Dental mishaps and emergencies happen every day.
It is important you contact your dentist immediately if you have sudden severe pain, a swollen face, swollen gums, a loose tooth, or tender gums. Because these are all signs of infection or an acute abscess.
But what if it’s on a weekend?
Or it happens when you’re out of town?
Or when your dentist is unreachable?
Has something like this ever happened to you?
Scene l – You Are Halted Mid-Chew
It’s Saturday night and you’re at a restaurant with friends. Or perhaps on a date.
Suddenly, you bite into something that’s unexpectedly hard – like an olive pit in your salad. You are jolted by a sharp wince of pain that halts you in mid-chew.
The pain continues with waves of aftershocks. It’s kind of like if you stubbed your bare toe on a block of concrete. Finally, the pain retreats.
But you realize your tooth just broke and you have no idea what to do when a tooth cracks.
Scene 2 – You Lose a Crown or Filling
You’re on vacation with your family. You’re in an old-fashioned candy when you spy some candy you haven’t seen since childhood – Charleston Chews! You can’t resist and you buy a bag.
You take one bite and feel the warm embrace of gooey chocolate taffy.
Uh-Oh! A crown has just been pulled off your tooth. Or…one of your large fillings just abandoned your molar.
What do you do?
Here are…
5 Common Dental Emergencies & What To Do Until You Can See A Dentist
1. A Chipped Tooth
- If there’s no pain: A chipped tooth usually will have jagged, sharp edges that love to grab your lip, cheek, or tongue. Use an emery board to gently smooth out the rough edges of your tooth until you can see a dentist.
- If the tooth is sensitive to cold, sugar, or heat: When a tooth first chips or breaks, it’s very sensitive to touch and temperature. This usually fades over time, but frequently applying Sensodyne toothpaste to the affected area can bring you some relief until you can see a dentist.
2. Your Tooth Cracks Or You Lose A Filling
Many products are available in the dental aisles of your local pharmacy that can help:
- DentTemp: Whether you use the premixed or powder version, place it in the void and pat it with water to harden the material. Then bite into it while it’s still soft. Scrape away any excess material with a toothpick.
- Dent’s Toothache Gum: Soften the gum in your mouth and place it on your affected tooth. If you can’t find Dent’s gum or can’t get to a pharmacy, you can use sugarless chewing gum, preferably sweetened with xylitol, instead. Mold it into the sensitive area to protect it. (A softened piece of household candle wax can also be hand-molded and pressed into place.)
- Sensodyne or Fluoridated Toothpaste: Coat your tooth with the toothpaste. Then cover the area with sugarless chewing gum or softened candle wax.
- If A Significant Portion Of Your Tooth Broke Off: If a significant portion of your tooth broke off and if the tooth has a large filling, there’s a good chance your filling is secure. This is even more serious than if your tooth cracks. If the tooth fragment has broken off completely, once the initial pain fades, you can continue your meal. But avoid cold, sweets, and extreme heat. If your tooth breaks and is dangling from your gum, go to the restroom with a glass of ice water. Place a piece of ice against your gum where the tooth is loose for 30 seconds. Be careful not to put the ice directly on the tooth. Your gum will get numb enough that you will be able to gently and painlessly remove the loose, broken piece of tooth. If the gum bleeds a bit, bite on a tissue or paper towel for a few minutes, and it should stop.
3. A Dislodged Cap Or Crown
- First, clean and dry both your tooth and the cap or crown. Place a dab of Fixodent or Polygrip into it and put it back in place. Then, tap your teeth together. If you can get to the store, make a loose slurry of flour and water and use it the same way. The cap or crown will only stay in place temporarily – so it is important to see your dentist as soon as possible.
4. A Dislodged Porcelain Veneer
- Try placing the veneer back on your tooth in the proper position. When you’ve got the hang of it, carefully place a dab of Krazy Glue inside and push it into place. Wipe away excess cement with nail polish remover. Remember, just a little dab will do ya!
5. Irritated, Tender Gums, Canker Sores or Inflamed Wisdom Teeth
- Rinse your mouth with Listerine or with a warm salt-water rinse. Swish vigorously. (Do not gargle). An anesthetic salve like Ambesol can also be applied for quick relief.
Remember, all the solutions above offer only temporary relief. If your tooth cracks or you lose a crown or you experience any of the dental emergencies above, please see a dentist right away.
