line (some tooth is below the gum line and some is just below but the outside of the tooth all remains above the gum line). The remainder of the tooth is still glued inside the the crown that now sits in my hand. The center of the tooth that was put in when the root canal was done has also snapped off along with the rest of the tooth at the gum line. The unfortunate part is that I currently have no dental coverage however I will qualify to be added to my spouses insurance in just a week. I assume it will take a few weeks to get the paperwork completed before I am able to be insured. Would you feel it is ok to clean the crown and remaining tooth by brushing and rinsing with mouthwash, drying, and then using a temporary dental glue such as fixodent (or perhaps you can recommend something else)? How long can I do this for? I have the money to go to the dentist if I need to go immediately, however it would be awfully nice to wait 3-4 weeks until the insurance kicks in. Thank you for your response Dr. Sinkin.

  • Michael Sinkin November 26th, 2014 9:02 am

    Dear Terry,
    Why do such dental mishaps seem to have such a bad sense of timing and Thanksgiving is tomorrow to boot? Anyway it’s hard to know if you have enough exposed tooth structure to offer enough “hold” or retention. You certainly can try some over-the-counter temporary cement like Dentemp or even Fixodent.
    I think you should call the dentist you plan on seeing when the insurance kicks in. There are some techniques he/she can use that can give you a front tooth for the holidays without incurring a major expense, at least until your your insurance kicks in. What you need is a safe and economical stop gap measure to bridge (pun intended) the insurance gap
    Besides, this will give you an opportunity to meet your new dentist. How he/she handles your current dilemma may give you insight as to whether you’ve chosen the right dentist for you. Happy holidays.

  • Terry November 26th, 2014 9:23 pm

    Thanks for the response Dr. Sinkin, and a quick one at that! I’m in Canada so lucky for me we have already had our thanksgiving :) I didn’t find any Dentemp today however I did pick up some Fixodent. It worked to hold the tooth in place during the day until I needed to have a meal and then the normal bumping from food, tongue, lips, etc managed to loosen the tooth. I just took it out so I could eat without worrying so much. I’ll see a dentist ASAP and see if I can get it temporarily glued until I am able to get on my spouses dental plan. Thanks again for putting my mind at ease and for the recommendations.


  • natalie December 1st, 2014 5:45 am

    Hi I don’t know if this is where I’m sapose to ask you but I had a tooth filled as a child and now its obviously fallen out disintegrated and has become a giant cavity in my far left bottom moler the sensitivity is un bearable as my cheek touching it causes constant pain is there any thing I can do to create a temperarty mold or something for relief I have called my dentist waiting for a call back to make an appointment but in the time being I have 2 children that require my attention and its hard ? Plz help me ?

  • Michael Sinkin December 1st, 2014 8:11 am

    Dear Natalie,
    You really need to see a dentist ASAP, as in make an appointment now. In the meantime, an over-the-counter temporary filling material such as DentTemp might offer your tooth both some shorter relief and protection. It’s simple enough to use, just follow the directions and if your dentist doesn’t call you back, call again. This is an emergence. Make an appointment BEFORE THIS GETS WORSE.
    Good luck!

    Dr Sinkin

  • Hayley December 12th, 2014 4:27 pm

    Hi, I had a big filling on my tooth from a few years ago, and recently realised I had a crack on the front of this tooth. I went to the dentist today who said he was going to refill the tooth and possibly cap it on wednesday, however as I was eating tonight the tooth has broken off from the crack which is very high in my tooth (leaving me with the tiniest bit of tooth left). Now my filling is fully exposed but my dentist is closed until monday. Is it okay to wait until wednesday or should I go in on monday and let them know that the crack has caused the tooth to break off? Also, is it okay to brush as it is literally all filling that is exposed instead of being protected by the front of my tooth as that has fallen off?

  • Michael Sinkin December 12th, 2014 6:31 pm

    Dear Hayley,
    Hardly a week goes by without my seeing the dental situation that you described. FYI…the filling protects the tooth; the tooth doesn’t protect your filling. So, brush away, but you should probably avoid flossing. You don’t want to chance dislodge the filling.From your initial description, this tooth was destined to have a crown.The thin wall of tooth offered no real structural support and was splintering away before your eyes hence the cracking. You might want to touch base with your dentist on Monday to give him/her the heads up. If nothing untoward happens over the weekend, I suspect you’ll be fine until Wednesday. In the meantime, chew on the other side.
    Dr. Sinkin

  • Jeanne December 19th, 2014 11:27 pm

    Hi, I just had a temporary crown placed over my front teeth this last week and ever since, there is tenderness in the front roof of my mouth; it almost feels like the crown is cutting into the top of my mouth. Also, I’ve noticed that whenever I drink anything it feels like it is inside my tooth. A friend that has had a crown before told me that it may not have been glued in properly or that it may not be fitted properly. The permanent crown is scheduled to come in next week. Is this something I should go back in and have fixed before then? Will the liquid getting between the tooth and crown cause problems? I’m not sure if the dentist could fit me in before the holiday but I don’t want to delay and cause more problems…

  • Michael Sinkin December 20th, 2014 9:27 am

    Dear Jeanne,

    From your description, I would say the problem you are experiencing is related to the temporary crown. Your friend’s suggestion that the temporary is not sitting properly on your natural tooth is the logical conclusion. Regardless of whether the temporary is ill- fitting or improperly cemented, your tooth should be comfortable without the symptoms you describe. My belief is that a temporary crown should fit precisely so that the tooth is protected, the health of the gum is preserved and the status of the natural tooth’s health i.e., the pulp (nerve) can be assesed.

    I would not permanently cement a new crown on a tooth that is sensitive or has inflamed gums because one can’t assume that the problem is caused solely by the poor fit of the temporary nor can one assume that the symptoms will totally disappear when the final crown is placed. The irritation of your inner gum could be caused by excess acrylic or composite (what the temporary crow is made of) or residual cement pressing into the tissue.

    Here is my suggestion: try to get an appointment with your dentist before the holidays. It may just require 10 minutes to correct and you can have piece of mind and comfort. If that doesn’t happen, I would not have the new crown permanently cemented until your tooth is perfectly comfortable. Either your dentist can place the final crown in with temporary cement and let you take it for “a test drive” or he corrects your temporary crown and makes sure your tooth is okay before placing the permanent one. Most likely, this is a minor problem that can be easily addressed,

    Happy Holidays.

  • Donna December 28th, 2014 5:39 pm

    I just went to the dentist expecting to need two crowns upper right redone due to decay. When the dentist removed the decay from the bicuspid it was more extensive then expected. He was unable to locate the canal to see if a root canal would be an option.As it was right before Christmas he was able to place a pin and use a temporary crown warning me that there could be pain when the anesthesia wears off. I have experienced no pain.He wants to place a bridge crowning the canine tooth, extracting the bicuspid and crowning the molar. Is this the best option? Is a pin not strong enough to support a crown? How long will a temporary crown last?…..thank you

  • Michael Sinkin December 29th, 2014 7:56 am

    Dear Donna.

    There are many treatment options to address your current dental dilemma and while I will offer my opinion, please understand that without more clinical information I can only speculate as to what the right approach for you might be. Assuming that the bicuspid needs to be removed, as I see it you have 2 options: 1. Make a permanent 3 unit bridge utilizing the cupid and molar. (I presume you had your other bicuspid extracted when you were younger for orthodontic treatment.) 2. Place an implant to replace the bicuspid and have 2 independent crowns made on the implant an molar.

    If your cuspid is healthy, I would be hesitant to “cut it down for a bridge abutment. That you need to replace 2 existing crowns due to decay, I would think twice before making a fixed bridge which is harder to clean than individual crowns. That raises the question: why and how did you develop decay under your crowns and what’s going on in the rest of your mouth? Performing root canal and placing a post/core and crown on your bicuspid (if it were possible) is almost as costly as replacing the tooth with the implant, BUT with a lower probability for long term success. Implants don’t decay.

    I suggest that you call your dentist to discuss the options and better understand his rationale. There are many considerations to take into account including the health of the adjacent teeth, prognosis, esthetics and of course, cost. In theory and practice, I have no problems with a 3 unit bridge. But, all things being equal, an implant is the more ideal approach with a much better outlook for long term success.

    Good luck.

  • Teresa December 31st, 2014 12:18 am

    I had 1/4 of a molar tooth break off, I saw a new dentist referred by a friend. He did not explain what a crown was, just told me I needed one. He numbed me, and drilled down the tooth (which I found out about during online research). A temporary crown was placed, which came off 10 days later. I was relieved when the crown came off (as funny at this sounds), because my tooth felt better when the crown was off of it. I called the dental office, left a message, as it was a Friday evening. The dentist called me back Sunday morning and told me to come back in on Monday and they will re-cement. It may sound silly, but I really don’t want a permanent crown. The temporary crown is bulky and feels thick over what’s left of my tooth. I am having anxiety about a permanent cemented crown. I would prefer the crown be cemented with a cement that could be removed (like the temporary crown), should I have a problem with the crown. I wish there was a way of getting a “removable crown” (like one you can remove to allow air and circulation, I feel like I have a blanket over my tooth smothering it. It’s making me feel claustrophobic in a way (I know this is silly). Is there a less permanent cement that can be used, so if the crown has to be taken off it’s less traumatic to the tooth and gums, should it need to be removed?? Thank you in advance for your response.

  • Fiona December 31st, 2014 1:26 am

    Hi, sorry to bother you. I am really worried. I am presently on a camping holiday and unable to get to a dentist. Last night while eating steak i have cracked a back molar. This has a large filling in it from 15 years ago. One of the cusps broke away and it was rebuilt with a filling (silver in colour. The crack is in the inner side of the tooth between the 2 cusps. The tooth is loose in the gum and hurts if pushed on. Otherwise no real pain. What can i do. Cant see a dentist until next Wednesday after returning from camping trip

  • Michael Sinkin December 31st, 2014 8:50 am

    Dear Fiona,

    What you describe is a pretty common occurrence for teeth with very large fillings. It sounds like you have a “dangling” cusp that is being held in place by gum fibers that connect to the tooth at the base. As the tooth fragment moves, it is tugging on the gum and causing pain. From what you describe, I don’t think it is the tooth itself or its nerve that is the problem. You will most likely need a crown on the tooth when you get back.
    Here is my suggestion for relief. If the nearby town has a pharmacy, get some Ambesol or some other over-the-counter topical anesthetic (generally 20% benzocaine) and apply it to the base of the gum where the loosse fragment is. This will numb the area and relieve the pain.
    If you are not squeamish, what I am about to suggest will resolve the problem until you get back….numb the gum adequately….keep the anesthetic against the gum and if possible allow it to flow between the tooth and the loose cusp (i.e., gently separate the cusp from the tooth and place the ambesol in the space created making sure the solution reaches the gum.) 1 or 2 minutes should suffice. Then, (here’s the adventurous part) displace the fragment out by pushing it away from the tooth…really away from the tooth , really lean it back towards the palate, place more ambesol if you need it, and when you have bent it back sufficiently, you should be able to remove the cusp with a twisting motion. Use your finger tips.. Alternately, after you loosen the cusp, you can bite into a warm sticky piece of caramel or Milky Way Bar and dislodge the piece by first hardening the candy by sipping cold water and then open your mouth quickly.If ambesol is not available, get a piece of ice and place it against the gum where the tooth is broken and loose, You might not want to place the ice between the tooth fragments as your tooth will likely be sensitive to the cold. You may need to work on it a bit, but it will come out with minimal distress.
    Your gum will bleed a bit (bite on gauze or a tissue and your remaining tooth might be sensitive to temperature for a bit (place toothpaste, preferably sensodyne against the remain tooth and you should be good to go. If the remaining tooth is sharp and irritating to your tongue, place a piece of sugarless gum against it to cover. This is dental first aid in the wilderness. I assume you do not have any bleeding disorders. Pressure with a tisssue for 10 minutes will stop any bleeding in a normal patient. If you are diabetic, I would take the antibiotic after the “procedure”. Good luck, enjoy your camoing and please let me know how it goes.
    Happy New Year.
    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.

