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Dr. Hall,
I have had a crown put on by a dentist and it was done same day. No temporary. Not sure what type of material he used for the crown. It fell out three times in less than a year. I went to a different dentist on the fourth time it fell out and he replaced the setting with a new one stating the other dentist didn’t create a good setting. This new crown is Zirconia Porcelain and it has fallen out twice in a month. He is suggesting a full porcelain crown on the same setting as he states the cement is adhering to my tooth but not the crown. He says the all porcelain has a more rough underside to adhere to the cement better. Any suggestions on what my next move should be?
– Stephanie from North Carolina
Stephanie,
Your same-day crown was a CEREC crown or a similar type that is milled by a computer in the dental office while you wait. But when properly prepared and bonded on, it will stay on permanently. It’s not the material your crown is made of. Gold crowns, porcelain crowns, CEREC crowns, zirconia crowns–all of them can be made to stay on solidly, permanently. I have most of those types of crowns in my own mouth and they stay on just fine.
There are two main factors for retention of a dental crown–the bonding strength of the cement, and the shape of the tooth preparation. Of those two, the shape of the tooth preparation is far more important. If the tooth is prepared with only a slight taper, a crown can be cemented with a very weak cement and it will still stay on. If it is prepared with a lot of taper, some of the strongest cements will not hold it on.
I’m not saying that getting a good bond between the crown and your tooth wouldn’t solve your problem. The strength of the cement is a factor. And I know very little about your tooth and the techniques these dentists used. But I do know that a tooth prepared with good retention form will not have a crown falling off three times in less than a year, regardless of the cement used. So even though I know very little about your tooth, I’m pretty confident that it was prepared with inadequate retention form.
So what should your next move be? I would find a dentist who knows how to do crowns that stay on. In 23 years of dental practice, I never had a crown fall off of any that I did for my patients, so I know it can be done.
For further understanding of this principle, of creating a crown that stays on, see my blog post from about nine months ago, “The main reason your crown probably fell off.”
I hope this is helpful.
Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
Yikes! I hope the dentists are at least ethical enough to give her money back on those visits. How frustrating. She’s much more patient than I would have been. I’d have found a new dentist after the second time it fell out.
When a crown isn’t done correctly, it is so unpleasant. I dealt with one that just didn’t feel right. After adjustments, re-adjustments and many complaints, I switched dentists to get it fixed. I was fortunate that the dentist reimbursed the fee.
I am dealing with the exact same issue. Ive had mine fall out 4 times in 8 months, it is loose again and i feel like it will fall out a 5th time fairly soon. I literally had it fall out 2 weeks after getting it put back in by my dentist, so i went to another dentist to reapply it. Still had the same issue. Talked to my dentist about getting an implant instead and he said “an implant wont stay in any better and would be a waste of money. Tried to tell me crowns just fall out and that it is normal. Honestly close to just having the tooth underneath extracted and dealing with the hole in my mouth. Really just want it to stay in for once (it is only 4 years old) and am sick and tired of it
How does one find a better dentist. I have multiple crowns with one constantly coming off. Now he want to charge me for a new one.
– Joan Lamb
Response by Dr. Hall –
I have a list on this site of great cosmetic dentists that I recommend.