If you’re one of my patients, you can always reach me by calling 212-685-3040. If the office is closed, listen to the message and you will be given my cell number.
Related Reading:
- What To Do When You Have A Dental Problem & Your Dentist’s Office Is Closed
- Chipped Front Tooth? You May Have Bruxism
DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as a springboard for discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.
259 Responses
Dear Dr Sinkin,
I am on holidays in Canada from Australia and will be away for another 3 weeks. Last night while eating dinner I thought I had bitten something hard and took it out of my mouth and realised it was part of a tooth – the back right lower molar / tongue side. The tooth has a large filling. There is no pain – slight discomfort if I touch it with my tongue. Can I put some temporary filling on it and would it be safe to leave it until I get home?
DEAR WENDY,
Why do these dental mishaps seem to happen at the most inopportune times? The description of your molar is a situation that I have seen on literally hundreds of occasions. You probably cleaved of the weakened cusp while biting and what remains is the filling and the rest of your tooth. That you have no pain and that the remaining portion is secure suggests that you are most likely not in any peril of acute distress. An over-the-counter temporary filling material may spare your tongue from any irrational and will cover any sensitive tooth structure, but unless these are truly problematic issues, you can probably get away with doing nothing until you get back home. Brush as normal, don’t floss this tooth as you don’t want to dislodge the filling and chew on the other side. You will likely need a crown. If you want more accurate care or if something changes and you experience greater symptoms, seeing a Canadian dentist is a good idea. Enjoy your vacation.
Dr Sinkin
Sent from my Verizon Wireless 4G LTE smartphone
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Dear Dr Sinkin,
I am on holidays in Canada from Australia and will be away for another 3 weeks. Last night while eating dinner I thought I had bitten something hard and took it out of my mouth and realised it was part of a tooth – the back right lower molar / tongue side. The tooth has a large filling. There is no pain – slight discomfort if I touch it with my tongue. Can I put some temporary filling on it and would it be safe to leave it until I get home?
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I agree with the Heather above… what a kind individual you are to be answering questions like this on a constant basis. Thank you for your time!
I had a second molar (which already had an amalgam filling in it) break off on the front buccal side. Of course it is 3pm on a Saturday and there is not a dental office open. I am worried about any “leaking ” of the filling as well as any precautions I should take. I am not in pain other than a very slight dull ache. I am afraid to eat or get it dirty. Is it okay to put a temporary filling product over it to protect it until Monday?
I appreciate your feedback and am happy to offer you some counsel. It is very common for a tooth with a very large amalgam filling to break off an entire cusp or wall. You have to be careful that the remaining filling doesn’t break off, so eat on the other side.
You can place a temporary filling like Dentemp (obtained from the pharmacy) if you are very sensitive or if it has a sharp edge. If not, place Sensodyne toothpaste on the exposed tooth to deal with the minor sensitivity. It’s common for the sensitivity to diminish.
You can brush with warm water and the Sensodyne to keep it clean but don’t floss. I don’t think you should have worries about leakage.
Best,
Dr. Sinkin
I found this website and just knew for sure that it wasn’t recent and that I wouldn’t be able to ask anyone for help, and I see that I was wrong. Thank you Dr Sinkin for being so helpful to everyone over the years, you are one unique individual.
My question for you is this:
I had a root canal on a molar years ago. I didn’t have insurance and didn’t get a crown put on it. The root canal failed and the tooth broke when I bit into a cookie. I went to the dentist and he said he would have to pull it, but that there wasn’t enough tooth to pull so it would need to be surgically removed. Over the years…maybe 3 or 4 now…I have just let it be. It has never given me problems. Recently, it hurt a little but I noticed it was because another piece of it was loose. I took it out, and no more pain. But within the past week, my gums are literally growing over it. It feels like it’s growing in the places where I have removed pieces of the tooth, but I’m not sure. And I’m worried if the gums will keep growing and cover the entire tooth and the little white thing that was left there from my root canal. Can that happen and what could it cause if it does? Is this something I should deal with BEFORE it grows over or will it cost the same either way? Thank you for your help….
Dear Heather,
Thank you for your kind words. I never imagined that I would reach so many people and be given a chance to share some helpful pearls.
