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Permanent Crown Fell Out With Post Attached: Causes & Treatment

Updated: Dec 24, 2023

If your permanent crown fell out with the post attached to it, it can be glued back on but that usually doesn't solve the problem. It will most likely fall out again in the next few weeks.


crown with post in sterilization pouch

We will explain why fallen off crowns with posts in them aren't the same as a crown that fell out without a post. They are two completely different conditions. What you need to do for your particular situation will be a bit more involved.


Table of contents:


Why it fell off

Crowns that have fallen off with posts still attached to them may seem like a similar situation to a permanent crown that fell out without a post. However, they are two completely different conditions.


fallen off crown with post attached upright view

The cause for fallen off crowns with posts in them are due to tooth fractures. Yes, you read that correctly, they fell out because the tooth was fractured. What that also means is that it wasn't due to the crown cement loosening or having melted away.


Is it really a fracture?

You may find it hard to believe but yes, it is a tooth fracture. It's a hard to describe with words but it is easier to understand if you watch our video explanation below. There we demonstrate for you what we mean by calling it a fracture.



In summary, as you can see in the video, the crowns with posts still attached to them always have tooth structure embedded into them.

  • They're not just the crown and the post.

  • They always have crown, post, with natural tooth structure in it.


Image comparison below to drive the point home.


Fallen off crown what it looks like underneath
Fallen off crown what it looks like underneath

fallen off crown with post attached side view
Fallen off crown with post attached side view

Therefore, your permanent crown with the post attached to it fractured off, not fell off!


Why doesn't it hurt?

You may be surprised that your tooth doesn't hurt despite having the post and the crown come off. However, if you recall you should've had a root canal on that tooth otherwise you wouldn't have been able to get a post in there.


x-ray with labeled posts, crowns, and root canals
x-ray with labeled posts, crowns, and root canals

The only teeth that are eligible to have posts put in them are the root canal treated ones. The posts are placed directly into the nerve canal and they are cemented in there. If the nerve was still there, you'd be feeling excruciating pain.


Therefore the reason that it doesn't hurt is because the tooth doesn't have a nerve in it.


Can it be reglued?

The crown with post can be reattached if you recement it with permanent glue by your dentist.


However, you need to know that for every patient that we've reattached the post with crown back on, it always falls back off shortly after. Typically within a few weeks or months, the patient will be back in the office with the prosthesis in their hand once again.


The reason is because there is most likely not enough natural tooth structure left to retain the crown and post. It had the most retention before it fell off the first time. Unfortunately after it fractured and fell off, it lost a lot of retention.


We also recommend against trying to replace it with a new one. A better alternative will be discussed in the next section.


What to do

There are three viable treatment options for fallen off crowns with posts attached to them.

  • Crown lengthening with new crown.

  • Extraction and dental bridge.

  • Extraction and dental implant.


All of these procedures will require seeing a dentist and they all have their own pros and cons. You should discuss with your dentist as to which option is best for you.


Crown lengthening with new crown and post

This treatment option involves three separate procedures:

  • Crown lengthening. Your jaw bone will need to be shaved away around the tooth to expose more of your natural tooth structure. This will provide more surface area for your new crown to grab onto which increases its retention.

  • New post. The missing post will need to be replaced with a brand new one.

  • New crown. Of course you will need a brand new tooth cap made.


This option is one of the more conservative ones despite the bone drilling part. You get to retain your natural tooth root if you go with this treatment.


Pros:

  • Conservative because you keep your natural tooth root.

  • Preserves the bridge and implant option if it fails.


Cons:

  • May make adjacent teeth sensitive since it can cause gum recession.

  • Requires a few months to complete all of the treatment.


Extraction and bridge

This treatment option involves extracting the tooth and then waiting for it to heal before you put a bridge on. Most patients opt to wear a temporary bridge while the extraction socket heals, which can take about 3 months.


Pros:

  • Very retention since the bridge is glued onto two teeth instead of one.

  • Less costly than an implant.

  • Avoids making adjacent teeth sensitive.


Cons:

  • Less conservative since it requires shaving down adjacent teeth for the bridge.

  • Cannot floss using traditional string floss.

  • Requires floss threaders or superfloss to clean underneath of it.


Extraction and implant

An alternative option would be to extract the tooth and then replace it with an implant. Essentially you'll be putting a titanium screw into your jaw bone and then placing a crown on top of that.


Pros:

  • Implants feel like real teeth.

  • Does not rely on remaining tooth structure for retention.


Cons:

  • Costliest treatment option.

  • Longest treatment time, about 8-12 months to complete.


Takeaway

A permanent crown that fell out with the post still attached to it can be reattached with permanent glue but it isn't the proper treatment for it. The reason is because it didn't just fall off, it fractured off. Technically, you've a tooth fracture so that needs to be properly treated.


Unfortunately, the treatment options for a fracture are a lot more involved than what you may have been anticipating. Nonetheless, it is still necessary because if you don't do it, you won't have a tooth to chew on. If you're in need of a dentist in Long Island city, our office can help you.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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