Usually, a crown or filling comes loose while eating. Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure. Crowns generally become loose because the tooth beneath is decaying. This decay causes shape changes in the tooth structure resulting in a crown that no longer fits.

Here are some steps to take: If a crown has dropped out of the mouth, make a dental appointment as soon as possible.  Keep the crown in a cool, safe place because there is a possibility that the dentist can reinsert it. If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.

When the dentist is not immediately accessible, here are the steps to take:

• Clean the crown and affix it onto the tooth with temporary dental cement.  This can be purchased at the local pharmacy.
• DO NOT use any kind of glue to affix the crown.
• The dentist will check the crown to see if it still fits. If it does, it will be reattached to the tooth. Where decay is noted, this will be treated, and a new crown will be made

The teeth are strong, but they are still prone to fractures, cracks, and breaks. Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme. Fractures, cracks, and breaks can take several different forms, but are generally caused by trauma, grinding and biting. If a tooth has been fractured or cracked, there is no alternative but to see the dentist as quickly as possible.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

• Call the dentist.
• Rinse the tooth fragment and the mouth with lukewarm water.
• Apply gauze to the area for ten minutes if there is bleeding.
• Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
• Take an over-the-counter pain medication, if necessary.
• The nature of the break or fracture will limit what the dentist is able to do.  If a fracture or crack extends into the root, root canal therapy may be the only effective way to retain the tooth.  In the case of a complete break, the dentist will usually affix the fragment back onto the tooth as a temporary measure.

When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it. If the tooth remains in the mouth and attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.

It is important to call the dentist immediately to make an appointment.  In the meantime, use a cold compress and over-the-counter medications to relieve pain. The dentist will reposition the tooth and add splints to stabilize it.  If the tooth fails to heal, root canal therapy may be required.