  • Fiona December 31st, 2014 10:24 am

    Thank you for your quick reply. Not sure that i want to remove the cusp as advised above. Would it be ok to leave until dental appointment next Wednesday. Will brushing hurt it any further. Can i just eat on the other side of my mouth until then. Do you think i would know if i had cracked the tooth below the gum line. Don’t have any real major pain except when pressure is applied to that 1 broken cusp. The tooth doesn’t appear to be sensitive to hot or cold drinks. Is this a good sign or not. Sorry to ask so many questions but i am a little scared at the moment and just want to get home.

  • Sherry January 1st, 2015 1:27 am

    Hi Dr.

    My upper right last tooth fell out with the gold crown and took the tooth with it.
    I can still feel a little bit of jagged pieces up in my gum but the tooth is gone. This was an old crown that was replaced only two months ago with a new gold one.
    Do you know when I go to the dentist he will have to extract the remaining pieces of tooth out of my gum and just let the Hole close up? I do not have any pain as I have had a root canal in this tooth.
    The gum is getting very sore though from eating because there is nothing there anymore. Thank you for your help I am just very nervous as I am afraid of what the dentist will have to do! Do you know if I will need an implant since it is the very last tooth in the upper right back? Happy New Year!

  • Michael Sinkin January 2nd, 2015 10:13 am

    Relax. You’ll be fine. There is nothing to worry about. If you want to chew on the other side and leave it as is, no harm will come to your tooth. I wouldn’t be surprised if the piece comes off over the next couple of days. Enjoy yourself. If it were my tooth and I was camping, I’d remove the piece. It’s your gum that hurts because it’s being traumatized and irritated like the skin around an ingrown nail. Enjoy your time away.
    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.

  • Michael Sinkin January 2nd, 2015 2:03 pm

    Well, you seem to have assessed your dental situation pretty well. That your dentist chose to restore your tooth with a gold crown indicates to me, at least on an intuitive level, that this was not the fault of improper care but rather a result of a weakened foundation. Evidently your tooth’s structural integrity was sufficiently compromised that it was unable to support your most recently placed crown.
    Based on your description, I would conclude that your tooth will need to be removed. Don’t work yourself up into a frenzy as dental extractions need not be a painful experience and you should not equate it to the removal of an impacted wisdom tooth (not all extractions are equal).
    As to whether you should have a dental implant will be based in part to what is going on in the rest of your mouth. My initial response is that if your tooth was strategically important enough to warrant previous root canal treatment and crown placement twice, it certainly justifies replacement with an implant, especially if the tooth opposing it is present.
    Call your dentist and schedule an appointment. Happy New Year (and don’t worry so much!).
    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.

  • Michael Sinkin January 2nd, 2015 2:05 pm

    Dear Teresa,

    What bothers me more than anything that you detail is that you were not sufficiently informed of the treatment performed. That does not mean you received improper care, you just would have been better prepared to understand what you have been experiencing.
    A filling is a restoration placed within the confines of a tooth as is in fact, supported by the tooth. When there is not enough tooth structure to support a filling, then a restoration, such as a crown, is needed that can actually support the tooth. A well-made crown is akin to a well fitting glove.
    Your difficulties and subsequent anxiety has more to do with the fact that there was a problem with your temporary crown. Perhaps it was not well-adapted to your tooth, maybe it was too bulky and impinging on your gum, interfering with your bite or placing pressure on the adjacent teeth. Clearly, you need to convey your experience with your dentist.
    This is not a matter of just recementing your temporary; it needs to be refined. You should be perfectly comfortable with both your temporary and permanent crown. And, based on your experience, the permanent crown should be initially placed with a temporary cement to allow for a “test drive” prior to permanent cementation. Your assessment of the situation is not silly. Your claustrophobic feelings are vivid description of sensations that can be readily addressed. I have placed thousands of crowns and know that there will come a time when you won’t be aware of which tooth has a crown.
    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.

  • Fiona January 4th, 2015 10:24 pm

    Thank you for your kind reply. Sorry to be such a pain but i am a little terrified at the moment. The cusp in question is only a little bit loose. To me it looks like it has cracked between the front and back cusp. The front part of the cusp that is next to the filling is a little loose. Only hurts if it is moved away from the filling. If pressure is applied to the inside of the tooth and downward pressure applied it does not hurt. Really worried that i could lose this tooth as i have been surfing the net and reading about cracks that go below the gum line. Phoned the dentist again today and the earliest i can get in is Wednesday. I am really really worried. Would you know if the tooth has cracked below the gum line. Do you think it can be saved

  • Fiona January 5th, 2015 8:37 pm

    Hi Dr Sinkin have just been to the dentist and have been advised that the inner front cusp of my tooth has broken below the gum line. She has advised that i have 2 options, either fill it and build it up or place a crown on it. This will cost around $1800 aust dollars. Advised that root canal is not necessary. The tooth has been 60% filled now. In a bit of a dilemma what to do. i have an appointment tomorrow so any advice you can give would be appreciated. Wasn’t forthcoming in advising the best option or should i just have it pulled. Your reply would most greatly be appreciated. Not sure whether to spend that type of money on the one tooth.

  • Fiona January 6th, 2015 2:39 am

    Also the internet advised that a tooth that is broken below the gumline will normally require a tooth lengthening procedure. Is this always the case because the dentist did not advise me of this. All she said wad that the tooths cusp had broken off below the gum and would require a crown. Asked if i would need a root canal and advised no, not at this stage. Does this mean i will need one later. In your experience what would you advise. I would really appreciate a response asap as i have a dental appointment at 9 tomorrow Aust time.

  • Michael Sinkin January 6th, 2015 4:05 pm

    Dear Fiona,

    By the tone, time and frequency of your e-mails, it’s not difficult to see the level of your stress. So, let me get right to it.
    Over the many years of dental practice, I have “saved” scores of fractured teeth that would fit the description of your tooth. The fact that your dentist has given you 2 options to restore your tooth, including a large filling, suggests that there is plenty of structure left for a successful outcome. Even with 60% of your tooth’s volume being filling and a broken cusp that goes below the gum-line, a beautiful, comfortable crown can be designed and fabricated and is how I would proceed.
    Yes, root canal is always a possibility when a tooth such as yours needs treatment (perhaps 20-30% chance over the lifetime of your tooth-my “guestimate”), but that is not sufficient reason to extract the tooth. Additionally, not all crown-lengthening procedures are equal (assuming that it’s even necessary. Sometimes a crown-length involves a simple gingivectomy (which is nothing more than trimming the gum) and can be accomplished at the time of crown preparation. Other times, crown lengthening is a bit more involved and the bone where the cusp fractured may need reshaping.
    As long as there is sufficient tooth structure (which sounds to be your situation) and the surrounding bone is healthy and any treatment doesn’t compromise the adjacent teeth, having a crown placed on this tooth is the desired treatment. The real question to ask your dentist is what the prognosis of the tooth is, once restored. If she is confidant that success can be achieved, saving your tooth is the best option.
    If the long term prognosis is questionable, I would seek a second opinion, since you have already invested so many hours surfing the net already, and have another pair of professional eyes assess the situation. The alternative might very well be extracting the tooth and have an implant placed. A new large filling would be a stop gap measure and not a long term solution FYI, I just went through a similar situation with my own tooth (see http://www.michaelsinkindds.com/blog/i-am-the-dentist-who-had-a-really-bad-toothache/), and am about to have the tooth prepared for a crown.
    A word of advice, the Internet is a great resource, but it does not replace the trust and rapport you should have with your own dentist. You have become quite informed, now use your newly-acquired insights and talk to your dentist about the treatment she recommends.
    Good Luck.
    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.

  • Fiona January 6th, 2015 8:47 pm

    Hi Dr Sinkin, just been to the dentist and have decided to go ahead with crown. Is scheduled to start on it next Friday. That is the earliest i could get in for the procedure. Has assured me that it will be ok to then. Had a extremely thorough check up and require multiple fillings as well. Have told her that i would like these done Asap. Will be spacing them out over a couple of months (7 in total 2 of which are wisdom teeth. The check up was quite scary and i informed her so. On multiple teeth she said the teeth were worn and that cracks were present. Could be a result of teeth grinding. At no time in the last 20 odd years of having dental checkups has a dentist told me of this wear or cracks. She told me that everything will be ok. I said jokingly i should have all of them pulled out and she asked if that is what i want to do. Of course i said NO. Many of my front teeth have been worn down 30% or more. Should i be worried. Please your opinion would be greatly appreciated. You have been so kind. With all that is going on in my mouth not sure whether to spend big money on crowns and fillings or not as i am unsure of how long i will have my teeth for ( i know no one really knows but it us extremely scary for me). Do i do my upmost to save then now only to have them pulled out later on. I am not sure how long cracked and teeth that have huge fillings will last. I will be 47 in February. I know you would have some wear and tear to your teeth, but i feel mine may be excessive. If you were in my shoes what would you do your opinion means a lot

  • Jessica February 17th, 2015 2:36 pm

    I don’t have insurance and my back tooth on the top left I don’t know if it is my wisdom tooth or a molar but it has been decaying for some time and last night a big portion of it came loose and I can’t brush it or eat or touch it on that on that tooth or else it’s very bad pain. I don’t know what I should do, I don’t have any money to get it pulled. I don’t know if it falls out if it will hurt way worse. Should I pull the piece off? Will it feel better If I do?

  • Michael Sinkin February 18th, 2015 10:21 am

    Dear Jessica,
    I am so very sorry for your dental woes. You have a problem that needs prompt professional attention. Delaying care will only lead to greater problems like serious infection or more pain. While I empathize with your financial troubles, you need help. Perhaps the local dental society could help you locate an affordable dental clinic in a teaching hospital or school. I wish I could be more helpful. Best of luck.
    Dr Sinkin

  • Chris Butler March 16th, 2015 5:25 pm

    Hi Dr Sinkin. I have a post crown on #7 that was installed in 1980. I’ve worn a night guard since 1989. Never any problems until about four years ago when my bite began to shift and the crown began to rub against #26. I went to the dentist looking for a preventive measure that could be done to eliminate the interference and instead was told, “That’s what happens when we get older, our bite changes. There is nothing we can do.” On July 14, 2015, the constant interference with #26 caused the root under the crown to break at the seam and the post and crown came out. My dentist says $8,000 to fix it! I don’t have that kind of money. I remove the tooth every 1-2 days and gently brush the gum, root, and crown. I then rinse with peroxide. The gum looks healthy, pink to slightly purple, and there is no pain or uncontrollable odor. It has been eight months now and the dentist is pressuring me to get this repaired, warning me of all kinds of doom and gloom if I do not. What dangers do I face if I don’t get this repaired anytime soon? What risk is there that my gum will recede to my forehead? Should I just get some glue and adhere it back in place? Any advice is appreciated. Thanks, Dr Sinkin!

  • Michael Sinkin March 19th, 2015 6:38 am

    Dear Chris,

    That your crown has failed after 35 years of service does not disturb me; it served you well. You clearly have a high dental awareness and an above average Dental IQ…(teeth #’s 7 and 26 and prematurities are not terms in most people’s vernacular). While one’s occlusion can change over time, especially in the presence of parafunctional habits like clenching and bruxing (grinding), it is a normal part of aging. And although you do wear a nightguard, it doesn’t preclude adverse effects of daytime clenching or bruxing.

