When a Crown or Bridge Comes Off: Interim Measures and Permanent Repair
Whether it can be recemented depends on the condition of the tooth beneath.
Why it comes off
A crown usually comes off not because the cement failed on its own but because the foundation beneath changed. The commonest cause is decay at the margin eroding the tooth, leaving less surface to hold. Other causes include cement dissolving through microleakage, insufficient remaining tooth in a root-treated tooth, a fractured post or root crack, and uneven bite load — repeated debonding is typical in people who clench at night.
What to do at the moment it comes off
- Take care not to swallow it and keep it in a dry container
- Do not try to clean or scrape out the inside
- Do not use household or superglue-type adhesives
- Pharmacy temporary cement is a short-term measure only
- Avoid hard and sticky food on that side
- Keep cleaning the exposed tooth with a soft brush
- Do not delay the appointment, and bring the crown with you
What is assessed for the permanent repair
First the tooth beneath is examined: is there decay, how much sound tooth remains, are the root and surrounding bone healthy? A radiograph is essential, since marginal decay and root cracks are not always visible. If the tooth is sound and the crown undamaged it can be cleaned and recemented. If there is decay it must be removed, which changes the shape so the old crown usually no longer fits. With bridges both abutments are assessed, since a problem in one affects the whole span.
Getting Here, Booking and Emergencies from Konakli
Route, booking and emergency arrangements for patients from Konakli.
Getting here from Konakli
Konaklı lies in the Alanya district of Antalya; Alanya is a coastal tourism district, about 132 kilometres from the clinic. We also see patients from neighbouring areas that share the route from Konakli, such as Aliefendi, Bayırkozağacı, Büyükhasbahçe, Çıplaklı. You can ask for the location on WhatsApp when travelling from Konakli.
Appointments for Konakli
Over the distance between Konaklı and the clinic each visit means a day, so a long slot is set aside and the number of visits needed is stated at the outset. As with patients from Alanya generally, appointments for families from Konakli can be scheduled consecutively.
Emergencies from Konakli
Always call before setting out from Konaklı at night; over this distance the guidance you receive on the phone matters in keeping the situation from worsening. For patients coming from Dental Clinic in Konakli, the clinic is open 24/7 and in an emergency the order is set by severity rather than arrival time. For spreading facial swelling, difficulty swallowing or breathing, or toothache with fever, go to the nearest emergency department.
Protecting the Pulp in Deep Decay
When decay comes very close to the pulp there are two risks: exposing the pulp while removing all of it, or leaving some behind and allowing infection to continue. The current approach has changed that dilemma.
Selective caries removal
Decay is removed completely at the margins and side walls — that is essential for a sealed margin. At the point closest to the pulp, part of the softened tissue is deliberately left and sealed over. Under a leak-free restoration the bacteria's food supply is cut off; the remaining tissue hardens and the lesion arrests. The tooth is saved without exposing the pulp.
What is done if the pulp is exposed
Not every exposure requires root canal treatment. In a young, vital pulp the exposed point can be capped with a biocompatible material and allowed to heal — a direct pulp cap. What determines success:
- The exposure being small and in a clean field
- Bleeding being controllable within a short time
- No history of spontaneous night pain
- The area being completely isolated from saliva
- A leak-free definitive restoration placed over it
Follow-up is required
Teeth whose pulp has been preserved must be followed up, since vitality can be lost months later. Vitality testing is done at review and the root tip assessed on a radiograph. The patient is warned too: if spontaneous pain, throbbing that increases at night or tenderness to biting appears, they should attend without waiting. Early intervention makes any root canal simpler.