Now onto your question. You have a dental situation which will ultimately need to be dealt with. As long as you don’t develop an abscess WHICH IS VERY POSSIBLE, your tooth will probably not cause your acute distress in the short term. The gum is probably irritated and inflamed. You most likely have what could be described as a dental splinter that is stuck in your gum which happens if a tooth is broken and decayed and is chipping away.
When the gum grows completely over the tooth often there will be bacteria trapped below and be the cause of a potential infection. In your case gum growth will probably not complicate the surgery but I would not delay any longer. Sooner is better.
Good luck, Heather.
Dr. SINKIN
Hi Dr. Sinkin,
I’m having an issue with a crown that keeps coming off (tooth #19). It has come off about 7 times in the last few months and I keep having it re-cemented. I’ve had a root canal on this tooth about three years ago and now it seems to want to start acting up. I had tooth #20 extracted and a bone graft three weeks ago and my dentist said that the pain I’m experiencing in #19 is because the bone graft isn’t quite healed and is still exposed because the tissue hasn’t covered it yet. I, however, disagree with this diagnosis! The pain I’m having is somewhat severe. It throbs and I feel all this pressure in the tooth, which worries me since it’s had a root canal. Putting any kind of pressure on the tooth causes me to wince in pain. Why would my gums all around the tooth that is bothering me be red and painful if it’s the bone graft site that he says is what’s bothering me, which doesn’t hurt or bother me at all?? I can actually feel the pain in the tooth. I have a history of teeth fracturing, which is why I had to have #20 extracted, as well as another tooth in the past year. All of the symptoms I’m having this time are pretty consistent with the pain and discomfort I was having with the other 2 teeth that I had to have removed. Of course I’m worried about a fracture and I go back to see my dentist in two weeks so he can check it out again. For now, I was told to leave the crown off until everything heals from the extraction and bone graft. Do you think having a new crown put on the tooth would be the solution if it is the tooth that is the problem and not because the bone graft hasn’t healed yet?? Thanks!!!
Christina
Dear Christina,
A crown that comes off 7 times doesn’t fit. If you were in my chair (and your 3-week old bone graft is not an issue) I would most likely have a well-fitting temporary crown made on 19. Since future treatment most likely will call for an implant where 20 was extracted, I would wait until the implant is placed and ready to be restored, which should be about 6 months hence. I would prefer to make crowns on 19 and 20 together.
So, I suggest getting a second opinion. I can’t imagine trying to re-cement the same crown so many times.
It has been said that insanity is doing the same thing over and over agian and expect different results.
Good luck.
Dr Sinkin
Hi Dr. Sinkin and God bless you.
I have a two-sided problem. Both of my back molars are in the process of getting crowns, and both have had temporary crowns on them. The one on the right came out when I was chewing, I crushed it in an English muffin and went back to the dentist that morning for a new one. Two days later, the newly placed one came out, same thing, crushed and can’t be put back in. That was on Friday at lunchtime. I called and it turned out the dentist’s office is closed on Fridays. I left a message on the emergency line, no callback. I left a second message, same. It didn’t hurt though because there was root canal on that tooth, so I wasn’t too worried.
The problem is that I know I shouldn’t chew on that side, but I’m afraid that if I chew on the left side, I’ll end up dislodging that temporary crown too, and that one does not have root canal so it will hurt!
So I’ve been chewing on the right. Now I read that’s not a great idea either. Making matters worse, now 36 hours later it’s starting to hurt, a lot — feels like maybe gum pain, between the missing temp. crown and the adjacent tooth, but I’m not sure. It’s a lot of pain. What should I do?
Sincerely,
Jo in LA
Dear Jo,
It seems like you bit off more than you can chew (that’s a joke.)
Your assessment seems accurate. The discomfort you’re experiencing where the temporary crown is missing is consistent with traumatized gums. You are wedging in food and your gums are taking a beating. You need to soften your diet and keep the heavy chewing off the area. I suggest you try to use the other side (the one with the intact temporary ) for most of your chewing, but avoid a rigorous diet, i.e., crunchy, chewy, sticky foods until you see your dentist. Some foods like bread, English muffins and steak can create “suction” that may unseat a temporary.As for your aching gum, advil or Tylenol , warm salt water rinses and see your dentist. No worries just some inconvenience.
Best,
Dr. Sinkin
Dear Dr:
I have a resin veneer on my canine which fell off tonight.
I have read, numerous places, that one shouldn’t use superglue but you suggest using it as a temporary fix. I can glue it tomorrow, Sunday before Memorial Day, and hopefully get into the dentist yet this week. Will he have an okay time getting the resin veneer off of the tooth after I’ve superglued it on?