    Dentists use many approaches to deal with occlusal prematurities including equilibration (bite adjustment), corrective orthodontics (such as Invisalign) and corrective restorative dentistry. You seem to have a problem that should be addressed before you develop an even bigger one.

    Your fractured #7 alone doesn’t indicate a failure in dental care. If it is vertically fractured or so compromised an extraction may be unavoidable. Perhaps your dentist is suggesting an implant or crowns and a bridge to replace the condemned tooth. If the tooth becomes infected or further damaged, the gum-line and supporting bone might very well be at risk.

    As detailed as is your description, a more careful assessment of your occlusion dynamics is warranted if for no other reason, to insure the success of future. Maintaining your tooth as you are currently doing is not a viable long term solution.

    I wish you the best.

  • Letty Montana May 23rd, 2015 8:46 pm

    Dear Dr:
    I have a resin veneer on my canine which fell off tonight.
    I have read, numerous places, that one shouldn’t use superglue but you suggest using it as a temporary fix. I can glue it tomorrow, Sunday before Memorial Day, and hopefully get into the dentist yet this week. Will he have an okay time getting the resin veneer off of the tooth after I’ve superglued it on?
    Thank you so much!

  • Michael Sinkin May 26th, 2015 9:54 am

    Dear Letty,
    Will your dentist have a difficult time removing your superglued resin repair? You raise a very good question that warrants an answer, but perhaps not the simple straightforward answer you would like to see…..maybe. Should you attempt to fix your cosmetic emergency for what might be a day or two of inconvenience before you can actually see your dentist….maybe, maybe not. If you’re getting married today or have a similarly high profile event planned, I’d say be very careful and practice positioning the broken fragment back on your tooth before using a miniscule drop of superglue to secure it. Make sure your tooth is dry and avoid getting the glue on your gum. If you can get in touch with your dentist for guidance before proceeding even better. As to whether your dentist can even use the broken piece is a question I can’t answer. You say that you have a resin veneer, not a porcelain veneer. Big difference. A resin veneer will probably be rebounded/repaired with new resin. A broken porcelain veneer will likely need to be replaced. A debonded (dislodged but intact) restoration will likely be recemented by your dentist and the less you do, the better.

    You certainly dont want to risk ruining or breaking an intact veneer if its not placed properly. That said, your dentist is the best person to offer you advice. For a day or two, I would say wait. If you decide to proceed and do it properly and your dentist can’t remove it, I’d say it’s likely to become dislodged again in short order and you will be exactly where you are now but hopefully not stuck in the middle of a holiday weekend. Good luck. (Call your dentist before doing anything, I assume he/she has an emergency phone number).
    Dr. Sinkin

  • Jo in LA May 30th, 2015 11:44 pm

    Hi Dr. Sinkin and God bless you.

    I have a two-sided problem. Both of my back molars are in the process of getting crowns, and both have had temporary crowns on them. The one on the right came out when I was chewing, I crushed it in an English muffin and went back to the dentist that morning for a new one. Two days later, the newly placed one came out, same thing, crushed and can’t be put back in. That was on Friday at lunchtime. I called and it turned out the dentist’s office is closed on Fridays. I left a message on the emergency line, no callback. I left a second message, same. It didn’t hurt though because there was root canal on that tooth, so I wasn’t too worried.

    The problem is that I know I shouldn’t chew on that side, but I’m afraid that if I chew on the left side, I’ll end up dislodging that temporary crown too, and that one does not have root canal so it will hurt!

    So I’ve been chewing on the right. Now I read that’s not a great idea either. Making matters worse, now 36 hours later it’s starting to hurt, a lot — feels like maybe gum pain, between the missing temp. crown and the adjacent tooth, but I’m not sure. It’s a lot of pain. What should I do?

    Jo in LA

  • Michael Sinkin June 1st, 2015 6:01 am

    Dear Jo,
    It seems like you bit off more than you can chew (that’s a joke.)
    Your assessment seems accurate. The discomfort you’re experiencing where the temporary crown is missing is consistent with traumatized gums. You are wedging in food and your gums are taking a beating. You need to soften your diet and keep the heavy chewing off the area. I suggest you try to use the other side (the one with the intact temporary ) for most of your chewing, but avoid a rigorous diet, i.e., crunchy, chewy, sticky foods until you see your dentist. Some foods like bread, English muffins and steak can create “suction” that may unseat a temporary.As for your aching gum, advil or Tylenol , warm salt water rinses and see your dentist. No worries just some inconvenience.
    Dr. Sinkin

  • Christina June 2nd, 2015 11:24 am

    Hi Dr. Sinkin,

    I’m having an issue with a crown that keeps coming off (tooth #19). It has come off about 7 times in the last few months and I keep having it re-cemented. I’ve had a root canal on this tooth about three years ago and now it seems to want to start acting up. I had tooth #20 extracted and a bone graft three weeks ago and my dentist said that the pain I’m experiencing in #19 is because the bone graft isn’t quite healed and is still exposed because the tissue hasn’t covered it yet. I, however, disagree with this diagnosis! The pain I’m having is somewhat severe. It throbs and I feel all this pressure in the tooth, which worries me since it’s had a root canal. Putting any kind of pressure on the tooth causes me to wince in pain. Why would my gums all around the tooth that is bothering me be red and painful if it’s the bone graft site that he says is what’s bothering me, which doesn’t hurt or bother me at all?? I can actually feel the pain in the tooth. I have a history of teeth fracturing, which is why I had to have #20 extracted, as well as another tooth in the past year. All of the symptoms I’m having this time are pretty consistent with the pain and discomfort I was having with the other 2 teeth that I had to have removed. Of course I’m worried about a fracture and I go back to see my dentist in two weeks so he can check it out again. For now, I was told to leave the crown off until everything heals from the extraction and bone graft. Do you think having a new crown put on the tooth would be the solution if it is the tooth that is the problem and not because the bone graft hasn’t healed yet?? Thanks!!!


  • Michael Sinkin June 2nd, 2015 7:57 pm

    Dear Christina,

    A crown that comes off 7 times doesn’t fit. If you were in my chair (and your 3-week old bone graft is not an issue) I would most likely have a well-fitting temporary crown made on 19. Since future treatment most likely will call for an implant where 20 was extracted, I would wait until the implant is placed and ready to be restored, which should be about 6 months hence. I would prefer to make crowns on 19 and 20 together.

    So, I suggest getting a second opinion. I can’t imagine trying to re-cement the same crown so many times.
    It has been said that insanity is doing the same thing over and over agian and expect different results.

    Good luck.
    Dr Sinkin

  • Heather Jennings June 7th, 2015 4:52 pm

    I found this website and just knew for sure that it wasn’t recent and that I wouldn’t be able to ask anyone for help, and I see that I was wrong. Thank you Dr Sinkin for being so helpful to everyone over the years, you are one unique individual.

    My question for you is this:
    I had a root canal on a molar years ago. I didn’t have insurance and didn’t get a crown put on it. The root canal failed and the tooth broke when I bit into a cookie. I went to the dentist and he said he would have to pull it, but that there wasn’t enough tooth to pull so it would need to be surgically removed. Over the years…maybe 3 or 4 now…I have just let it be. It has never given me problems. Recently, it hurt a little but I noticed it was because another piece of it was loose. I took it out, and no more pain. But within the past week, my gums are literally growing over it. It feels like it’s growing in the places where I have removed pieces of the tooth, but I’m not sure. And I’m worried if the gums will keep growing and cover the entire tooth and the little white thing that was left there from my root canal. Can that happen and what could it cause if it does? Is this something I should deal with BEFORE it grows over or will it cost the same either way? Thank you for your help….

  • Michael Sinkin June 7th, 2015 9:10 pm

    Dear Heather,

    Thank you for your kind words. I never imagined that I would reach so many people and be given a chance to share some helpful pearls.

    Now onto your question. You have a dental situation which will ultimately need to be dealt with. As long as you don’t develop an abscess WHICH IS VERY POSSIBLE, your tooth will probably not cause your acute distress in the short term. The gum is probably irritated and inflamed. You most likely have what could be described as a dental splinter that is stuck in your gum which happens if a tooth is broken and decayed and is chipping away.

    When the gum grows completely over the tooth often there will be bacteria trapped below and be the cause of a potential infection. In your case gum growth will probably not complicate the surgery but I would not delay any longer. Sooner is better.
    Good luck, Heather.

    Dr. SINKIN

  • Heather June 13th, 2015 5:39 pm

    I agree with the Heather above… what a kind individual you are to be answering questions like this on a constant basis. Thank you for your time!

    I had a second molar (which already had an amalgam filling in it) break off on the front buccal side. Of course it is 3pm on a Saturday and there is not a dental office open. I am worried about any “leaking ” of the filling as well as any precautions I should take. I am not in pain other than a very slight dull ache. I am afraid to eat or get it dirty. Is it okay to put a temporary filling product over it to protect it until Monday?

  • Michael Sinkin June 14th, 2015 8:32 am

    I appreciate your feedback and am happy to offer you some counsel. It is very common for a tooth with a very large amalgam filling to break off an entire cusp or wall. You have to be careful that the remaining filling doesn’t break off, so eat on the other side.

    You can place a temporary filling like Dentemp (obtained from the pharmacy) if you are very sensitive or if it has a sharp edge. If not, place Sensodyne toothpaste on the exposed tooth to deal with the minor sensitivity. It’s common for the sensitivity to diminish.

    You can brush with warm water and the Sensodyne to keep it clean but don’t floss. I don’t think you should have worries about leakage.


    Dr. Sinkin

  • Wendy July 12th, 2015 7:16 am

    Dear Dr Sinkin,
    I am on holidays in Canada from Australia and will be away for another 3 weeks. Last night while eating dinner I thought I had bitten something hard and took it out of my mouth and realised it was part of a tooth – the back right lower molar / tongue side. The tooth has a large filling. There is no pain – slight discomfort if I touch it with my tongue. Can I put some temporary filling on it and would it be safe to leave it until I get home?

  • Michael Sinkin July 12th, 2015 12:22 pm

    Why do these dental mishaps seem to happen at the most inopportune times? The description of your molar is a situation that I have seen on literally hundreds of occasions. You probably cleaved of the weakened cusp while biting and what remains is the filling and the rest of your tooth. That you have no pain and that the remaining portion is secure suggests that you are most likely not in any peril of acute distress. An over-the-counter temporary filling material may spare your tongue from any irrational and will cover any sensitive tooth structure, but unless these are truly problematic issues, you can probably get away with doing nothing until you get back home. Brush as normal, don’t floss this tooth as you don’t want to dislodge the filling and chew on the other side. You will likely need a crown. If you want more accurate care or if something changes and you experience greater symptoms, seeing a Canadian dentist is a good idea. Enjoy your vacation.
    Dr Sinkin

    Sent from my Verizon Wireless 4G LTE smartphone

    ——– Original message ——–
    From: WordPress
    Date: 07/12/2015 7:16 AM (GMT-05:00)
    To: sinkinfeeling@aol.com
    Subject: [Dr. Michael Sinkin, D.D.S] Please moderate: “What to do if your Tooth Cracks or You Lose a Crown ”

    A new comment on the post “What to do if your Tooth Cracks or You Lose a Crown ” is waiting for your approval

    Author: Wendy (IP:, modemcable003.52-48-24.mc.videotron.ca)
    E-mail: Whywonder@gmail.com
    Whois: http://whois.arin.net/rest/ip/
    Dear Dr Sinkin,
    I am on holidays in Canada from Australia and will be away for another 3 weeks. Last night while eating dinner I thought I had bitten something hard and took it out of my mouth and realised it was part of a tooth – the back right lower molar / tongue side. The tooth has a large filling. There is no pain – slight discomfort if I touch it with my tongue. Can I put some temporary filling on it and would it be safe to leave it until I get home?

