Why does this temporary crown keep falling off?

[luckyman316]

So you can read my history of what is going on with me if you like. But for the sake of time, I'll just tell you that I have a crown going on tooth number 31 (live tooth) and an implant going on with tooth number 30. This has been going on since May of 2020 and I'm pretty much done at the last piece now of actually getting the permanent ones being put in, after delays due to the pandemic and 2 neck surgeries (and I'm *still* hurting) and finding a new dentist to finish the job due to insurance.

Since I switched to this new dentist, he has been fantastic. The problem is the temporary crown he puts in. It *always* falls out. They decided to wait until the last part of the implant to put in the permanent one since the teeth are next to each other (I refuse to go with a bridge because last time I had one for 5 years, it fractured tooth 30 after making my teeth and jaw shift).

This is now my 4th go around on a temporary crown
- 1st time it fell out after 2 weeks, so he decided to use stronger temp glue to keep it in
- 2nd time it fell out after 3 months
- After I swallowed the crown, he made a new one, which fell out literally the next night. I refused to go back to get it done because it kept falling out
- I'm now on my fourth one on day 2 and I legit feel it so loose that I'm afraid it will fall out again. It is supposed to last me 3 weeks now.

So my question is, why does it keep falling out? Is it the glue he is using here? Does it wear off this quickly and my body is rejecting it? Is it because my jaw keeps shifting? He confirmed with a 3D CT scan that I have bone loss in my jaw from the missing teeth on the right side but the bone has grown enough around the implant to put it in, and my jaw/cheek is misaligned because of this.. but my TMJ joint is ok despite me clenching at night. Or is it because my neck structure is just so bad that when it puts it in when I'm in a chair, leaned back, it's fine but when my neck gets out of whack again it just screws up?

Obviously my bigger concern here is what happens when he goes to put in the dental implant and the permanent crown. I may not be too concerned with the dental implant since that screws in and when he fitting me for it, it felt very secure. But the natural concern is the permanent crown.

I'm ready to ask him to start a 2nd implant there, especially since the tooth has sharp pain from time to time and radiates into the jaw (he scanned this with every possible tool he had, x-ray, 3D scans, etc) and confirmed the tooth was not damaged in the slightest. Of course, same happened with tooth number 30 which ended up being a re-infected root canal and fractured tooth that none of these images could catch.

What is my next step here? Just keep going back if the thing falls out? I honestly don't have that much time while working 16 hours a day with a dentist with limited hours.

 

[luckyman316]

3 hours after I wrote this, the temp crown popped right out while I was eating (I did not chew on that side). So there it is! I felt it loose in the morning and just knew. Dentist isn't open until Monday but I'll live I guess. The temporary glue I get over the counter doesn't work for me either, my body rejects it. I tried last go around too. Ironically last time I swallowed it, it was because I was eating as well! Thankfully this time I felt it pop.

 

[luckyman316]

Ok, so I think I *may* have figured this out after a friend of mine asked me "Are you sure you have enough tooth for them to cement the crown to?" and I'm thinking.... you know, she may be right. This is the 3rd time I'm getting crowns on it (2013 was a crown, it was cut down extremely short and was put on as a bridge with the other tooth in 2015 and now it's a single crown). I suspect this tooth is just too short for a crown now because of how it was cut so short. I need to figure this one out with the dentist!

 

[Gordon]

Your body isn't rejecting anything.
If it's quite a short tooth then temp cement isn't going to be strong enough to hold on the crown. The good news is that the permanent cement stuff is really good at holding crowns on, even with a compromised preparation. So your next step is getting a permanent crown done I think (I'd maybe change my mind if I saw your tooth).

 

[krlovesherkids777]

Luckyman316..

Just want to say.. aghh. I'm so sorry you've had all these temps fall out. Talk about stressful
it sounds like it feels like a ticking time bomb , when is it going to fall.. I've had several fall and it really is stressful. also have had quite a few in the same predicament , very little tooth left, my last crown fell off several times after my dentist did heroics to save it. So far it is still on after several years with the permanent . And they did something called "etching" to make it stay on more. I hope you get this all sorted soon and things stay on for you!

 

[luckyman316]

@Gordon Thanks for the reply. I wonder if it pays off going back to him or not or just wait it out the 2 weeks for the permanent now. I mean, if I go back and he gets it on, and it falls out again, it may just be a repeated cycle and waste of time.

 

[luckyman316]

@krlovesherkids777 Etching... I'm going to bring this up to him and see what he says.

 

[Gordon]

Don't. It's not relevant. Sorry KR.

Honestly I'd be inclined to wait for the permanent crown. The other factor is that the permanent crown will fit the prep much more tightly, so you'll get more mechanical retention as well as having the permanent cement used.

 

[krlovesherkids777]

@Gordon No apologies needed I would be curious though your take on etching and what it does. or doesn't . you do have me curious now.

 

[Gordon]

"Etching" is what you do to a tooth before you start bonding to it. Normally uses a mild acid such as Phosphoric.

Sometimes it's done as a separate stage or there are more modern "self etching" bonding agents which cut that stage out.

You would emphatically not do it when you were placing a temp crown, because you'll mess up the bond for later when you're putting the permanent crown, or worse you'll not be able to get the cement off the prep when you're cementing the permanent one. You would maybe do it if you were using a composite based cement to stick on a permanent crown.

 

[krlovesherkids777]

@Gordon Interesting... my last dentist was a man of few words he didn't explain much as he was going about.. but if I made an appt to ask questions he'd elaborate as much as I'd ask. I'd forget 1/2 what I wanted to ask him by then though