Thank you so much!
LettyMontana
Dear Letty,
Will your dentist have a difficult time removing your superglued resin repair? You raise a very good question that warrants an answer, but perhaps not the simple straightforward answer you would like to see…..maybe. Should you attempt to fix your cosmetic emergency for what might be a day or two of inconvenience before you can actually see your dentist….maybe, maybe not. If you’re getting married today or have a similarly high profile event planned, I’d say be very careful and practice positioning the broken fragment back on your tooth before using a miniscule drop of superglue to secure it. Make sure your tooth is dry and avoid getting the glue on your gum. If you can get in touch with your dentist for guidance before proceeding even better. As to whether your dentist can even use the broken piece is a question I can’t answer. You say that you have a resin veneer, not a porcelain veneer. Big difference. A resin veneer will probably be rebounded/repaired with new resin. A broken porcelain veneer will likely need to be replaced. A debonded (dislodged but intact) restoration will likely be recemented by your dentist and the less you do, the better.
You certainly dont want to risk ruining or breaking an intact veneer if its not placed properly. That said, your dentist is the best person to offer you advice. For a day or two, I would say wait. If you decide to proceed and do it properly and your dentist can’t remove it, I’d say it’s likely to become dislodged again in short order and you will be exactly where you are now but hopefully not stuck in the middle of a holiday weekend. Good luck. (Call your dentist before doing anything, I assume he/she has an emergency phone number).
Dr. Sinkin
Hi Dr Sinkin. I have a post crown on #7 that was installed in 1980. I’ve worn a night guard since 1989. Never any problems until about four years ago when my bite began to shift and the crown began to rub against #26. I went to the dentist looking for a preventive measure that could be done to eliminate the interference and instead was told, “That’s what happens when we get older, our bite changes. There is nothing we can do.” On July 14, 2015, the constant interference with #26 caused the root under the crown to break at the seam and the post and crown came out. My dentist says $8,000 to fix it! I don’t have that kind of money. I remove the tooth every 1-2 days and gently brush the gum, root, and crown. I then rinse with peroxide. The gum looks healthy, pink to slightly purple, and there is no pain or uncontrollable odor. It has been eight months now and the dentist is pressuring me to get this repaired, warning me of all kinds of doom and gloom if I do not. What dangers do I face if I don’t get this repaired anytime soon? What risk is there that my gum will recede to my forehead? Should I just get some glue and adhere it back in place? Any advice is appreciated. Thanks, Dr Sinkin!
Dear Chris,
That your crown has failed after 35 years of service does not disturb me; it served you well. You clearly have a high dental awareness and an above average Dental IQ…(teeth #’s 7 and 26 and prematurities are not terms in most people’s vernacular). While one’s occlusion can change over time, especially in the presence of parafunctional habits like clenching and bruxing (grinding), it is a normal part of aging. And although you do wear a nightguard, it doesn’t preclude adverse effects of daytime clenching or bruxing.
Dentists use many approaches to deal with occlusal prematurities including equilibration (bite adjustment), corrective orthodontics (such as Invisalign) and corrective restorative dentistry. You seem to have a problem that should be addressed before you develop an even bigger one.
Your fractured #7 alone doesn’t indicate a failure in dental care. If it is vertically fractured or so compromised an extraction may be unavoidable. Perhaps your dentist is suggesting an implant or crowns and a bridge to replace the condemned tooth. If the tooth becomes infected or further damaged, the gum-line and supporting bone might very well be at risk.
As detailed as is your description, a more careful assessment of your occlusion dynamics is warranted if for no other reason, to insure the success of future. Maintaining your tooth as you are currently doing is not a viable long term solution.
I wish you the best.
I don’t have insurance and my back tooth on the top left I don’t know if it is my wisdom tooth or a molar but it has been decaying for some time and last night a big portion of it came loose and I can’t brush it or eat or touch it on that on that tooth or else it’s very bad pain. I don’t know what I should do, I don’t have any money to get it pulled. I don’t know if it falls out if it will hurt way worse. Should I pull the piece off? Will it feel better If I do?
Dear Jessica,
I am so very sorry for your dental woes. You have a problem that needs prompt professional attention. Delaying care will only lead to greater problems like serious infection or more pain. While I empathize with your financial troubles, you need help. Perhaps the local dental society could help you locate an affordable dental clinic in a teaching hospital or school. I wish I could be more helpful. Best of luck.