    Approve it: http://www.michaelsinkindds.com/blog/wp-admin/comment.php?action=approve&c=251945
    Trash it: http://www.michaelsinkindds.com/blog/wp-admin/comment.php?action=trash&c=251945
    Spam it: http://www.michaelsinkindds.com/blog/wp-admin/comment.php?action=spam&c=251945
    Currently 64 comments are waiting for approval. Please visit the moderation panel:

  • Katherine July 22nd, 2015 7:51 pm

    Dear Dr. Sinkin, thank you for hosting this wonderful website. I am astonished at the level of detail in your responses.

    We are in Fort Lauderdale, about to embark on a three week anniversary cruise (a gift from our children). I have had extensive dental restoration done the past 18 months. The last quadrant is not complete. Gum tissue still healing, etc.
    #8 – #15 are my own teeth. My dentist back in Chicago used a type of dental material to form teeth #9 and #10 as a single temporary unit. Part of my own tooth #10 is the anchor for the unit. He made a second prosthetic unit to stand in for #11 and #12 That unit was fixed in place with two wires embedded in the units.
    This morning, a large visible part of the first unit (#9) broke off in pieces. The upper part is still all there, but the portion below is broken in a jagged way. It looks dreadful. An hour later the entire second unit (11 and 12) fell out, wires and all. When I picked it up it fell apart in my hands. No pain at all.
    I am heartbroken and frantic. Our cruise departs tomorrow morning!
    The only hope is that I watched my dentist make these prosthetics with his fingers, like shaping pottery. Is it possible I could attempt to make another? Or fix the broken area on the front of #9? I don’t know what the material is, though, and his office is closed for 2 weeks.
    Please tell me what do.

  • Jean July 24th, 2015 6:25 am

    I am on vacation and my back molar which had a crown has broken off at the gum line. I am not in pain. Do I need to see if I can get in to a dentist today (Friday) while I am out of town, or could this wait until I return home next Thursday? Thank you for your response.

  • Michael Sinkin July 24th, 2015 8:04 am

    Dear Katherine,
    Bad timing, as if there was ever a good time for a dental disaster. Hopefully there is a dentist available on board. I’m so sorry for your troubles.
    Bonus voyage.

    Dr. Sinkin

  • Michael Sinkin July 24th, 2015 10:19 am

    Experience tells me that you most likely will be fine until you return home. Either you already had root canal treatment or the nerve is no longer vital. Since you are not in distress or feeling discomfort, you will probably be ok not to seek care from an out of town dentist. But you will need to have the tooth fully evaluated and there is a good change you will need a new crown and a post placed which will require multiple visits. Meanwhile, keep the stump clean, it’s usually OK to brush in these situations. Set up an appointment as soon as you return home. Have fun!
    Dr. Sinkin

  • Patricia Kelley July 28th, 2015 7:56 pm

    Dr Sinkin I recently had a tooth extracted(crowned 10 years ago) I experienced intermittent pain from that tooth affecting other teeth (all upper right side)off and on visited several dentists nothing could be found to cause this no cracks, nothing. This past winter this worsened I visited another dentist and he found a split root only option extraction. We are in the process of a bridge and another tooth in its place (I sustained extensive bone loss)
    My dentist,MD injected something (900.00) to promote some sort of graft (if I’m saying this right, so he has something to be able to attach a new tooth to. It’s been 6 weeks since the extraction and the pain is back just like it was before extraction. How can this be? I’m confused and I’m wondering if this caused this pain or is it something else. Should I seek a 2nd opinion?

  • Michael Sinkin July 31st, 2015 7:08 am

    Dear Patricia,
    Dental pain intensity can range from background annoyance to all-consuming. I never think that a second opinion is a bad way to go. In fact I encourage it. But before you running to other offices, what has your dentist told you? By your description, I’m not exactly sure what’s going on with your post extraction experience. Are you having a bridge or an implant? Did you have a bone graft where your tooth was extracted and are you going to have an implant? Was an implant considered? The bone loss on the tooth that might be supporting the bridge – was that the area that you had the graft? Is the tooth strong enough to support a bridge. Where is your pain coming from? Referred from, another tooth in the area? Extraction/graft related?
    I suggest that you have an evaluation by a Board Certified Oral Surgeon and/or a Periodontist to get another point of view and I would include your dentist in the process. I’m sure he’d be more than willing to recommend some specialists for you. What you need is more information before taking the next step or having more treatment. Be well.
    Dr Sinkin

  • Mika August 25th, 2015 2:31 am

    So, I have no clue how this happened, but my back tooth on my upper jaw is either chipped or cracked (I can’t really tell which), but I think its a slight chip or crack. I’m not feeling any pain right now, but I’m scared! I don’t ever recall having any problems with my teeth, and I don’t know what to do. I’m already planning on staying away from coffee for awhile until I know exactly what’s going on. I have a huge fear of seeing dentists since I was 12 (I’m 18, now), and if seeing a dentist means having a needle stuck in me (I have an even bigger fear of needles)….I just don’t know what to do right now, and I’m scared. Please help!

  • Michael Sinkin August 25th, 2015 1:05 pm

    Dear Mika,

    For your own sake, please try to calm down. You are getting way too ahead of yourself and will make yourself sick with worry for perhaps no reason at all. If you chipped your tooth, you might only need to have the area polished. Or you could possibly have the chipped area bonded and might not need any anesthetic. If an old filling came out and there’s no decay, bonding without drilling or anesthetic is entirely possible. Obviously you need to see a dentist. Dental fear can be crippling and quite dreadful. You need to calmly share your feelings with both the receptionist and the dentist. Make an appointment for an emergency examination and explain that you do not expect/wish to be treated during this first encounter. You need to prepare yourself and understand the recommended treatment. This way you can have your tooth evaluated with the peace of mind that the dentist will just be looking. Once you know what’s needed you can discuss strategies to help you deal with your fear.
    You mentioned that it’s an upper back tooth – the easiest area to give a nearly painless injection, IF you need anesthetic. Nitrous oxide and/or a mild sedative may be helpful, but in truth, nothing trumps compassionate care.
    One step at a time. Don’t torment yourself needlessly, find out what the problem is and take it from there. Dentistry has come a long way and so have you….you’re older and wiser!

    Good luck and let me know how it goes.

    Dr Sinkin

  • Amy August 28th, 2015 6:37 pm

    I have a crown over a root canaled molar. The crown just came off while I was eating some nuts. I read through your q and a’s and think I have it handled. But I just want to thank you for providing this blog to those of us who have these dental emergencies. This is Friday night, going into a weekend, and here in Florida, we are expecting a tropical storm or hurricane by late Sunday into Monday. My dentist has no emergency line, so I’ll have to wait until Monday to call and hope we have electricity by then. So, I have no pain, and I believe I should be saving the crown, brushing the tooth stump, and not eating on that side. I think I prefer to skip temporarily gluing it back in, unless it’s necessary to do so. Thanks a million!

  • Michael Sinkin August 29th, 2015 10:04 am

    Dear Amy,
    It sounds like you have the situation well under control. Put your crown in a safe place. I can’t tell you how many times patients wrap their displaced restorations in a tissue only to then throw it in the garbage! I hope the storm fizzles out and sun comes out with no harm done. Good tidings.
    Dr Sinkin

  • Debra September 14th, 2015 1:56 pm

    I had a root canal done about seven years ago but didn’t get the crown. The tooth broke off at the gum line about five or six years ago and has never caused a problem. Last week I felt a fragment of tooth come loose and a some sliver came out. Now this week, another piece of tooth is protruding, loose, but I can’t get it out. My gum is now sore and swollen. My pain is increasing and my gum is turning black.

  • Michael Sinkin September 14th, 2015 10:54 pm

    Dear Debra,

    I am truly sorry for your dental tribulations. Unfortunately, your story is all too common. The number one reason that teeth treated with root canal therapy are lost is that they were not properly restored and protected with a crown. I have received scores of emails describing your very predicament and have seen far too many emergencies stemming from a broken endodontically treated tooth (root canal) that was broken beyond repair because of a failure to place a proper restoration.

    The rhetorical question that I frequently ask myself when I encounter this situation is why invest the time, effort and money trying to save a tooth with root canal only to see the tooth extracted because of a failure to complete the needed treatment? Of course, I know that finances play a big part in this frequent conundrum. Root canal is the first step when a painful tooth requires the removal of an infected or irreversibly inflamed nerve and pain is a big motivator to seeking dental treatment. But it’s just the first step in the successful treatment of a tooth at risk.

    Root canal, post and core and crowns usually go hand in hand and this triumvirate of care can involve a significant financial investment. Of course, both patient and dentist desire seeing the completion of such care, but oftentimes when the pain is gone, the cost weighs in heavy and the restorative phase of treatment is often delayed for months, for years, or even forever…until disaster strikes.

    Debra, without seeing your tooth, your description leads me to surmise that your tooth may need to be extracted. The gum is clearly inflamed, quite possibly infected. You need to see a dentist ASAP.

    In the meantime, use warm salt water rinses and analgesic pain medication. Don’t procrastinate any longer lest your problem gets even worse. Best of luck.

    Dr. Sinkin

  • April September 20th, 2015 1:32 pm

    My last molar on the top, #15, is largely a filling that has been there for a number of years. There is no problem with the filling. However, there is a small cavity on that tooth on the part of it that is next to the next tooth. The dentist wants to do a crown. He doesn’t think that a filling will hold. Why wouldn’t it hold? I would prefer a filling if possible.

  • Michael Sinkin September 20th, 2015 6:04 pm

    Dear April,

    Of course you would prefer a filling as opposed to a crown…who wouldn’t? A filling is done in one visit, is less “invasive,” and less costly. But less treatment is not necessarily more conservative treatment if one considers the long-term prognosis of a tooth. And less treatment can be tantamount to “patch” work that may ultimately fail.

    You have a second molar (#15) that has a large filling. More specifically, in your own words, it is largely filling. Now you have a cavity on the part of the tooth that is filling-free. Placing a filling in this situation can compromise the integrity of the existing restoration and could weaken the entire tooth. What you are hoping is that the patch will cure the problem, but in fact it could lead to your second molar breaking and needing a crown, anyway. Additionally, because #15 is subjected to much biting force, your tooth could break below the gum or through the nerve and that would lead to more costly and involved treatment.

    What it may boil down to is this: a “patch” could save you time and money now but it may cost you much more in the future, be it in 2 months or two years from now. It’s certainly something to think about. You might want to ask your dentist to show you a photograph of the tooth. That might give you a clearer view of the situation and make you feel better about the crown.

    Good luck!

    Dr Sinkin

  • Georgette October 4th, 2015 11:10 pm

    Hi, this is about my 7 yr old son , one of his teeth has been loose for about 2-3 weeks now except now it’s pretty much dangling the thing I’m worried about is his gums although they’re not swollen it’s very purple just the part of his gums where the loose tooth is . It’s i think what you call a lateral incisor maybe it’s the tooth next to his two front top teeth. It has a cap/crown on it and it’s a baby tooth. Will his gums be ok? I’m not so much worried about the tooth because he’s already lost several of his baby teeth the only thing I worried about is his gum being purplish where the tooth is coming out. Is this something to be worried about??

