A little more than a year ago, a dentist placed a same-day crown on a left side tooth. I don’t know what type of material he used to make the crown, but it fell out four times with ten months. The fourth time that it fell out, I saw a different dentist who said that my previous dentist didn’t create the setting correctly, so he replaced it.
The new crown, zirconia porcelain, fell out twice in a single month. Now the dentist suggests that I get a full porcelain crown placed on the same setting. He says that the cement is secure on my tooth, but not the crown, and a full porcelain crown has a rough underside that cements better. I’m overwhelmed. Is my second dentist’s recommendation valid? – Thanks. Serena from Georgia
Same-day crowns are ceramic restorations that dentists mill in their office. When a crown is bonded and prepared correctly, it won’t fall off. The issue is not with the material that your dentist used to make the same-day crown. Whether a crown is ceramic, gold, porcelain, or zirconia, a skilled dentist can make it to stay in place solidly.
Why Does a Crown Keep Falling Off?
Two factors can cause a crown to fall off: the cement bonding strength and the tooth’s shape after your dentist prepares it. Correct tooth shape is essential. If a dentist slightly tapers a tooth and uses a very weak cement, the crown will be secure. If a dentist tapers the tooth too much, some of the strongest types of cement won’t secure the crown.
A good bond between the crown and your tooth might resolve the issue. But the strength of the cement matters, too. Dr. Reddy would need to examine your tooth and know which techniques your dentist used to determine the real issue. But a crown doesn’t fall off a well-prepared tooth with good retention form, regardless of the cement’s strength.
We recommend that you find a dentist with advanced training in cosmetic dentistry and same-day crowns who knows how to secure crowns and prevent them from falling off.
You can schedule consultations with two cosmetic dentists. Take a copy of your digital x-rays and dental records. After you discuss your options with each dentist, you can decide which provider you trust to restore your tooth and prevent the same-day crown from falling off again.
Dr. Rekha Reddy of Dallas, TX, sponsors this post.