Dr Sinkin
Hi Dr Sinkin, just been to the dentist and have decided to go ahead with crown. Is scheduled to start on it next Friday. That is the earliest i could get in for the procedure. Has assured me that it will be ok to then. Had a extremely thorough check up and require multiple fillings as well. Have told her that i would like these done Asap. Will be spacing them out over a couple of months (7 in total 2 of which are wisdom teeth. The check up was quite scary and i informed her so. On multiple teeth she said the teeth were worn and that cracks were present. Could be a result of teeth grinding. At no time in the last 20 odd years of having dental checkups has a dentist told me of this wear or cracks. She told me that everything will be ok. I said jokingly i should have all of them pulled out and she asked if that is what i want to do. Of course i said NO. Many of my front teeth have been worn down 30% or more. Should i be worried. Please your opinion would be greatly appreciated. You have been so kind. With all that is going on in my mouth not sure whether to spend big money on crowns and fillings or not as i am unsure of how long i will have my teeth for ( i know no one really knows but it us extremely scary for me). Do i do my upmost to save then now only to have them pulled out later on. I am not sure how long cracked and teeth that have huge fillings will last. I will be 47 in February. I know you would have some wear and tear to your teeth, but i feel mine may be excessive. If you were in my shoes what would you do your opinion means a lot
Also the internet advised that a tooth that is broken below the gumline will normally require a tooth lengthening procedure. Is this always the case because the dentist did not advise me of this. All she said wad that the tooths cusp had broken off below the gum and would require a crown. Asked if i would need a root canal and advised no, not at this stage. Does this mean i will need one later. In your experience what would you advise. I would really appreciate a response asap as i have a dental appointment at 9 tomorrow Aust time.
Hi Dr Sinkin have just been to the dentist and have been advised that the inner front cusp of my tooth has broken below the gum line. She has advised that i have 2 options, either fill it and build it up or place a crown on it. This will cost around $1800 aust dollars. Advised that root canal is not necessary. The tooth has been 60% filled now. In a bit of a dilemma what to do. i have an appointment tomorrow so any advice you can give would be appreciated. Wasn’t forthcoming in advising the best option or should i just have it pulled. Your reply would most greatly be appreciated. Not sure whether to spend that type of money on the one tooth.
Dear Fiona,
By the tone, time and frequency of your e-mails, it’s not difficult to see the level of your stress. So, let me get right to it.
Over the many years of dental practice, I have “saved” scores of fractured teeth that would fit the description of your tooth. The fact that your dentist has given you 2 options to restore your tooth, including a large filling, suggests that there is plenty of structure left for a successful outcome. Even with 60% of your tooth’s volume being filling and a broken cusp that goes below the gum-line, a beautiful, comfortable crown can be designed and fabricated and is how I would proceed.
Yes, root canal is always a possibility when a tooth such as yours needs treatment (perhaps 20-30% chance over the lifetime of your tooth-my “guestimate”), but that is not sufficient reason to extract the tooth. Additionally, not all crown-lengthening procedures are equal (assuming that it’s even necessary. Sometimes a crown-length involves a simple gingivectomy (which is nothing more than trimming the gum) and can be accomplished at the time of crown preparation. Other times, crown lengthening is a bit more involved and the bone where the cusp fractured may need reshaping.
As long as there is sufficient tooth structure (which sounds to be your situation) and the surrounding bone is healthy and any treatment doesn’t compromise the adjacent teeth, having a crown placed on this tooth is the desired treatment. The real question to ask your dentist is what the prognosis of the tooth is, once restored. If she is confidant that success can be achieved, saving your tooth is the best option.
If the long term prognosis is questionable, I would seek a second opinion, since you have already invested so many hours surfing the net already, and have another pair of professional eyes assess the situation. The alternative might very well be extracting the tooth and have an implant placed. A new large filling would be a stop gap measure and not a long term solution FYI, I just went through a similar situation with my own tooth (see https://michaelsinkindds.com/blog/i-am-the-dentist-who-had-a-really-bad-toothache/), and am about to have the tooth prepared for a crown.
A word of advice, the Internet is a great resource, but it does not replace the trust and rapport you should have with your own dentist. You have become quite informed, now use your newly-acquired insights and talk to your dentist about the treatment she recommends.