  • Michael Sinkin October 5th, 2015 2:06 pm

    Dear Georgette,
    That the gum being purple is usually consistent with inflammation associated with a loose baby tooth. That said, the tooth has a crown and there is no way to determine if it’s the tooth that is loose or the crown itself. I suggest you call your dentist and have it looked at. Better safe than sorry.
    Dr. Sinkin

  • Bruce lee October 11th, 2015 7:00 am

    Hi Dr Sinkin,

    I wonder if you can please help me with a query about my half crown which which fell out a few weeks ago – this tooth has had root canal work about 5 years ago. I had the crown glued back on by my dentist but this fell off after a couple of weeks. After returning to the dentist 5 days later, he put in a temporarily (soft) filling as I was shortly to go on holiday. His intention is to replace the half crown with a full crown on my return – none of this preparation work has been done. However whilst on holiday the soft filling has come out and fallen down the sink hole. I have still a week on holiday in Tenerife (I live in the UK) and not in any pain. Can you please advise whether I need immediate treatment (filling) on my tooth? Any advice would be greatly appreciated.

    Thanks Bruce

  • Michael Sinkin October 11th, 2015 5:02 pm

    Dear Bruce,
    You will likely be able to manage the problem until you get home. Most important: Chew on the other side and don’t forget. If you bite on it you could do some real damage. Brush the tooth as normal; be diligent about keeping it clean but not overly agressive. If you can get to a pharmacy you may be able to find temporary filling material; if so, you can use it to plug up the root canal access hole until you get home.
    Best wishes,
    Dr. Sinkin

  • Bruce lee October 11th, 2015 5:38 pm

    Thank you Dr Sinkin for the prompt response and help.
    It’s always worrying to experience dental problems whilst on holiday so it’s good to hear your advice.

    Thanks again, Bruce

  • Kelsey October 14th, 2015 5:16 pm

    I had a terrible fall last thursday and lost a huge piece of my right front tooth. Thankfully my dentist was able to see me, perform a root canal and put a temporary cap on it. I have an appointment with him in two weeks to get a permanent crown made for it. My doctor mentioned that my left front tooth was cracked and although the x-rays didn’t show that I needed work done on it, I could still possibly lose it. He told me to look out for browning, near by pimples on the gum line and burning sensitivity of the tooth as indicators that it also will need a root canal and crown. Well it’s almost a week later and although the sensitivity of my left front tooth has gone down, I have noticed more cracks on the front than I’d previously thought. The bottom edge of the tooth also is starting to show a maybe brownish/yellow/translucent tint.
    Would putting sensodyne gently on the surface of my front left tooth where the cracks are help the enamel regenerate?
    Is it possible for the cracks to heal?
    I will see my dentist in a couple weeks but I’m wondering if there is anything I can do to avoid losing this tooth as well?
    I am trying to stay on a liquid and soft foods only diet but sometimes my bottom tooth underneath will tap my front left tooth when I’m talking and I get a sharp pain.
    Thank you so much for the help!

  • Michael Sinkin October 20th, 2015 8:42 am

    Dear Kelsey,

    So sorry to hear of your dental trauma.
    As far as your soon-to-be crowned tooth goes, it sounds like you received timely and thorough care. As for your other front tooth, there is really no way to refortify your tooth as in remineralizing those cracks. It appears that the fall targeted your teeth, but luckily no further harm came to you. I do not view restoring your tooth or teeth with beautiful crowns, even if root canal is needed, as losing one’s teeth. They are being saved- meaning they are not being extracted. And with the proper care, your teeth should look as good and perhaps even better then before, though, admittedly, breaking one’s front teeth is very traumatic…physically as well as emotionally.
    Wishing you the best,
    Dr. Sinkin

  • Kelsey October 20th, 2015 6:28 pm

    Thank you Dr.Sinkin for the quick response. I feel more at ease just knowing that I am doing what I can to not further the damage. Thanks again for helping me get a better perspective on the situation!

  • Michael Sinkin October 23rd, 2015 9:13 am

    You are very welcome.

  • Sandi October 28th, 2015 3:27 pm

    Dr. Sinkin, I recently had a tooth repaired with a I guess a bonding. My molar had broken and my dentist repaired it with a filling of sorts. My problem is that I am afraid to eat on that side of my mouth in case it breaks again. I do grind my teeth at night and I have a hard mouthguard and I am scared to sleep because I’m afraid I will bite down to hard and break the tooth again. I don’t know what to do, I’m driving myself nuts worrying about this.
    Thanks Sandi

  • Michael Sinkin October 29th, 2015 8:20 am

    Dear Sandi,

    Bonding a broken tooth is a common procedure that can serve as the definitive restoration/filling for years to come. Or it can be a quasi-temporary repair that can tide you over until a more durable solution can be offered, such as a crown. Did your dentist explain your particular situation?

    In the long run, a crown could be a better and less costly option because repeated repairs can add-up. And the fact that you wear a night guard indicates that your teeth get a “work-out” every night. But I’m sure that your dentist has a good handle on your situation. You may just need him or her to explain a little more to you about the procedure and what to expect.

    So, call the dentist for some guidance. Also, if you feel that your night guard puts extra pressure on the affected tooth either by way of the fit or the bite, it may need to be adjusted.

    You need a little more explanation, but don’t let it keep you up at night. Just keep wearing your night guard.



  • Benjamin October 29th, 2015 11:06 pm

    My #3 tooth was in extreme pain and my endodontist found a crack that ran through the root. He removed the “angry” nerve and tissue and packed the tooth with meds and a temp filling. I’m scheduled for the tooth to be extracted, but my tooth feels great now. No pain and no sensitivity to cold. Do I still need to follow through with the extraction? Since my tooth feels much better now, can’t I just put a crown over the temp filling? I really don’t want to pull my tooth out!

  • Michael Sinkin October 30th, 2015 8:04 am

    Dear Benjamin,
    In a word……no.
    Your endodontist did “too good” a job making you comfortable in an emergency situation. Believe me, most endodontists would prefer to save the tooth, complete the root canal and place a nice crown. But, your tooth is cracked and it’s just a matter of time before you likely will have more problems, including a possible infection.
    You can’t place a crown on a tooth without finishing a root canal, and you can’t finish a root canal if a tooth is split. My advice: follow your endodontist’s
    Best of luck,
    Dr Sinkin

  • Alice November 15th, 2015 12:03 am

    I had a 2 temporary crowns put on 3 days ago (they are connected, so one big crown) and now it’s Saturday night. I ate a handful of Reese Pieces and the area that that the temps are on was aching. I went to go brush my teeth and floss on the front and back of the crown. On the back side when I pulled the floss out the crown popped up. Not off, but I pushed it back down and bit down to make sure it lined up still and it does. But it is still aching. I am not sure why and I left a voice mail for the dentist so I am sure I can get in Monday morning. But in the mean time should I do anything, or not do anything, other than no sticky or sweet foods? I don’t know if something got under it making it ache or what? Any help would be so very much appreciated.

  • Michael Sinkin November 15th, 2015 9:09 am

    Hi Aice,
    Your temporary crowns have become dislodged and the cement seal holding your temporarily splinted (attached) crowns have become “unglued”. The intense sugary sweet candy caused an assault on your teeth’s nerve endings. Rinse with warm salt water to neutralize the irritation. Don’t floss. Use SENSODYNE toothpaste. During this time avoid sweets.
    Get in to see your dentist ASAP.
    Good luck!
    Dr. Sinkin

  • Sandi November 16th, 2015 1:33 pm

    Dear Dr., I was just at my dentist this morning complaining of pain in my left upper back molar. It hurts if I drink anything cold or move my tongue to far to the right side of my mouth. When I feel with my finger it feels as though my gum is split and it really hurts to touch it. My dentist checked it and took x-rays; he says he doesn’t see anything that could be causing my pain, just a little irritation. He did fix a chipped filling I had on the same side. and put some desentizing goop on the tooth that was bothering me. but now it’s been almost an hour since I was there and it’s starting to hurt again. He told me to put warm compresses on my cheek and take ibuprofen for the pain and it should subside in a few days. But I’m worried there is something else going on although he said there is nothing in the x-rays. He told me to continue wearing my mouth guard because he thinks that’s why it’s hurting because of my grinding. I don’t know what to do, I don’t think I can handle this until I go back in January. My insurance is used up for this year.

  • Michael Sinkin November 18th, 2015 8:37 am

    Dear Sandi,
    Sometimes diagnosing the cause of someone’s tooth pain can be an elusive endeavor. When clinical findings, such as xrays, temperature and bite testing are all negative, a bit more of the art of diagnosis is called upon. I think time will reveal the culprit. The root cause of the dental malady may not at first be evident, but clearly you need to see the dentist again, regardless of your insurance.
    Good Luck.
    Dr. Sinkin

  • Sandi November 24th, 2015 5:43 pm

    I am such a chicken, I was supposed to get a root canal this morning but I was too scared. I had cold sensitivity on another tooth that I asked her to look at and she said that one needed a root canal as well. I hi-tailed it out of there, terrified. I immediately went to my regular dentist (I was at the endo this morning) and he said it was probably just sensitivity and put some stuff on it. So here I am sitting at home feeling sorry for myself and mad at myself. I have only been to this endo one time for an evaluation. I’m so scared, I really don’t like the dentist and I am really scared of pain. Help Me….

  • Chery November 25th, 2015 9:23 am

    Hi, I hope you can help me. The tooth next to my Eye tooth was surpise to have a root canal diwn kast summer, but I didn’t have the funds. Now I’ve waited to long and it’s to late. The temp filling is gone and the toith is exposed. Yesterday I was eating some hard bacon and the tooth fills loose. Im surpose to get the tooth extracted in two weeks. Should I go right away or can I wait. For the last two weeks the gum around it feels puffy and sore.

  • Michael Sinkin November 25th, 2015 5:07 pm

    Dear Chery,
    I suggest you go sooner rather than later. You certainly don’t want to develop an infection.
    Good luck and have a happy Thanksgiving.
    Dr. Sinkin

  • Michael Sinkin November 25th, 2015 5:11 pm

    Dear Sandi,
    Your reaction to the prospect of having root canal treatment is not uncommon. We have been indoctrinated and influenced by the hype and terror that has been ascribed to root canal therapy. Movies, books, television all have used dental humor and root canal in particular as a focal point of unpleasantry. But much of this is based on archaic notions from decades ago when root canal was not as refined a procedure as it is now. In fact, many of my patients find it boring and some even nod-off!
    Please read my previous blog: Painless Root Canal, An Oxymoron? http://www.michaelsinkindds.com/blog/painless-root-canal-treatment-an-oxymoron/
    It will amuse and educate you. Good luck!
    Dr. Sinkin

  • Arun January 4th, 2016 4:23 am

    I had a root canal a year ago and had a crown placed on my front tooth, while eating today i broke my crown and the tooth which it was placed on has been halved , I am nervous please tell me what to do

  • Michael Sinkin January 4th, 2016 10:25 am

    Dear Arun,
    I understand your concern. There isn’t much I can offer you in the way of advice except the obvious….you need to see your dentist right away. If you broke the crown without damaging the tooth, a new crown can be made. If the tooth did not have a post placed, and the remaining tooth structure is sound, it is entirely possible that the broken tooth can be restored. If the tooth is split too far below the gum or the root is fractured, other options exist including a dental implant. But don’t get too far ahead of yourself. See your dentist and get the facts. Good luck.
    Dr. Sinkin

  • Melody January 29th, 2016 1:48 am

    I’d truly appreciate your insight into my question:

    About a year and a half ago, the dentist put a porcelain crown on my broken tooth, I got a root canal previously. From the very beginning I developed sensitivity, I went back to the dentist and one time he worked on the crown and the told me that I wouldn’t have this sensitivity afterwards, it just worked for a while, but then through time, this sensitive developed into pain, I came back to him, and while examining me, he used the tool dentists use to tap the tooth, he did it but very hard, it hurt me, both to the crown and of course, the broken tooth underneath: Could this have caused the total breakage of my tooth? … at the same time, he advised me to go back to the DDS and get a check up, because he told me it was related to the root canal, I went and he said that my tooth breakage has extended and that I needed to have it removed: To me this is very unfair, for I paid a high amount of money to have these two procedures done, and as I know, crowns are supposed to last for several years.

