Lost a filling or crown: what to do tonight

What’s probably going on

A filling or crown can come out without much warning, often while you’re eating. The usual reasons:

• It wore out. Dental work doesn’t last forever. Cleveland Clinic says fillings can last 10 to 20 years, and crowns usually 5 to 15.
• Something hard or sticky pulled it loose. Ice, hard nuts, popcorn kernels, taffy and caramels are common culprits. Cleveland Clinic lists them as foods that can damage or pull off a crown.
• It wasn’t the filling. Sometimes the hard piece in your mouth is part of the tooth. If a corner is missing or the edge feels jagged, see cracked tooth. Temporary filling kits aren’t made to repair a broken tooth.

The spot often feels sensitive. Without the filling, the softer layer under the enamel is exposed. Tiny channels in that layer let heat, cold, and acidic or sticky foods reach the nerve.

Mild sensitivity usually means the tooth can wait a few days for a dentist. Throbbing pain or swelling is different; see the list at the top of this page.

What to do tonight

1. Keep what came out. Put the filling or crown in a small bag or container and bring it to your appointment.
2. Rinse with warm water. Swish gently to clear food out of the hole.
3. Check for sharp edges. Run your tongue over the spot carefully. A jagged edge can cut your tongue or cheek; the patch in the next step covers it.
4. Patch the hole with temporary filling material. Pharmacies sell it as a small kit. In general, you rinse the tooth and leave it damp. Then you roll a small ball of material and press it into the hole. Bite down gently a few times to check it isn’t sitting too high, then remove the extra. Follow the package directions, including how long to wait before eating; it varies by product. A temporary filling kit is worth keeping at home.
5. No kit yet? Cleveland Clinic suggests pressing a small piece of sugarless gum into the hole for the night. Sugary gum can make it hurt.
6. Chew on the other side. Until a dentist fixes it, keep hard and sticky food off that tooth. Go easy on sugar, and skip very hot or very cold food and drinks.

If the tooth aches, see what to do for a toothache right now for pain relief that’s safe to use.

If a crown came off

1. Keep the crown. Rinse it, store it somewhere safe, and bring it with you.
2. Check that it fits. Set it on the tooth with nothing inside. If it doesn’t seat all the way, don’t force it. Leave it out and call a dentist.
3. Hold it with temporary dental cement from the pharmacy. Clean out any old cement you can reach. Put a little along the inside edge of the crown, press it onto the damp tooth, and bite gently to seat it. If your bite feels off, take it out and start again. Clear away the extra and follow the package directions.
4. Ask first if it’s on an implant or a post. Temporary cement packages say to check with a dentist before using them there.
5. Don’t use superglue or household glue. Cleveland Clinic warns specifically against superglue. Use dental cement made for the job, or leave the crown out.

What not to do

• Don’t patch over throbbing pain or swelling. Temporary filling products warn against it, because it can be a sign of infection. Call a dentist instead.
• Don’t put aspirin on the gum or tooth. It can burn the tissue.
• Don’t treat the patch as the fix. The package warns that skipping the permanent repair may cause infection.

How a dentist fixes it, and what it costs

Call your dentist the next business day and aim to be seen within a few days. Bring the filling or crown with you.

• A lost filling is usually replaced with a new one.
• A tooth that’s too damaged for a filling often needs a crown, a cap that covers and strengthens it.
• A crown that came off gets checked. The dentist decides whether it can go back on or needs replacing because it’s cracked or damaged.
• If decay has reached the nerve, throbbing pain is a common sign, and a root canal may be needed.

The price depends on what the tooth needs, the material, where you live and your coverage. Ask for a written estimate before any work starts. If you don’t have dental insurance, a dental savings plan (a discount membership, not insurance) can lower the price at participating dentists.

How to keep it from coming back

You can’t make dental work last forever, but you can make it less likely to fail at 10 p.m.

• Brush twice a day with a fluoride toothpaste, for two minutes.
• Clean between your teeth once a day.
• Don’t chew ice, hard nuts or popcorn kernels. If you have crowns, go easy on taffy and caramels.
• Keep up with checkups, so worn fillings get replaced on your schedule.
• If you grind or clench, ask your dentist about a night guard. See jaw and tooth pain from grinding.

A good electric toothbrush makes the first habit easier. See the best electric toothbrush.