Lost crown or filling

A lost crown is uncomfortable but rarely a true emergency. The first questions are: is the underlying tooth painful, is the edge sharp, and did you find the crown? Those three answers shape what happens next.

The first ten minutes

1. Find the crown if you can — in your mouth, in food, on your pillow. Rinse it gently and set it aside. Do not throw it out.
2. Rinse your mouth with warm water. Look at the underlying tooth. If you see a darker stub, that’s normal. If you see a black spot or feel a soft area, the crown may have come off because the tooth decayed underneath.
3. Cover sharp edges with sugar-free gum or dental wax (any pharmacy).
4. Avoid chewing on that side. Stick to soft food and the opposite side until you’re seen.
5. Call. 212-382-3782. Same-day care if there’s pain, swelling, or sensitivity; next business day if it’s quiet.

Re-cementing at home (only if you have to)

Dental cement from any pharmacy — Dentemp, Recapit, similar — works for a few days. Clean the inside of the crown, dry the tooth, follow the package directions, bite gently. This is a temporary seal that protects the tooth from sensitivity and shifting; it is not a long-term fix. Do not use super glue, gorilla glue, or any household adhesive. They damage the tooth and complicate proper re-cementation later.

What we do when you arrive

First, look at the crown and the tooth. If the crown is intact and the tooth underneath is clean and intact, we clean both surfaces and re-cement properly. This is a 20–40 minute visit and usually the end of it.

If the tooth has decayed underneath — common when the crown was older — the decay is cleaned out and rebuilt with a core, then the crown is either re-cemented or remade. Same-day porcelain is an option for the remake when the case fits it.

If the tooth has fractured — also common, especially on a back molar that has had a crown for many years — the next conversation is about whether the tooth can be saved with a new crown and a root canal, or whether extraction and an implant is the better long-term answer. That decision is shared, not made for you.

Lost filling, same idea

A lost filling almost always means decay underneath the old restoration. Keep the area clean, avoid chewing there, come in within a few days. The replacement visit cleans out the new decay and rebuilds the tooth. If there isn’t enough tooth left to hold a filling, the conversation moves to a crown — or, if the loss is on a front tooth, sometimes a veneer or onlay.

Other emergencies: knocked-out tooth · broken front tooth · all emergencies.