    None of these two professional people are taking responsibility, for they said that it was my option to have the crown on my broken tooth.

    Isn’t a crown supposed to be there to protect and cover up the tooth totally and that for several years??? .. if not, why would they recommend it??? Now, I noticing it’s affecting my gum next to the crown. I talked to the dentist and the only option he gave me it’s to have my tooth removed and afterwards to either to put an implant or a removable kind of a denture to cover up that space of the missing tooth, for either one, these are both very expensive!

    Thank you!



  • Michael Sinkin January 29th, 2016 12:04 pm

    Dear Melody,
    I completely empathize with you and your predicament.
    Here are a few questions:
    1. Did your dentist or Endodontist convey to you at the onset of treatment that the prognosis of could be in question?
    2. Do you know if your tooth had a vertical root fracture? Vertical root fractures nearly always need to be removed.
    3. Were you given a cone beam C-T scan (which many root canal specialists have in their office may have detected a fracture, unless it was not necessarily present at the time of root canal.)
    4. Did the tooth receive a post when the crown was made? Sometimes that can help propagate a crack down the root.

    Most important, your gum irritation suggests that something needs to be done ASAP the surrounding bone is lost. I have to suggest a second opinion from an oral surgeon or periodontist.

    Dr Sinkin

  • Alina March 5th, 2016 2:51 pm

    One of my top baby teeth have been needed to be pulled out because of not moving for an adult tooth that is growing out of my gum. But yesterday, I thought that it had finally started to come loose, Little did I know that it had cracked in half and only the front was loose. This tooth also required a filling but the dentist had said that it needed to come out soon so don’t bother. When I look in the mirror I can see that from the side one half has cracked off, and that yesterday I was helping crack open the other side. the only thing holding this piece in is the rest of my tooth.
    My dentist check up is due in a month or two.

  • Michael Sinkin March 8th, 2016 2:57 pm

    Dear Alina,
    Clearly the future status of this tooth has already been determined i.e., it needs to be extracted (according to your dentist). That it just broke only moves up the time table. I assume that you are not in pain. Often times the nerve of an over- retained baby tooth disintegrates naturally. If you are asking if you should wait until your next regularly scheduled appointment, I would suggest not and get the recommended treatment started before your gum possibly becomes irritated.
    Good luck!


  • Mellissa March 11th, 2016 12:11 am

    I have recently stopped taking a mediation after 21 years, it was very toxic, posion to my body. I have Epilepsy and the medication was Depakote, it tore me up inside and out without me even knowing it was that, until I found my great Neurologist who took me off of this and told what it was doing to me. Anyway, getting to the point I my enamel on my teeth is coming off as a result from this medication and their chipping and sharp and I have lost some already, already have a partial, gums are red and bleed if I brush even a little bit soft, teeth are loose all through my mouth, and I am sensitive to cold in some spots. And I am not yet 40 yrs old, at least not for another 3 weeks. I am extremly embarressed by this hoping that one day a tooth or teeth just dont fall out or chip off at work, I have heard so many people say how hard it is with dentures and how it hurts. Man I am so young, its not right. Is there another alternative that is not so costly as veneers, which I most defintly can not afford. Just need help at my wits end.

  • Michael Sinkin March 11th, 2016 9:15 am

    Dear Melissa,

    I sympathize with you on many levels. My younger brother has had epilepsy since age 26 (he’s 50 now) and has been on Depakote for over 20 years. Although he has not experienced the dental problems you describe, the meds certainly have side effects including dry mouth, which puts teeth at risk. You need a thorough dental evaluation to get active disease, like your periodontal health, under control. Gum disease, if left untreated, can cause tooth loss.

    I cannot make any treatment recommendations regarding your chipping teeth without more information. But it might be possible to restore your teeth with direct bonding as a stop-gap measure and replace your missing teeth with a relatively inexpensive removable partial until dental implants can be placed, but that is entirely up to your dentist.

    I have personally orchestrated comprehensive care over a 10-year period where now my patient is coming to the end of active care with her missing teeth replaced with strategically-placed implants. She did not have a partial denture, but rather a fixed (non-removable) bridge using the few teeth she had for support. She is a nanny, so money was an issue…still is. Yet over the 10 years she never lost her smile.

    You are young. Don’t despair…there are solutions available for you.

    Best of luck,

    Dr. Sinkin

  • Elizabeth April 15th, 2016 11:37 pm

    I had the frontal exposed portion of my crown break off last week. It didn’t hurt then, but now the entire remainder is handing off like a snaggle tooth and it’s painful! It’s Friday night and I work all day Saturday and Sunday. To boot, I just moved to the are and have no dentist yet as my insurance was just activated. I’m in PAIN!

  • Michael Sinkin April 17th, 2016 1:28 pm

    Dear Elizabeth,

    The best advice I can give for right now is coat the tooth with Sensodyne to get some relief from the pain. Advil or (not at the same time)will help. Now, you are going to have to find a dentist ASAP for proper and definitive care. Advil or Tylenol for the pain if you’re good those medications. I hope you got through the weekend OK. Feel better.

    Dr. Sinkin

  • Amy May 5th, 2016 1:36 am

    I have a filling on the side of my very last tooth on the bottom…I can feel it lifting out and literally have to push it back it from time to time…its very painful and its starting to swell my face a bit as well.

  • Michael Sinkin May 5th, 2016 8:33 am

    Dear Amy,
    Your filling is obviously loose and mostly likely needs to be replaced. Why it has become dislodged is a matter to be determined by your dentist – and yes, you need to visit a dentist! The filling could have physically broken or there may be decay under it. Don’t delay. Things can only get worse leading to more involved treatment. Good luck!
    Dr. Sinkin

  • China Harvey June 9th, 2016 9:13 pm

    I had a root canal about 1 1/2 to 2 years ago and shortly after that I had a crown put on. This is a front tooth. The dentist filed my tooth down to a peg and placed the crown. Today the crown fell off and the peg (tooth) is broken off inside the crown. I was told root canal teeth do this often (break off). Can I just have the tooth re-cemented and will it stay on? What options do I have to repair this tooth? Someone said my only option is to have a costly implant done. Thanks for any assistance you can provide.

  • Michael Sinkin June 10th, 2016 12:50 pm

    Dear China,

    So sorry for your troubles.
    While it is true that teeth with root canal therapy are more prone to fracture than vital (non-root canaled teeth), generally that is because the tooth had been structurally compromised because of previous restorations, traumatic injury before or after root canal or possibly improper restoration of the tooth after the root canal was completed. (And sometime, things just happen, like biting into something very hard which can also break natural teeth.)
    In your case, you didn’t mention whether a post was placed into the tooth when the crown was made. If this is the case and your root is not split, it could be possible to place a post in the root and make a new crown. If your tooth broke flat across the gum-line, so the aforementioned scenario might be possible.
    If the tooth is un-restorable, then an implant may be a viable option.
    (As an aside, the cost of a root canal, post and core and crown is often not much different than replacing a tooth with an implant and crown.)

    Obviously, you need to have your tooth evaluated before any decision is made. I hope this information was helpful and quite possibly reassuring.

    Dr. Sinkin

  • China Harvey June 11th, 2016 2:36 pm

    Thanks sooo much Dr. Sinkin for responding. I really appreciate it, that was good information. I’m not sure that a post was added prior to putting on my crown. Yes my tooth broke off evenly across the gum line and exposes the tooth. When my tongue touches it, it feel somewhat smooth not jagged. So if I understood your comment correctly I (the dentist) can possibly add a post and reuse the current crown or will another one have to be made? The current one has the old tooth inside is their a way to remove the broken tooth from the crown?

  • Michael Sinkin June 12th, 2016 10:44 pm


    Your dentist is the ultimate decision maker, but in my experience it would appear that you likely need a new crown.

    Dr. Sinkin

  • Jeff B July 1st, 2016 7:51 pm

    Hello Dr., I am on vacation in NYC until July 6th. My temporary crown just cracked in several pieces and came off. It is not salvagable. I cannot get in touch with a dentist because of the July 4th holiday weekend. The tooth has had a root canal and it is extremely sharp. The tooth will be getting a permanent crown. I am also nkt feeling any pain atvthe moment. Will I be ok to wait 1 week to see the dentist and get it fixed? Is there something else I can do? I thank you im advance for any ideas or suggestions you may have.


  • Kim Sheppard July 2nd, 2016 12:01 pm

    Hello Dr Sinkin, I had a root canal in my lower back molar and then the tooth cracked in half. My new dentist then removed half of the tooth and cut my gums to gain enough tooth to attach a temporary crown to. Last night the temp. Crown broke off. It is the Canada day long weekend and on Monday morning I am flying to Las Vegas for 6 days. Of course there is no pain due to the previous root canal a and there are no sharp edges, but should I try to find emergency care to replace the crown or can I wait until I get home.

  • Michael Sinkin July 4th, 2016 9:53 am

    Dear Jeff,
    Why do these things seem to happen at the most inopportune times?
    Since your tooth had root canal, sensitivity to temperature, sweets, etc., should not be a problem. If it’s not your front tooth, esthetics is not a problem. You can probably brush as normal l. As far as the sharp edge, you may try placing sugarless gum over the tooth to protect your tongue from abrasion and don’t eat on that side. I’ll be in my office until Tuesday if you are still in trouble, feel free call for an appt.

    Dr. Sinkin

  • Michael Sinkin July 4th, 2016 10:33 am

    Hi Kim,

    I suggest that you call your dentist and let him or her know what happened as soon as their office is open. Your dentist is the best position to advise you. Enjoy your trip.

    Dr. Sinkin

  • Dave Mags July 17th, 2016 2:09 pm

    Hi Dr.Sinkin
    So I had a root canal on a bottom molar tooth few years ago and never followed through with finalizing crown treatment etc. Couple years ago broke off half the tooth chewing peanuts. No pain no swelling no issues. Now one last fragment is remaining and has been currently loosened a week ago and continues to loosen. Feels like it could come outt. This happened on the other side last year and the fragment fell out no problem no issues as my dentist told me it was a dead tooth with dead nerves due to not completing another root canal due to lack of insurance and money . I don’t have dental insurance and money is very tight right now for me as well. Will this tooth break off too? What do you suggest.

  • Michael Sinkin July 18th, 2016 8:25 am

    Dear Dave,

    Unfortunately, yours is a common dental tale in which root canal therapy is not completed. Hindsight is 20/20 and while I am sure you had the best of intentions to complete treatment and save your teeth, you know have two teeth that might be destined to be extracted. Yes, it is possible that the loose piece may just break off and free you from the irritant. But it is also possible that you can develop an infection in the gum and or bone. You should have it looked at before an inconveniently timed emergency occurs. If you develop swelling, pain or difficulty swallowing get to a dentist ASAP.

    Good Luck,

    Dr. Sinkin

  • Ryan Delaune August 16th, 2016 9:32 pm

    Hi Dr Sinkin,

    I was a terrible tooth brusher as a younger man and had to have fillings done in many of my teeth. With time and the addition of teeth grinding at night in my twenties, more work needed to be done, so I have 4 crowns and every filling has been redone. I wear an oral occlusive device at night religiously. A couple of questions-

    1. Is there a type of specialty or technique to help adjust bite and my occlusion? My dentist does good work on fillings & crowns but I feel like their bite adjustments have never really worked out. Current example- my back upper molar has a big plunging stalactite that presses into the lower molar. I had been telling them the lower tooth was under a lot of pressure. Even though they did work on the lower filling recently, saw that it was under a lot of pressure, and made some adjustments, it still presses quite hard. The lower tooth is cracking and now needs a crown. I understand that I have limited tooth to work with, so if there is some technique to really get it right I’d love to hear about it. Right now they do the thing where I bite on a thing that leaves marks on my teeth and they trim the marked parts.