Good Luck.
Dr. Sinkin
DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.
Thank you for your kind reply. Sorry to be such a pain but i am a little terrified at the moment. The cusp in question is only a little bit loose. To me it looks like it has cracked between the front and back cusp. The front part of the cusp that is next to the filling is a little loose. Only hurts if it is moved away from the filling. If pressure is applied to the inside of the tooth and downward pressure applied it does not hurt. Really worried that i could lose this tooth as i have been surfing the net and reading about cracks that go below the gum line. Phoned the dentist again today and the earliest i can get in is Wednesday. I am really really worried. Would you know if the tooth has cracked below the gum line. Do you think it can be saved
Hi Dr.
My upper right last tooth fell out with the gold crown and took the tooth with it.
I can still feel a little bit of jagged pieces up in my gum but the tooth is gone. This was an old crown that was replaced only two months ago with a new gold one.
Do you know when I go to the dentist he will have to extract the remaining pieces of tooth out of my gum and just let the Hole close up? I do not have any pain as I have had a root canal in this tooth.
The gum is getting very sore though from eating because there is nothing there anymore. Thank you for your help I am just very nervous as I am afraid of what the dentist will have to do! Do you know if I will need an implant since it is the very last tooth in the upper right back? Happy New Year!
Well, you seem to have assessed your dental situation pretty well. That your dentist chose to restore your tooth with a gold crown indicates to me, at least on an intuitive level, that this was not the fault of improper care but rather a result of a weakened foundation. Evidently your tooth’s structural integrity was sufficiently compromised that it was unable to support your most recently placed crown.
Based on your description, I would conclude that your tooth will need to be removed. Don’t work yourself up into a frenzy as dental extractions need not be a painful experience and you should not equate it to the removal of an impacted wisdom tooth (not all extractions are equal).
As to whether you should have a dental implant will be based in part to what is going on in the rest of your mouth. My initial response is that if your tooth was strategically important enough to warrant previous root canal treatment and crown placement twice, it certainly justifies replacement with an implant, especially if the tooth opposing it is present.
Call your dentist and schedule an appointment. Happy New Year (and don’t worry so much!).
Dr. Sinkin
DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.
Thank you for your quick reply. Not sure that i want to remove the cusp as advised above. Would it be ok to leave until dental appointment next Wednesday. Will brushing hurt it any further. Can i just eat on the other side of my mouth until then. Do you think i would know if i had cracked the tooth below the gum line. Don’t have any real major pain except when pressure is applied to that 1 broken cusp. The tooth doesn’t appear to be sensitive to hot or cold drinks. Is this a good sign or not. Sorry to ask so many questions but i am a little scared at the moment and just want to get home.
Relax. You’ll be fine. There is nothing to worry about. If you want to chew on the other side and leave it as is, no harm will come to your tooth. I wouldn’t be surprised if the piece comes off over the next couple of days. Enjoy yourself. If it were my tooth and I was camping, I’d remove the piece. It’s your gum that hurts because it’s being traumatized and irritated like the skin around an ingrown nail. Enjoy your time away.
Dr. Sinkin
DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.
Hi, sorry to bother you. I am really worried. I am presently on a camping holiday and unable to get to a dentist. Last night while eating steak i have cracked a back molar. This has a large filling in it from 15 years ago. One of the cusps broke away and it was rebuilt with a filling (silver in colour. The crack is in the inner side of the tooth between the 2 cusps. The tooth is loose in the gum and hurts if pushed on. Otherwise no real pain. What can i do. Cant see a dentist until next Wednesday after returning from camping trip
Dear Fiona,
What you describe is a pretty common occurrence for teeth with very large fillings. It sounds like you have a “dangling” cusp that is being held in place by gum fibers that connect to the tooth at the base. As the tooth fragment moves, it is tugging on the gum and causing pain. From what you describe, I don’t think it is the tooth itself or its nerve that is the problem. You will most likely need a crown on the tooth when you get back.
Here is my suggestion for relief. If the nearby town has a pharmacy, get some Ambesol or some other over-the-counter topical anesthetic (generally 20% benzocaine) and apply it to the base of the gum where the loosse fragment is. This will numb the area and relieve the pain.
