Sodding dental crown fallen out again

[ChilledProsecco]

Posting in chat for more traffic.

I had a dental crown placed about a year ago, after a root canal, and had to pay privately for it as I wanted a white crown rather than a silver filling. It cost almost £1000 IIRC.

The original crown only lasted a matter of weeks, before it fell out, and then the dentist drilled more & placed a new,bigger crown on it too.

This has fallen out about 5 times in the last year, the latest being tonight.

I'm not eating toffees etc!

Each time it's been replaced, free of charge - but now I'm wondering what the future holds for this tooth - how long can this go on for?

And it's a lot of money to pay for something which doesn't feel fit for purpose.

Any advice?

I'm not a dentist, and I don't know what the problem is, but there's something very wrong.

I had a crown placed 5 years ago, and it has NEVER fallen out.

Is it a full crown over the entire tooth, or just an onlay over a part of the tooth?

I’m sorry to hear it, it’s so annoying and especially so close to Christmas. When I had this problem, it turned out that the root of the tooth had cracked. I ended up having the tooth removed and a dental implant.
I have several other crowns and none of them has ever fallen off - I think there’s probably something else going on here.

hope you can get it sorted before Christmas.

I had one put in over part of a tooth 3 years ago. Fell out after a week. Put back in and not a stir since. Might be time for straight talking with the dentist.

@Fulmarinepetrel - thanks - it was originally an inlay & turn replaced with a full crown.

If I'd known this would happen, I would have chosen an implant.

What is the dentist's explanation of why it has been falling out?

@Fulmarinepetrel - she's said that it's just the difficulty of bonding 2 smooth surfaces together.

Hmmm ... As I said, I had a crown 5 years ago which has never fallen out, and DM has had two crowns, 5 and 4 years ago which have never fallen out.

Maybe some MN dental professionals will weigh in.

Thanks - I was hoping someone on MN might be a dentist or dental nurse with inside knowledge.

It just doesn't seem right - I could appreciate that if I was eating lots of chewy foods, but it's now got to the point that I'm avoiding eating in that side of my mouth.

Shameless bump before I phone the dentist

I feel the pain- well annoyance more than physical pain. I'm not a dentist BTW.

I had a crown 10yrs before it started to crumble off. Had a replacement recently and was told it had a 5yr warranty. Also paid privately. Within a few weeks, I was eating and could feel the centre crumble and the next day- the entire thing had fallen out.

They'd had a trainee nurse in the room, so I asked the dentist whether the glue might have been mixed incorrectly. She said she'd never seen a crown crumble after only a few weeks, and couldn't explain it falling out. I've had the replacement one for a month now- and so far, so good.

There is definitely something wrong if yours has fallen out 5x! If they are claiming its due to two smooth surfaces, surely they need to roughen up the post that is left or be using a different glue.

Sorry, this was long to say I can't help, but a hopeful bump for you anyways.

Dentist here.
It’s likely to be one of three things.

1. poorly designed crown - although most crowns stay on however badly they are designed.
2. the root canal has failed and the exudate from the chronic infection is de-bonding the crown - pus moves from the root through the dentine and dissolves the bonding cement
3. you have a fractured root which essentially has the same affect as 2. with the addition of an unstable structure to which the crown is bonded.

If the root filling has failed it doesn’t necessarily cause pain. Might be worth asking for an X-ray to check that root canal has healed. With a crown that is failing as often as yours that would be my first action.

Root canals do fail, it has nothing to do with how good or bad the root filling is but the initial condition of the tooth. If a tooth is fractured it is doomed to failure. The root filling doesn’t really seal the fracture which continues to leak and reinfect the tooth.

Current practice is to try and retain as much healthy tooth tissue as possible, therefore crowning is becoming less popular. But it takes a while for new ideas to be adopted because it takes years to build up evidence. Cynically it is more profitable to crown the tooth and takes less skill than restoring with composite inlay. Gold standard would be to use a gold inlay. Gold is a brilliant restorative from a mechanical point of view and bacteria hate heavy metals so discourage growth of bacteria. It is technically much harder to prepare a tooth for a gold restoration and gold prices are very high. The inherent strength means that you don’t need to remove as much tooth tissue.

I only have one restoration in my mouth, a gold inlay, which has been in place for 34 yrs. it has fallen out once about 15 yrs ago and the tooth was still solid underneath so it was re-cemented.

I chose gold because in my early career I saw loads of gold restorations which were decades old and when they fell out there was rarely any decay under them. I still have patients whose gold restorations are older than me and I was 60 this year.
It’s an historic material and most dentists under 50 would have no idea how to prepare a cavity so I don’t see it becoming popular again.

Thanks so much for that comprehensive reply @Angrymum22 - very informative.

It's just been - it was put back in & I asked a few questions. She says it's failing because somehow moisture is getting in & it's something that's never happened to her before.

The tooth did not fracture before the crown, but I've managed to find a NHS dentist so I can ask for an xray when I'm registering.

The original inlay was much smaller than the current crown & I wish that had been replaced multiple times compared to drilling more tooth away & making a crown.

I had a metal crown over a lower molar 13 years ago and it’s never fallen out or had any issues. I was told at the time that the metal ones are more long-lasting (and I couldn’t afford at porcelain crown then!).

@Angrymum22 that's interesting about root canals failing. I had one done 5 years ago by my fantastic dentist and it started hurting last year. She referred me to a specialist endodontist who discovered an extra canal that he said sometimes is present in this particular molar. He said my dentist wouldn't have found it as she wouldn't have the equipment that he has. He managed to save my crown by drilling through it too, so I kept my tooth and my crown!