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Dr. Gerard
Dr. Gerard, Dentist (DDS)
Category: Dental
Satisfied Customers: 60
Experience:  General/Cosmetic Dentist, Boca Raton, FL
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My implant crown (tooth) came out last thursday and i havent

Resolved Question:

My implant crown (tooth) came out last thursday and i haven't been able to get in to see a dentist or my periodontist. How long can the crown stay out before it becomes an issue?
Submitted: 2 years ago.
Category: Dental
Expert:  Dr. Gerard replied 2 years ago.

Dr. Gerard :

Hi, thanks for using JustAnswer.com!

Customer:

no problem. seems you're the only dentist available today.

Dr. Gerard :

The fact that the crown is being supported by an implant rather than a natural tooth fortunately eliminates the problem of pain

Dr. Gerard :

if it is not a front tooth and cosmetics is not an issue, the only potential problem of leaving the crown out is the possibility of the gum tissue closing up around the implant post, technically called the 'abutment'

Customer:

that's what i'm worried about. losing the abutment in my gum

Dr. Gerard :

if the edge of the crown goes fairly deep under the edge of the gum, the tissue around an implant tends to close up over the edges pretty quickly...however, it's not a v. serious problem if that happens either...

Dr. Gerard :

unless the abutment has for some reason come loose from the implant, which is not supposed to happen, the worst case scenario is that the dentist will have to administer a couple of drops of local anaesthetic to numb up that gum tissue and trim it a little so the crown fits back all the way down without trapping the gum tissue inside it

Customer:

that won't be painful?

Dr. Gerard :

if the position of the implant is such that the edge of the crown is at or just barely below the level of the gum, that probably won't even be necessary

Dr. Gerard :

the crown will simply push the gum tissue that may have collapsed a bit out of the way as it goes back in

Dr. Gerard :

if that little bit of gum tissue trimming has to be performed, it's very minor and shouldn't hurt a bit

Dr. Gerard :

as long as the dentist numbs up the tissue 1st...if you were to choose to go it without the anaesthetic, you might feel it a tiny bit, but even then it would not be bad...very minor bit of surgery

Dr. Gerard :

botXXXXX XXXXXne is if it's not a cosmetic issue, waiting a couple of days is no problem

Customer:

it'll be almost a week before i can see my dentist

Dr. Gerard :

any collapse of tissue that is going to occur will have occurred within the 1st 15 mins or so

Dr. Gerard :

the implants are immune from tooth decay...just brush is well, keep it clean, you can rinse the area a couple of times per day with something like Listerine

Customer:

ok. so what i thought was a big deal, is not really.

Dr. Gerard :

unless food somehow gets impacted under the gum tissue of the implant, which is unlikely if you're keeping it nice and clean best you can, another week, in this case, is not going to be a big issue...

Dr. Gerard :

another v. slight issue might be v. v. slight shifting of the tooth opposing the implant crown tooth...

Dr. Gerard :

meaning if the implant tooth is a lower, it is possible that the upper tooth that chews against that crown normally may shift downward very, very, very slightly with in that 2 week period

Dr. Gerard :

or vice versa if the implant crown is an upper

Customer:

can i chew on the abutment side?

Dr. Gerard :

and the worst case scenario in this case, is that the dentist carefully checks the bite on the implant crown and has to make a TINY adjustment to the porcelain and repolish it. That's it...no big deal at all

Dr. Gerard :

yes, you can chew there

Dr. Gerard :

you won't damage anything

Customer:

it took 3 tries to get the right fitting tooth in the first place.

Dr. Gerard :

just don't get anything jammed accidentally under the gum

Dr. Gerard :

that's unusual because making an implant crown should be easy as pie: the lab is actually just putting pieces together that have already been machine-milled to fit perfectly

Dr. Gerard :

perhaps it was the bite that was off?

Customer:

no. it was a baby tooth. so not a typical implant for someone my age.

Dr. Gerard :

it's difficult for me to speculate on why it took 3 tries...did the Dentist take a bitewing xray of the implant crown in place before he/she cemented it to confirm that it fits perfectly?

Dr. Gerard :

A baby tooth...what do u mean?

Dr. Gerard :

do u mean u had a retained baby tooth that they removed to place the implant?

Customer:

yes. the tooth didn't fall out because there was no tooth under it.

Customer:

yes.

Dr. Gerard :

got it...not at all uncommon

Dr. Gerard :

should not complicate things at all

Dr. Gerard :

you made an excellent decision to replace that missing tooth the way you did, that is, with an implant-supported crown!

Customer:

it was between an implant and a bridge, and i didn't want a bridge.

Dr. Gerard :

do u recall if an xray was taken to confirm the fit of the final implant crown?

Dr. Gerard :

yes, an excellent decision...leave the other adjacent untouched teeth ALONE... the only thing that will "last forever" is an untouched tooth!

Customer:

yes. multiple xrays were done to confirm. it seemed to fit very well. by that, i mean very snug, so i don't know why

Customer:

it fell out

Dr. Gerard :

well, it's not that unusual for an implant crown to occasionally fall out and I'll tell you why

Customer:

go on

Dr. Gerard :

often, we want to "try in" the crown to make sure everything is right with it...like a "road test" when you buy a car

Dr. Gerard :

so we put the crown -- whether it is an implant crown or a natural tooth crown -- in with a temporary cement

Dr. Gerard :

this is just in case there are corrections that need to be made by the lab, the crown can be removed for those corrections

Dr. Gerard :

If the crown is put in permanently right off the bat, it's MUCH more difficult, if not impossible, to make corrections...

Dr. Gerard :

with implant crowns, getting the temporary cement to be

Dr. Gerard :

'just right' can be tricky: strong enough so the crown doesn't fall out too soon, but not so strong that it cannot be retrieved at all

Dr. Gerard :

however, if that crown is been in your mouth for a while and it's been OK, perhaps the dentist can be a bit more confident and recement it with a bit stronger cement

Dr. Gerard :

I hope this helps answer your question

Customer:

yes. very much so. thank you

Dr. Gerard :

Feel free then to hit the 'Accept' button and you can also leave positive feedback ...this helps me help others with their questions. Good luck with that!

Dr. Gerard, Dentist (DDS)
Category: Dental
Satisfied Customers: 60
Experience: General/Cosmetic Dentist, Boca Raton, FL
Dr. Gerard and 2 other Dental Specialists are ready to help you

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