If you are not squeamish, what I am about to suggest will resolve the problem until you get back….numb the gum adequately….keep the anesthetic against the gum and if possible allow it to flow between the tooth and the loose cusp (i.e., gently separate the cusp from the tooth and place the ambesol in the space created making sure the solution reaches the gum.) 1 or 2 minutes should suffice. Then, (here’s the adventurous part) displace the fragment out by pushing it away from the tooth…really away from the tooth , really lean it back towards the palate, place more ambesol if you need it, and when you have bent it back sufficiently, you should be able to remove the cusp with a twisting motion. Use your finger tips.. Alternately, after you loosen the cusp, you can bite into a warm sticky piece of caramel or Milky Way Bar and dislodge the piece by first hardening the candy by sipping cold water and then open your mouth quickly.If ambesol is not available, get a piece of ice and place it against the gum where the tooth is broken and loose, You might not want to place the ice between the tooth fragments as your tooth will likely be sensitive to the cold. You may need to work on it a bit, but it will come out with minimal distress.
Your gum will bleed a bit (bite on gauze or a tissue and your remaining tooth might be sensitive to temperature for a bit (place toothpaste, preferably sensodyne against the remain tooth and you should be good to go. If the remaining tooth is sharp and irritating to your tongue, place a piece of sugarless gum against it to cover. This is dental first aid in the wilderness. I assume you do not have any bleeding disorders. Pressure with a tisssue for 10 minutes will stop any bleeding in a normal patient. If you are diabetic, I would take the antibiotic after the “procedure”. Good luck, enjoy your camoing and please let me know how it goes.
Happy New Year.
Dr Sinkin
DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.
I had 1/4 of a molar tooth break off, I saw a new dentist referred by a friend. He did not explain what a crown was, just told me I needed one. He numbed me, and drilled down the tooth (which I found out about during online research). A temporary crown was placed, which came off 10 days later. I was relieved when the crown came off (as funny at this sounds), because my tooth felt better when the crown was off of it. I called the dental office, left a message, as it was a Friday evening. The dentist called me back Sunday morning and told me to come back in on Monday and they will re-cement. It may sound silly, but I really don’t want a permanent crown. The temporary crown is bulky and feels thick over what’s left of my tooth. I am having anxiety about a permanent cemented crown. I would prefer the crown be cemented with a cement that could be removed (like the temporary crown), should I have a problem with the crown. I wish there was a way of getting a “removable crown” (like one you can remove to allow air and circulation, I feel like I have a blanket over my tooth smothering it. It’s making me feel claustrophobic in a way (I know this is silly). Is there a less permanent cement that can be used, so if the crown has to be taken off it’s less traumatic to the tooth and gums, should it need to be removed?? Thank you in advance for your response.
Dear Teresa,
What bothers me more than anything that you detail is that you were not sufficiently informed of the treatment performed. That does not mean you received improper care, you just would have been better prepared to understand what you have been experiencing.
A filling is a restoration placed within the confines of a tooth as is in fact, supported by the tooth. When there is not enough tooth structure to support a filling, then a restoration, such as a crown, is needed that can actually support the tooth. A well-made crown is akin to a well fitting glove.
Your difficulties and subsequent anxiety has more to do with the fact that there was a problem with your temporary crown. Perhaps it was not well-adapted to your tooth, maybe it was too bulky and impinging on your gum, interfering with your bite or placing pressure on the adjacent teeth. Clearly, you need to convey your experience with your dentist.
This is not a matter of just recementing your temporary; it needs to be refined. You should be perfectly comfortable with both your temporary and permanent crown. And, based on your experience, the permanent crown should be initially placed with a temporary cement to allow for a “test drive” prior to permanent cementation. Your assessment of the situation is not silly. Your claustrophobic feelings are vivid description of sensations that can be readily addressed. I have placed thousands of crowns and know that there will come a time when you won’t be aware of which tooth has a crown.
Best,
Dr. Sinkin
DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.
I just went to the dentist expecting to need two crowns upper right redone due to decay. When the dentist removed the decay from the bicuspid it was more extensive then expected. He was unable to locate the canal to see if a root canal would be an option.As it was right before Christmas he was able to place a pin and use a temporary crown warning me that there could be pain when the anesthesia wears off. I have experienced no pain.He wants to place a bridge crowning the canine tooth, extracting the bicuspid and crowning the molar. Is this the best option? Is a pin not strong enough to support a crown? How long will a temporary crown last?…..thank you
Dear Donna.