    2. When do braces like an oral occlusive device generally need to be redone? Mine is missing the part that covers my back left molars, and several teeth have been worked on since I got it, so I doesn’t fit super well. I don’t, however, have any issues with my jaw clicking or getting stuck like I used to.

    3. Any general advice as a provider for when your dentist seems to have high technical skill but maybe lacks a particular skill set you need or seems to focus on specific problems but fails to see the big picture?

    I’ve been reading your blog quite a bit recently, really appreciate what you do here!


  • Michael Sinkin August 24th, 2016 1:34 pm

    Dear Ryan,

    I appreciate your insightful questions and of course your positive feedback.

    As you so keenly observed, comprehensive dentistry involves so much more than technical excellence. Though I am in no way minimizing the importance of technical precision and skill, one must be mindful of the forest as well as the individual tree. When restoring a tooth, a dentist must appreciate and factor in all kinds of variables that differ from person to person. Some people are heavy clenchers or bruxers (grinders), some people have large bones and heavy musculature that can generate a lot of force while others are more petite. Some people have a “normal” occlusion where the teeth align properly while many have a malocclusion that doesn’t provide for a more protected harmonious distribution of forces.
    And diet plays an important role in the forces placed or teeth, restored or otherwise. For example, oatmeal is easier on the system than granola.
    Most times a “filling” is a simple restoration that requires no special consideration. But there are situations in which the forces placed on a tooth and the planned restoration exceed normal physiological tolerances. The aforementioned variables are just a few examples of when greater than average forces can come into play. That said, when a patient such as yourself requires restorative dentistry, it may be necessary to take a step back and evaluate the health of the forest before attending to the ailing sapling trying to take root.
    What you described on your opposing tooth (the plunging stalactite) is actually referring to as a plunger cusp and often needs to be re-contoured to diminish force concentration. You are astute in your observations and hopefully you shared your concerns with your dentist.
    Sometimes, it is prudent to take a “step back” and evaluate the, as you said, evaluate the bigger picture. I strongly suggest requesting a consultation with your dentist to discuss your concerns. If he has the technical skills than perhaps he just needs to hear your input. Patients often have the diagnosis, we the healthcare providers just have to listen closely enough. If you are not satisfied with his response, then you might consider making a change.
    The marking paper you refer to is called articulating paper and it is a mainstream staple in the practice of dentistry. It does indicate areas of tooth-to-tooth contact. But it is just a tool, an important one, but just one of many. Sight, sound and “feel” are important considerations as well. And yes, occlusal guards do need replacement or modification when additional dental care alters the shapes of the teeth involved. Yours very well need replacement.
    Ryan, I hope that I have answered your questions to your satisfaction. Be well.
    Dr. Sinkin

  • Rachel September 18th, 2016 12:36 am

    Dear Dr. Sinkin,
    The short version of my question is this: in desperate times, what is the worst that can happen if I use superglue to attach a temporary crown to a post and core?
    The long version:
    I had a permanent crown on my front incisor that came off a few months after its initial placement, and most of the tooth underneath crumbled away immediately after it came off. The dentist tried several times to cement the crown back on, but it kept falling off because of the small amount of tooth left.
    The next step was a post, core and crown treatment, but it involved having a small inflamed area at the bottom of the root removed with a surgery. The temporary crown that was put on at that point stayed on for 3 weeks. At that point the dentist prepared the core for the permanent crown, and gave me a new temporary crown.
    The temporary crown fell off the same day. I have chronic fatigue problems, so I waited three days to have it re-glued. Again, it fell off the same day. So now, two days later, I had it re-glued for the third time. It just fell off again. I still have 6 days until my appointment for my permanent crown. I’m desperate to not keep going back to the dentist for this, but also horrified at the idea of anyone seeing me like this. I have some temporary dental adhesive from the drug store, but it doesn’t hold for more than a few minutes. This is the reason for my main question.

    I also want to be a good self-advocate when I see the dentist for my permanent crown. I’m afraid that the permanent crown will have similar problems with falling out. When the dentist prepared the core for the permanent crown, he drilled it down to a very small stub, barely bigger than the old tooth. I know he did this to avoid it making contact with a lower tooth, but I’m afraid that this small stub won’t be enough to hold it. I’m already feeling desperately overwhelmed by this situation, and I don’t know what I’d do if the permanent crown came off again after all this. Do you have any advice for me as to how I can express this to the dentist and make sure I’m being taken seriously?

    Thank you so much,

  • Michael Sinkin September 18th, 2016 3:41 pm

    Dear Rachel,

    Temporary crowns can become loose or dislodged. But at least in my personal experience that is the exception rather than the rule. Assuming that you’re being careful with the tooth, and it sounds like you are, you have every right to be concerned. You invested quite a bit of time, effort, money, and perhaps some degree of discomfort or inconvenience into your treatment…including the surgical apicoectomy that you alluded to. It is possible that the temporary simply doesn’t fit well.

    Here’s my advice: either call your dentist immediately and tell him or her exactly what you just told me or send your comment in an email. A patient with the complications you have had should be able to get in to see her dentist immediately.

    And to answer your question about the worst that could happen to your tooth, it could fracture and require extraction. Today an implant can be put in its place that will look and feel like your own natural tooth. But before you get that far, reach out to your dentist and be strong!

    I wish you the best of luck,

    Dr. Sinkin

  • Misty perry September 25th, 2016 12:09 am

    A while back, a part of one of my back teeth came out in a piece of gum. The filling is still there and hadn’t caused me pain for quite a while. Now, I’m eating 800 mg ibuprofen like candy (4 times per day), and my dentist can’t get me into the office to pull it until the 5th of October. Anything I can do until then? Once the ibuprofen kicks in, I’m lucky to have relief for an hour or so. Thanks so much.

  • Michael Sinkin September 25th, 2016 4:48 pm

    Dear Misty,
    Theshort answer is to call back your dentist’s office and make it clear that you are in distress. Your dentist should be able to accommodate you and at least be able to give you some temporary relief to tide you over until October 5th. If not, you might consider having him refer you to an oral surgeon. Being in the type of pain that you describe for another 2 weeks is,not an option.
    CALL YOUR DENTIST! Pain and infection don’t pay attention to the clock or calendar. Good luck and feel better.
    Dr. Sinkin

  • Nicole October 3rd, 2016 4:13 pm

    I had my tooth prepped for my crown and got my temporary crown put on. It came off and they put it back on. It lasted a week and a piece on the inner side of my temp crown chipped. I left it and today the rest came off and now it feels like the tip of the prepared tooth has chipped a little off. I’m really hoping that means they don’t have to do a totally new impression and I have to wait for another crown… this one should be in any day:( Do you think if the tip is chipped that they could still use the crown they have coming? Going in tomorrow to get the temp put back on.

  • Michael Sinkin October 3rd, 2016 5:37 pm

    Dear Nikki,
    The harsh reality is that there is no point discussing what may be, it is what it is. And while having a new impression (the time, the taste, the unpleasantries associated with it) is surely an inconvenience, I am more curious as to why the temporary mishap occurred in the second and third place. I would ask your dentist why this is happening. Sometimes a the patient an over zealous flosser, or gum chewer, or grinds her teeth at night, etc.

    Anyway, more important than if a new impression is needed, but rather that you receive proper care and I am sure that your dentist can explain all. Don’t be afraid to ask!

    Good luck,

    Dr. Sinkin

  • Alicia November 8th, 2016 6:25 pm

    Dr. Sinkin,
    As with everyone I have a question. My tooth that is next to the front tooth had a crack in it and I broke a small piece off in the bottom left corner. My previous experience this year has been 3 root canals and 3 crowns. With the present state of our insurance, which we had never had dental, I paid out of pocket for the crowns and some of the root canal. My question is how can I repair the tooth asthetically until Feb 1 when my insurance covers a crown or is there a way? Also have to find a new dentist that accepts our plan :/ Thank
    You in advance!

  • Michael Sinkin November 9th, 2016 12:59 pm

    Dear Alicia,

    When it rains, it pours. But from what you describe, simple direct bonding with tooth colored composite may possibly restore your tooth like new, but of course, without examining you I can’t say for sure. So your dentist would be the right person to ask. Good luck!

    Dr. Sinkin

  • Veronica December 10th, 2016 12:15 am

    Hello! For several days I’ve felt like there was something stuck between my teeth. turns out it was a loose filling and it popped out this evening. There is no pain. However, i am in holiday until January and I’m not comfortable seeing anyone who is not my dentist. Can i wait til then to see my dentist or do i absolutely have to go asap to have it done again?

  • Linda Visathep December 11th, 2016 1:59 pm

    I’m from California and have had bad teeth all my life. As a teenanger my dentist performed a series of root canals some of which never got completed. Over the years I’ve struggled with my teeth breaking, abscesses, excruciating pain and illness from infection. Despite all of my efforts at maintaining a diligent at home cleaning routine I still lost tooth after tooth. No insurance kept me from seeking care as well as a lack of available dentists locally. I was finally able to get an appointment here in my hometown and he began treatment. He came highly recommended unfortunately he made my problems much worse. Over the course of his care I had multiple teeth pulled to prepare for a removable partial denture. Weak infected teeth were left to act as anchors. It was ill fitting from the very start, too small and extremely painful, he told me not to worry I would get used to it and to keep it in my mouth at all times. I did as instructed and at a follow-up appointment when I voiced my concern again he told me he was very busy and didn’t have time to deal with it. I was devastated, he was supposed to make my pain go away yet he left me in worse pain than before. He said I would be able to eat again and I’d regain my lost confidence, I’m now left with a partial denture that I paid cash for I’m unable to wear. The teeth that had been anchors are now horribly broken and I’ve lost all confidence. I’m left with less than half of my teeth and am barely able to eat without excruciating pain. Everyday I spit out blood. I believe the infection in my mouth has begun to spread to my sinuses as I feel pressure in my head and sinus cavities. I look forward to hearing from you and can be reached both by phone or email. Thank you for your time

  • Michael Sinkin December 12th, 2016 10:40 am

    Dear Linda,
    I am so sorry for your troubles. Your story and your struggles sadden me. Clearly your dental problems have been a long time in the making and what you hoped was the long desired solution has only perpetuated them and left you in this precarious and deeply troubling state. You clearly need an careful evaluation and professional help to determine what went awry with your treatment and how to move forward. Unfortunately, I am in New York and can’t possibly get an accurate clinical picture. You need to see another dentist for an accurate diagnosis and assessment of your current condition. I realize finances are an issue, but the cost for a thorough examination and treatment plan is modest relative to the actual care. Knowing where you are now dentally and where you need and want to be (obviously free of pain and fully functional and cosmetically intact) is critical in determining how to get there. Once you have the road map to dental health, you can figure out the details of how to get it done and done properly. Perhaps your physician can make a recommendation to you or even a local dental school, if there is one. Knowledge is what you need. I realize you are upset with your current dentist, but perhaps you can start with him and find out what exactly is your problem and why you are still having such issues. In as much as his trestment hasnt yielded the successful outcome that you both desired. Then ask for his opinion as to what can be done to correct them- i.e., a new treatment suggestion. Then take this information and seek a second or third opinion before proceeding with care with the dentist of your choosing. I’m sorry I can’t be of more help. Good luck.
    Dr Sinkin

  • Michael Sinkin December 12th, 2016 10:41 am

    Dear Veronica,
    Based on what you have told me, if you want to wait until you get home be careful not to chew anything hard which may crack your tooth. Keep the area clean.

