What to Do If a Porcelain Crown or Veneer Breaks or Falls Off

Porcelain restorations are remarkably durable in the mouth, but they are still ceramic, and under certain conditions they can chip, crack or come loose. Finding yourself in this situation can be unsettling, yet staying calm and taking the right steps usually makes the next stage of treatment easier. In this article we look at the types of damage seen in porcelain restorations, why they happen, what to do first and the options available at the clinic.

What Kinds of Damage Can Occur?

Problems with porcelain crowns and laminate veneers generally fall into a few categories:

• Edge chipping: A small fragment breaks away from the tip or corner of the ceramic; your tongue feels it as a rough spot.
• A crack in the ceramic layer: This appears as a fine line on the surface and may cause no symptoms at first.
• The restoration coming off: The crown or veneer detaches from the tooth in one piece.
• A fracture in the underlying tooth: Even when the restoration looks intact, the tooth structure supporting it may have broken.

Why Do Restorations Break or Come Off?

The most common factor is teeth clenching and grinding, often done unconsciously at night or during the day. Biting on hard objects such as nutshells, ice, pen tips or fingernails, as well as trauma from sport or accidents, can also cause sudden fractures. Over time, decay starting at the margin of the restoration or breakdown of the cement can loosen it until it falls out.

What to Do First

• Do not throw away the broken fragment or the restoration; keep it in a clean container and bring it to your appointment.
• Avoid chewing on the affected side, and take a break from hard and sticky foods for a while.
• If a sharp edge is irritating your tongue or cheek, rinse with lukewarm water and let the clinic know.
• Do not try to reattach the restoration at home with any kind of glue. Such products can harm the tooth and gums and make it harder to reuse the restoration.
• If the exposed tooth feels sensitive, stay away from very hot and very cold foods.

What Options Are Considered at the Clinic?

Small chips

A limited chip can be smoothed by polishing the edge, or the damaged area can be repaired in the mouth with composite filling material.

A restoration that has come off

If both the restoration and the tooth underneath are sound, the surfaces are cleaned and the restoration can be cemented back in place.

Extensive damage or cracks

Where there is a large fracture or a deep crack in the ceramic, replacing the restoration becomes an option. If decay or a tooth fracture is found underneath, that problem is treated first and a new restoration is planned afterwards. You can also read more about how porcelain crown and veneer treatment is carried out.

When Should You See a Dentist?

An assessment should not be put off if a restoration comes off, a noticeable piece breaks away, or you feel pain, swelling or a twinge when biting. The signs of a cracked tooth underneath are not always easy to spot, so it is advisable to have even minor-looking damage checked at an examination.

How Can Breakage Be Prevented?

For people who clench their teeth, a custom-made night guard helps reduce the load on restorations. Avoiding biting hard objects, not using your teeth as tools to open packaging, and wearing a mouthguard during contact sports also matter. Regular check-ups allow problems such as decay at the margin or loss of cement to be noticed early.

Summary

Porcelain restorations can chip, crack, come off, or be affected by a fracture in the tooth beneath them. If this happens, keeping the fragment, avoiding chewing on that side and not trying to glue it back at home are the first steps. At the clinic, depending on the extent of the damage, polishing, composite repair, recementation or replacement are considered.

This article is intended for general information purposes. A clinical examination is required to determine the right treatment plan for you.