There are many treatment options to address your current dental dilemma and while I will offer my opinion, please understand that without more clinical information I can only speculate as to what the right approach for you might be. Assuming that the bicuspid needs to be removed, as I see it you have 2 options: 1. Make a permanent 3 unit bridge utilizing the cupid and molar. (I presume you had your other bicuspid extracted when you were younger for orthodontic treatment.) 2. Place an implant to replace the bicuspid and have 2 independent crowns made on the implant an molar.
If your cuspid is healthy, I would be hesitant to “cut it down for a bridge abutment. That you need to replace 2 existing crowns due to decay, I would think twice before making a fixed bridge which is harder to clean than individual crowns. That raises the question: why and how did you develop decay under your crowns and what’s going on in the rest of your mouth? Performing root canal and placing a post/core and crown on your bicuspid (if it were possible) is almost as costly as replacing the tooth with the implant, BUT with a lower probability for long term success. Implants don’t decay.
I suggest that you call your dentist to discuss the options and better understand his rationale. There are many considerations to take into account including the health of the adjacent teeth, prognosis, esthetics and of course, cost. In theory and practice, I have no problems with a 3 unit bridge. But, all things being equal, an implant is the more ideal approach with a much better outlook for long term success.
Good luck.
Hi, I just had a temporary crown placed over my front teeth this last week and ever since, there is tenderness in the front roof of my mouth; it almost feels like the crown is cutting into the top of my mouth. Also, I’ve noticed that whenever I drink anything it feels like it is inside my tooth. A friend that has had a crown before told me that it may not have been glued in properly or that it may not be fitted properly. The permanent crown is scheduled to come in next week. Is this something I should go back in and have fixed before then? Will the liquid getting between the tooth and crown cause problems? I’m not sure if the dentist could fit me in before the holiday but I don’t want to delay and cause more problems…
Dear Jeanne,
From your description, I would say the problem you are experiencing is related to the temporary crown. Your friend’s suggestion that the temporary is not sitting properly on your natural tooth is the logical conclusion. Regardless of whether the temporary is ill- fitting or improperly cemented, your tooth should be comfortable without the symptoms you describe. My belief is that a temporary crown should fit precisely so that the tooth is protected, the health of the gum is preserved and the status of the natural tooth’s health i.e., the pulp (nerve) can be assesed.
I would not permanently cement a new crown on a tooth that is sensitive or has inflamed gums because one can’t assume that the problem is caused solely by the poor fit of the temporary nor can one assume that the symptoms will totally disappear when the final crown is placed. The irritation of your inner gum could be caused by excess acrylic or composite (what the temporary crow is made of) or residual cement pressing into the tissue.
Here is my suggestion: try to get an appointment with your dentist before the holidays. It may just require 10 minutes to correct and you can have piece of mind and comfort. If that doesn’t happen, I would not have the new crown permanently cemented until your tooth is perfectly comfortable. Either your dentist can place the final crown in with temporary cement and let you take it for “a test drive” or he corrects your temporary crown and makes sure your tooth is okay before placing the permanent one. Most likely, this is a minor problem that can be easily addressed,
BUT BETTER IT’S BETTER TO BE SAFE THAN SORRY.
Happy Holidays.
Hi, I had a big filling on my tooth from a few years ago, and recently realised I had a crack on the front of this tooth. I went to the dentist today who said he was going to refill the tooth and possibly cap it on wednesday, however as I was eating tonight the tooth has broken off from the crack which is very high in my tooth (leaving me with the tiniest bit of tooth left). Now my filling is fully exposed but my dentist is closed until monday. Is it okay to wait until wednesday or should I go in on monday and let them know that the crack has caused the tooth to break off? Also, is it okay to brush as it is literally all filling that is exposed instead of being protected by the front of my tooth as that has fallen off?
Dear Hayley,
Hardly a week goes by without my seeing the dental situation that you described. FYI…the filling protects the tooth; the tooth doesn’t protect your filling. So, brush away, but you should probably avoid flossing. You don’t want to chance dislodge the filling.From your initial description, this tooth was destined to have a crown.The thin wall of tooth offered no real structural support and was splintering away before your eyes hence the cracking. You might want to touch base with your dentist on Monday to give him/her the heads up. If nothing untoward happens over the weekend, I suspect you’ll be fine until Wednesday. In the meantime, chew on the other side.
Dr. Sinkin