    Happy Holidays.
    Dr Sinkin

  • Vickie Brescol December 27th, 2016 11:22 pm

    My dentist is out of town for the next week…She had me on penicillin for an infection in my molar that had a crown with a root canal that was done after the crown so that crown has a filling. Now that the infection is gone the crown is loose but hadn’t come off. Is it possible that the filling is holding it on and what can I use to keep it from wiggling around until next week?

  • Michael Sinkin December 28th, 2016 9:15 am

    Dear Vickie,
    From your description, I would say you are spot on with your assessment. Unfortunately there is nothing you can do to secure the crown until you see your dentist. My advice is to avoid eating on that side and avoid flossing. It is possible that during the root canal and subsequent filling the cement seal was disturbed. If the supporting walls and margin (that’s where the crown and tooth meet) are intact, the crown can probably be rescued.You may need a post to reinforce and replace some missing tooth structure, but if all else is sound, your crown will be fine. There is a possibility that you may need a new crown but that will need to be determined once your dentist has the chance to evaluate the situation. Just be careful – you don’t want a dislodged crown swimming in your mouth to be chomped down upon while you’re eating and swallowing. Good luck and Happy New Year.

    Dr. Sinkin

  • Tilly December 31st, 2016 11:01 am

    Hi Dr,

    My 6 year old son was eating a mini candy cane last night and said “my tooth feels funny”. So we looked and saw that one of his stainless steel crowns had a hole in it. The metal had pulled away and was sharp. At the advice of the emergency dentist on the phon I bent it back as best as I could-there is still a rough edge and part of the white tooth underneath is visible-a few mm. Very small but still exposed.

    He had 3 stainless steel crowns put in 2 years ago, all with “baby root canals”. With it being the long weekend we can’t really be seen until Tuesday Jan 3. I have been told it will be ok until then-just keep it clean and encourage him to avoid chewing-but regardless I’m worried that it is exposed. I also have never heard of a stainless steel crown chipping in such a way-all my googling before his procedure and now seems to suggest they are a pretty foolproof solution for the duration of the primary tooth. Any guesses if the crown can be filled or needs to be replaced? Have you ever heard of this happening? Thanks for your time.

  • Michael Sinkin December 31st, 2016 2:23 pm

    Dear Tilly,
    What you described is definitely something that can occur (obviously, since it happened to your son’s tooth!) and may very well be remedied with a simple procedure, such as a filling. It is possible that the crown has thinned out over time or was thinned during placement as stainless steel crowns are prefabricated and adapted to the baby tooth before and adjusted after it is placed. Eating hard sticky candy canes can wreak havoc on natural teeth, let alone teeth with large restorations. Your son could have pulled the entire crown off. I think the advice you got was spot-on.
    Enjoy the weekend and Happy New Year.
    Dr. Sinkin

  • Lucy December 31st, 2016 9:34 pm

    Hi. I had a root canal done on 12/15 for a back molar. In the last few days I’ve been experiencing mild pain and irritation around the gumline. I noticed that my temporary filling has a gap between it and my gumline. My tooth broke off at the gumline so it’s there that the irritation is at. My dentist is gone til Tuesday. Should I be concerned? She prescribed me antibiotics which I can take if it’s really necessary. What do I do?

  • Michael Sinkin January 1st, 2017 11:12 am

    Dear Lucy,

    From what you describe your gum irritation may be due to bacteria around the site of the break and the mechanical irritation of the temporary filling, not to mention the gap that has opened near the “seam.” Until you can see your dentist keep the area clean and avoid heavy chewing on the tooth. Swishing with warm salt water may ease the discomfort. If you are really uncomfortable or if you develop swelling call your dentist right away. He or she may instruct you to start taking the antibiotic. Best of luck!

    Happy New Year,

    Dr. Sinkin

  • Terri January 3rd, 2017 8:47 pm

    Hi, I had pain happen in a tooth that had root canal. The pain was bad but when the dentist gave me an antibiotic within the 3rd dose I was dramatically better. I went to see dentist today and they are telling me that they think the tooth is cracked under the crown. That posts sometimes act as wedges and can crack the tooth. There was a darker pocket in the x-ray but now it isn’t showing. They suggesting to extract tooth and get bridge. How can I know if this is cracked tooth. I don’t want to lose a tooth if I don’t have to?

  • Michael Sinkin January 4th, 2017 11:56 am

    Dear Terri,

    The correct treatment for a cracked or split root is often an extraction.The important step prior to such treatment is confirming the diagnosis – which can be challenging. Often times a cracked tooth has a deep isolated “gum” pocket in the area of the crack. Sometimes an exploratory surgery can be done in an attempt to visualize the crack directly. A CBCT (cone beam computerized tomography) or a dental C-T scan can detect the crack because it can render a three dimensional view of the tooth. If you’re very concerned, which it sounds like you are, you may want to opt for a scan. Your dentist should be able to give you a referral to a specialist who has such a device.
    Good luck!
    Dr. Sinkin

  • Mark Richardson January 7th, 2017 2:10 pm

    Hi – I lost a crown 24hrs ago and cannot get to a dentist for around 5 days in total.
    Could I get infection or gum growth by then?
    Its a bottom tooth that I think has had root canal done and the metal post came out with the crown.
    I can place it back in but cannot find a suitable type of glue locally.



  • Michael Sinkin January 8th, 2017 12:41 pm

    Hi Mark,
    Until you see the dentist keep the area clean but carefully, you do not want to break your tooth. Trying to put it back in by yourself runs the risk of cracking/splitting the tooth -not good. Until you see the dentist you may wan to keep the crown off and keep food from impacting into tooth’s void. Best of luck.

    Dr. Sinkin

  • Ann February 2nd, 2017 4:25 pm

    I broke three front teeth when I was 10 years old (7,8, and 9). I had root canals and no cap on my two front teeth, #8 and #9 and a root canal and crown on #7. Now at age 44 I went to the dentist and he discovered a cavity under tooth #7. He recommended that I also cap #8 and #9 because the root canal had compromised the integrity of the teeth and they could crack on me at any time. Although I probably should not have, I agreed to proceed. He capped my four front teeth, 7,8,9, and 10. He fused the crowns, splinting #7 to #8 and #9 to #10. When I went home I had a ledge on #8 large enough for me to hide my floss between the top of the crown and my natural tooth. I went back and he assured me the crown was sealed and he then filled in the ledge and buffed it out. When I went home the ledge was still there on the back and side of the tooth. I went back and he filed it down more and then offered to replace the crown. He said he would cut the splinted crown in half, separating crown #8 from #7 and leave #7 in my mouth. He would then polish up #7 and put a new individual crown on #8. So I would now have 2 separate crowns there. My question is, is it safe to cut the two crowns in half and leave half behind? Is it worth the risk to redo the crowns or should I live with what I have now? I would hate to make things worse and need crown lengthening surgery, which would be cosmetically worse. Any advice would really be appreciated. Thank you!

  • Michael Sinkin February 7th, 2017 9:31 am

    Dear Ann,

    You have provided an excellent dental history. Before you proceed, I suggest that you have a very candid conversation with your dentist and ask these questions: Why were my crowns splinted after so many years of healthy function? If 7 and 8 didn’t need to be splinted then why should 9 and 10 be? If number 8 didn’t fit, how can (I be assured that the other crowns do?) Were x-rays taken after they were cemented?

    Best of luck.

    Dr. Sinkin

  • Anne February 7th, 2017 12:26 pm


    Thank you for so much for your response. I had asked those questions and he said that crowning the teeth that had been functioning for so many years was a preventative measure. He said that if these front teeth cracked (because they were compromised by the root canal) the crack could go beyond the gum line and I was risking completely losing a front tooth if this happened. The splinting he said would make them even stronger. At this point, I realize that I probably should not have proceeded with the crowning and should have kept my teeth (especially because I also suffer from dry mouth due to Sjogren’s syndrome), but it too late now. I just want to get them done right at this point. He did take an x-ray afterwards and he said all the crowns are sealed. He offered to redo #7 and #8 as a splinted crown again, but I asked if he would redo them as separate crowns. This is because I read online that splinted crowns are difficult to seat and I was afraid he may do them wrong again. Instead of redoing 7 and 8 individually, he said he could just cut the splinted crown in half and leave #7 in my mouth and polish it down. Then he would do a new crown for #8. So I was wondering if I should let him do this? Is this common practice? Will the vibrations or stress of drilling and separating the crown possibly affect the seal on number #7, which will be left in my mouth? Thank you so much for any advice you can give!

  • Des February 8th, 2017 8:08 pm

    Hi! I’m Des. I’m and I’ve had pretty rough teeth for a long time. I have a crown, many fillings, and genetically did not develop adult molars on the first set after I lost my baby teeth semi recently within the last couple years, but I never got a small denture to replace them, because not only were funds tight, but they had said having the gaps might slowly straighten my crowded, crooked lower teeth. (To give you a background of my teeth) But unfortunately, right now, I don’t have any health insurance. My mom lost her job and with it, the insurance, and we don’t know when we can get some. (It depends on her job) I knew I needed dental work pretty soon (my fillings feel eroded and like they have a gap between the filling and teeth) so I’ve been minding how I chew and the hardness of it. However today,I’m in a tough spot since we can’t get any work on them- I was enjoying pan fried tortilla chips and I cracked one of the upper left front teeth on the side of the largest two. It’s not a small chip or crack, it’s a decent sized one I can’t file down. (It resembles a rip starting from the bottom of a page) and it feels sensitive, uncomfortable and i feel like if i touch it it might even be slightly painful. I dont want to damage my teeth more than I have to in case it’s salvagable, and it’s going to be a long time before I can have work done. Is there anything can do to protect the tooth for the time being? Because I grind at night sometimes unfortunately as well. I’m concerned about causing further damage or breaking the tooth up until it needs to be removed permanently… because I already feel self concious about my missing teeth that can’t be seen. This is easily seen with even a small smile. Anything you can suggest to protect it until I can be seen would be seriously helpful. Thank you for your time, Des.

  • Michael Sinkin February 9th, 2017 9:31 am

    Dear Des,
    I understand your plight and wish there were some miracle concoction that I could offer up to make things right with your teeth. Obviously, you need to see a dentist to evaluate and treat the problems described. You can desensitize the areas with a small dab of Sensodyne toothpaste and “plug up” the voids with an over-the-counter temporary dental filling material. Then wait it out until you can visit a dentist. Strategically placed sugarless gum can be used fill in gaps. Sight unsee Des, I can only share what I’ve seen done by patients in your situation, I don’t know if this approach is right for you but I wish you the best of luck.
    Dr. Sinkin

  • Jim February 11th, 2017 12:29 am

    Had a temporary crown put on a few days ago and it just fell off tonight – a Friday night. It didn’t hurt when it was off, other than drinking cold liquids, nor did it hurt when I placed it back on without any glue. Ever since putting the crown back on with Dentemp, however, my tooth and jaw are in a moderate amount of constant pain. It was almost unbearable for the first 20 minutes. Is it normal for Dentemp to actually cause pain?

    Should I leave the temp crown on with Dentemp until I can see the dentist on Monday, even though it’s throbbing, or leave if off (with no pain) until then? Thanks!

  • Michael Sinkin February 12th, 2017 7:23 pm

    Dear Anne,
    It’s a pretty straight forward procedure but if you have doubts or reservations, there’s no harm in getting a second opinion!
    Dr. Sinkin

  • Michael Sinkin February 12th, 2017 7:25 pm

    Dear Jim,
    While its possible that there may be an underlying problem, I suspect that your tooth is just irritated. It is most likely that either your tooth was wet and the temporary didn’t go into place or that you placed too much Dent Temp with the same result. Or you have a lot of extra cement pressing into the gum. I hope you’re doing ok since I wasn’t able to respond until today. Good luck at the dentist tomorrow!
    Dr. Sinkin

© 2008 Dr. Michael Sinkin, D.D.S.