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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 Temporary Dental Crown Fell Off

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.

Hi, thanks for using JustAnswer.com!

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

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 very serious problem if that happens either.

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 anesthesia 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.

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.

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

Customer :
That won't be painful?

Dr. Gerard :
If that little bit of gum tissue trimming has to be performed, it's very minor and shouldn't hurt a bit, as long as the dentist numbs up the tissue first.

If you were to choose to go for it without the anesthesia, you might feel it a tiny bit, but even then it would not be bad...very minor bit of surgery. 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.

The implants are immune from tooth decay. Just brush it 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. This is unlikely if you're keeping it nice and clean. Another week in this case, is not going to be a big issue.

Another very slight issue might be very very slight shifting of the tooth opposing the implant crown tooth.

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, vice versa if the implant crown is an upper.

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.

Customer :
Can I chew on the abutment side?

Dr. Gerard :
Yes, you can chew there. You won't damage anything. Just don't get anything jammed accidentally under the gum.

Customer :
It took 3 tries to get the right fitting tooth in the first place.

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.

Perhaps it was the bite that was off?

It's difficult for me to speculate on why it took 3 tries. Did the Dentist take a Bitewing X-ray of the implant crown in place before he/she cemented it to confirm that it fits perfectly?

Customer :
No. It was a baby tooth. So not a typical implant for someone my age.

Dr. Gerard :
A baby tooth? 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.

Dr. Gerard :
Got it. Not at all uncommon.

Should not complicate things at all. Do u recall if an X-ray was taken to confirm the fit of the final implant crown?

Customer :
It was between an implant and a bridge, and I didn't want a bridge.

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 X-rays were done to confirm. It seemed to fit very well. By that, I mean very snug, so I don't know why 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.

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.

So we put the crown, whether it is an implant crown or a natural tooth crown, in with a temporary cement.

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

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

With implant crowns, getting the temporary cement to be '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.

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.

I hope this helps answer your question.

Customer :
Yes. Very much. So, thank you!

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

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Dr. Gerard
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General/Cosmetic Dentist, Boca Raton, FL