My Tooth Crown Fell Off Four Times
Although our family has had the same dentist for over 15 years, I have given up on my dentist because my crown won’t stay on. I first received a crown for my lower left second molar after a root canal in 2009. My dentist replaced the crown in March 2022. Over the past year, the crown has come off four times. The fourth time it came off was two weeks ago, and I decided not to return to my dentist. I knew I couldn’t leave my tooth bare, so I found an emergency dentist who re-cemented it. She wants me to return to her so she can determine why the crown repeatedly falls off. I’m not sure what to ask or what to do. This ordeal is making me nervous. I wish it would go away, but I know better. I would like to know why the crown keeps coming off. – Thanks. Dakota from NJ
Dakota,
Dr. Michalski would need to examine your crown and tooth to determine why the crown keeps falling off.
Why Does a Dental Crown Fall Off?
If a crown repeatedly falls off, the issue is likely with how your dentist prepared your natural tooth for the crown—not the strength of the cement or bonding. If that is the case, you need a new crown.
When a tooth has a root canal and little structure remains to support a crown, a dentist needs a specific technique to ensure the crown is secure. Although a dentist who understands how to resolve the issue might have a slightly different approach, the process generally includes the following:
- Place and cement a semi-flexible fiberglass post deep into the canal, about 2/3 the length of the tooth
- Bond core material to the tooth and the fiberglass post
- Bond the post into the canal with composite.
The composite builds the core for the crown preparation. This method works because some tooth structure remains. But if a tooth breaks off at the gumline, a post alone will not work. Twisting stresses on the post from daily oral function will dislodge the post, and the crown will keep falling off.
If the dentist with whom you had an emergency visit has advanced cosmetic dentistry training, you may check her patient reviews to decide if you want her to complete the work. Otherwise, look for a dentist with advanced cosmetic training. Talk to the dentist about your increasing anxiety and get details on sedation options to calm you during treatment.
Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post.
How Can I Fix My Gummy Smile and Be Less Self-Conscious?
I am self-conscious about my gummy smile and small teeth. Would I be a candidate for gum contouring? I guess porcelain veneers are an option, but you know…money. I can’t afford to get veneers on all my teeth, and they are all small. I consulted with one dentist, and she said I have naturally small teeth. I know that. She encouraged me not to alter my teeth but to embrace them. Okay… That’s a nice philosophy, but I’m still self-conscious. I know your dentist would need to see my teeth in person to really recommend anything, but can you list the options for a gummy smile? Thanks! Bethany – Canton, OH
Bethany,
Most family dentists lack advanced cosmetic dentistry training to improve a gummy smile, so be careful when choosing a dentist. Do not allow a dentist to alter your teeth with dental crowns; it’s too aggressive and unnecessary unless your teeth have extensive damage. Nor should a dentist refer you to an oral surgeon to shorten your jaw. You can trust an advanced cosmetic dentist for healthy, natural-looking results.
What Is a Gummy Smile?
A gummy smile is an excessive amount of gum tissue around your teeth. You may feel that too much of your gums show when you smile, making your teeth look small. A gummy smile can make you feel self-conscious and hesitant to show your teeth when you smile. However, cosmetic dentistry can address your concerns and give you a healthy, attractive smile.
How Can You Improve a Gummy Smile?
You can improve a gummy smile with one or more treatments, including a gum lift, porcelain veneers, dental bonding, or orthodontics. However, an expert cosmetic dentist will complete a comprehensive exam and take X-rays to determine the causes of your gummy smile before recommending treatment.
Gummy Smile Treatment Options
An advanced cosmetic dentist will explain whether you can benefit from the following treatment options.
- Gum lift (gingivectomy) – Removing a small amount of gum tissue and supporting bone can expose some upper front teeth to lengthen their appearance. A 2019 article in the International Journal of Oral and Dental Health confirms that a great advantage of a gum lift is easier oral hygiene in gum pockets around your teeth, which helps prevent gum disease.
- Porcelain veneers – A skilled cosmetic dentist can take impressions of your teeth and work with a master dental ceramist to craft custom porcelain veneers for the fronts of your teeth. Only an expert cosmetic dentist understands how to lengthen your teeth without interfering with your bite or speech. High-quality veneers can last 15 to 20 years, making them a long-lasting solution for a gummy smile and small teeth.
- Dental bonding – Advanced cosmetic dentists skillfully blend dental composites to reshape small teeth and make them look larger. A dentist will apply bonding by hand to each tooth after roughening the surface. Your cosmetic dentist will expertly shape the bonding to enlarge your teeth, harden it, further shape it, and polish it to a natural gloss. Well-maintained dental bonding can last five to ten years. It costs less than porcelain veneers, but a dentist will eventually need to replace the bonding due to wear and staining.
- Orthodontics – Misalignment can make adult teeth look small. Your cosmetic dentist will determine whether your teeth are in healthy positions. Orthodontic treatment with Invisalign or other braces can improve your teeth’s appearance.
Consult with an Advanced Cosmetic Dentist
It is essential to consult a dentist who understands how to improve your gummy smile and small teeth while protecting your oral health and ensuring a healthy bite. To keep your smile healthy, a dentist must have advanced cosmetic dentistry, occlusion, and bite training. Look for dentists with the training we mentioned and schedule consultations with at least two of them to discuss and compare your options. You will get options to help your gummy smile look better so you can smile more confidently.
