A Guide to Lost Fillings and Crowns

What is a filling?

Most of us have lost a filling on occasions. Usually, it does not constitute a dental emergency as it does not necessitate immediate treatment.

A filing is the material your dentist uses to fill a cavity in your teeth. A cavity is caused by dental decay, so if cavities are not spotted and filled by your dentist, then they can gradually become worse as the decay spreads. This can ultimately lead to the inner part of the tooth becoming infected.

Nowadays, fillings can be made from a variety of materials. Traditionally, fillings are made from an amalgam of metals. However, the traditional black amalgam filling can be unsightly. In modern practices, many patients who need a filling now have the choice of compound materials that are tooth-coloured and more aesthetic.

What is a crown?

A crown is slightly different to a filling and is required when the structure of the tooth has deteriorated. In these instances, it could be that a cavity has been unnoticed and the tooth has decayed to the point where it is not possible to simply fill the cavity.

Alternatively, sometimes when the tooth is undermined by decay, it can split or fracture. On these occasions, it is not possible for the dentist to treat the problem with a filling. It needs a solution that is going to seal the tooth up so that decay cannot enter it, yet at the same time reinforce the overall structure of the tooth.

These sorts of problems usually require that your dentist fits a crown to the tooth. Crowns are also sometimes called caps. They are literally cemented over the tooth to support the weakened structure and provide a new bite surface. They can only be fitted it the root of the tooth is still strong. They are often fitted after root canal treatment where the root of the tooth is embedded in the jaw but the crown of the tooth is no longer supported by vitamins and nutrients from the blood stream.

How can they be lost?

On a daily basis, we put our teeth through a lot of work when it comes to eating and chewing. They also have to tackle a lot of different types of foodstuffs. Unfortunately, in the face of this constant use, nobody has yet managed to create a material for fillings or cement for crowns that is guaranteed to last a lifetime.

Fillings and crowns can be pulled out by eating toffees, for example, or any other chewy sweets. They can break if you are chewing on the end of a pen or if you crunch down on something hard.

Usually, your filling will break and come apart. With crowns, on the other hand, it is usually the cement which becomes loose. So the crown stays intact, even though it comes away from the tooth.

Is it painful?

No, it is not usually painful. It can be slightly alarming when you suddenly feel bits of a filling or a loose crown in your mouth. It can also be slightly sensitive to hot and cold when the cavity of the tooth is exposed.

Even though a missing filling or crown is not immediately painful, it can become painful in a short period of time as food and other debris gather in the cavity. Unless the cavity is sealed up again, decay and infection may also cause the tooth to ache. This is why it is important to visit your dentist, at least within a few days of realising your filling or crown has come loose.

What should I do?

As we mentioned, it can be a little unnerving when you suddenly feel something in your mouth that you didn’t put there on the end of your fork. If it is a crown that has come loose, just make sure you don’t swallow it!

It is possible that your dentist will be able to replace your crown. Therefore, make sure that you put it in a safe place and visit your dentist as soon as possible. If you lose a fillings, it may disintegrate in your mouth. If you have some to hand, use an antiseptic, alcohol free mouthwash to rinse your mouth.

One option you could try is to use a temporary dental kit. These are available from your local pharmacy. These kits usually include a temporary cement so that you can cement your crown back in place until you can make an appointment at your dentist. This dental cement can also be used to fill a cavity until you can get a permanent filling.

Dental kits are particularly useful if you are on holiday in a foreign country, where finding emergency dental treatment is either difficult or expensive. However, it should not be viewed as a long term solution. It simply ensures that your already weak teeth have some protection against decay and debris. It can also make it a little more comfortable to eat hot and cold foods, as your teeth will not be so sensitive. Clearly, though, a visit to the dentist for a permanent solution should still be high on your list of priorities.

What can the dentist do?

If you have lost a filling, it should be a relatively straightforward procedure for your dentist. Your dentist will usually clear any debris from the cavity and check to ensure that further decay has not set in. Sometimes, unnoticed decay can be the cause of the filling coming loose in the first place – in these cases, your dentist may need to resort to the dental drill to drill the decay away. Once the tooth has been cleaned up, the filling can be re-applied.

As we mentioned earlier, there are now a number of different types of composite materials available which provide a more aesthetic alternative to traditional amalgam fillings. Some patients, therefore, view losing a filling as an opportunity to replace an old amalgam (sometimes, it could be a filling that has been there since they were a teenager) with a ‘white’ filling. This may especially be an option if your filling is near the front of your mouth and therefore noticeable when you smile and talk.

If you have managed to keep your crown, your dentist may simply be able to cement it back into place. However, as with a filling, it could be that underlying decay in the tooth has caused the crown to become ill fitting and therefore loose. In these instances, the tooth will need to be cleaned and the decay removed. Your dentist may also have to reshape the tooth slightly and then prepare a new crown.

A new crown can take around three weeks to prepare, so in the meantime your dentist will fit a temporary crown. It is also worth remembering that one of the reasons a crown was required in the first place was because the structure of the tooth had become too weaken to function effectively. Therefore, if any more decay has set in, it may mean that the tooth has become more badly damaged. Root canal treatment may be required if the inner part of the tooth is infected. If the infection continues to return, it could mean that the tooth will need to be extracted.

Your dentist will be able to advise you on whether a crown is a suitable treatment for your tooth.

What about in the future?

As a rule of thumb, dentists expect treatments such as fillings and crowns to last around a decade. Different types of materials and cements have different levels of durability and it goes without saying that cheaper dental work will often use inferior materials with a shorter lifespan.

Once you have had your crown or filling fitted, it is important that you give it time to strengthen and for the cement to harden. Your dentist will usually recommend that you avoid brushing for the first twenty four hours or that, at the most, you brush your teeth very lightly (especially around the area of treatment). Your dentist will be able to demonstrate the correct technique for brushing around the area of treatment.

Your dentist will also recommend that you avoid certain types of food for a period of time. These foods will probably include things such as soft, chewy sweets and hard, crunchy items – however, there is no definitive list of things you should or should not eat. Common sense should help you decide though. You should also avoid alcohol and smoking for around 24 hours.

As with the majority of dental treatments, your dentist may recommend bringing your next check up forward. This enables your dentist to check and evaluate the previous treatment and ensure that the filling or crown has set correctly and that there is no evidence of decay in the tooth or in the neighbouring teeth. Your dentist will probably ask how comfortable your crown or filling is, so be prepared to explain any areas of concern you may have.

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