Cosmetic dentist Dr. Thaddeus Michalski of Rocky Hill, Connecticut, sponsors this post. Dr. Michalski provides cosmetic dentistry services to patients in Hartford, Wethersfield, Newington, Cromwell, Portland, New Britain, and surrounding areas.
Will I Need a Tooth Implant If My Dental Crown Fractured?
One of my four porcelain crowns cracked, and I would like to know if it is an emergency and whether I will need a tooth implant. The tooth is my left lateral incisor; I’ve had a crown on it since 2002. I do not want to jeopardize my tooth and need a dental implant. The fracture is near the bottom. I took pictures of the crack when I first noticed it, and it’s more noticeable than it was a few months ago. I do not want it to break while I am out of town visiting my mom for two weeks. The other issue is that I have a new dentist whom I have only seen for cleanings and exams. I’m unsure if I want this practice to do any cosmetic work on my teeth. Is my fractured crown an emergency? – Thank you. Ellis from MI
Ellis,
Thank you for your question.
Is a Fractured Dental Crown an Emergency?
A fractured crown is not an emergency that immediately jeopardizes your tooth. Thin fractures (craze lines) in teeth or crowns usually affect only the tooth enamel. However, if you can see the fracture and it is more visible than before, it may worsen. And the crown will eventually break completely.
Do You Need a Tooth Implant if a Crown Breaks?
You do not automatically need a tooth implant if a crown breaks. However, if you leave the tooth unprotected for an extended period, your natural tooth might weaken and break. A cosmetic dentist will examine and x-ray your tooth and look for any signs of damage. Unless you experienced trauma or internal damage to the tooth and the tooth is unsavable, you don’t need a tooth implant.
Get a Dental Crown Second Opinion
You are wise not to trust a dentist whose cosmetic work you haven’t experienced or seen. We recommend scheduling an appointment with an advanced cosmetic dentist to replace the crown. If you are concerned about the crown while out of town, consider seeing a cosmetic dentist as soon as possible. It usually takes about two weeks to get a new crown.
Replacing one crown requires a dentist to have the color-matching skill to ensure the replacement matches your natural teeth and other crowns. Color-matching is a challenge for many dentists, who seldom admit when they do not have the skill.
If you must delay a dental visit and anything happens to your crown while out of town, look for an accredited cosmetic dentist or one with advanced cosmetic dentistry training. Look at dentists’ websites for a smile gallery of before-and-after photos of crowns on front teeth. You can prevent the need for a tooth implant by getting an experienced dentist to examine the condition of your crown and tooth promptly.
Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologist, sponsors this post. Read how Dr. Michalski strives to provide patients with some of the best dental care in Rocky Hill.
When Will I Need to Replace My Porcelain Veneers?
I got my porcelain veneers in 2019. When will I need to replace them? I ask because two have fallen off within the past six months. I got the veneers when I lived abroad for two years because they were much more affordable than U.S. prices. My dentist in TN says that the dentist who placed the veneers didn’t bond them correctly, so my dentist bonded them back. My dentist doesn’t do a lot of porcelain veneers cases, though. How long are porcelain veneers supposed to last, and when will I need to replace them? – Thank you. Klaus
Klaus,
Thank you for your question.
When Will You Need to Replace Your Porcelain Veneers?
Ordinarily, you will need to replace your porcelain veneers every seven to 20 years. The May 2021 issue of the European Journal of Dentistry published an article on the survival rate for porcelain veneers. In a sample of 499 porcelain veneers, the long-term survival rates were reported for five, ten, fifteen, and twenty years. The survival rates for porcelain veneers in the sample are as follows:
- Five years – 98%
- Ten years – 96%
- Fifteen years – 91%
- Twenty years – 91%
The lifespan of your veneers depends on several factors, including:
- Porcelain quality
- Bonding quality
- How well you take care of them
Porcelain veneers are stain resistant, and well-bonded veneers do not fall off. You can ask a skilled cosmetic dentist to examine your veneers in anticipation of future concerns.
What Should You Consider Before Replacing Your Veneers?
We hope your dentist can help you preserve your existing veneers. When it is time for new porcelain veneers, consider the qualifications and credentials of the cosmetic dentist you choose. We recommend the following:
- Look for dentists with extensive post-graduate cosmetic dentistry training.
- Ask family or acquaintances for recommendations.
- Read the dentists’ patient reviews.
- Schedule consultations with at least two cosmetic dentists.
- Ask to see pictures of each dentist’s porcelain veneers cases.
- Express your concerns about your existing veneers and receiving long-lasting replacement veneers.
Best wishes for the health and beauty of your smile.
Rocky Hill, Connecticut, cosmetic dentist Dr. Thaddeus Michalski sponsors this post.
Considering Dental Implants in Rocky Hill
Until dental implants came into common use during the 1960s, dentures or bridges were the only options people had for replacing missing teeth. Although these are both aesthetically attractive, they could not offer a long-term solution for tooth loss. These types of prostheses can only be expected to last five to 10 years before needing to be replaced. However, with dental implants, Rocky Hill dentist Dr. Thaddeus Michalski provides a permanent solution for missing teeth.