When a dental crown comes loose, the immediate concern is often what to do with the unexpected cap, especially if it slips down the throat. A dental crown is a permanent cap, custom-made from materials like porcelain, ceramic, or metal alloy, cemented over a damaged tooth to restore its function and appearance. While swallowing this small restoration can feel alarming, it is a relatively common occurrence and usually does not pose a serious medical threat. The primary concern shifts from the crown itself to the safety of the airway and the unprotected tooth left behind.
Recognizing Acute Danger and Seeking Help
The first distinction to make is between swallowing (ingestion) and inhaling (aspiration), which is far more dangerous. If the crown has gone down the esophagus into the digestive tract, acute danger is usually minimal. However, if it has entered the airway, it is an emergency situation. Aspiration means the crown has entered the trachea and potentially settled in the lungs, which can obstruct breathing and lead to severe complications like pneumonia.
Symptoms indicating aspiration include sudden, severe, and persistent coughing, difficulty breathing, wheezing, or a high-pitched sound upon inhalation. If any respiratory symptoms appear immediately after the crown is lost, emergency medical services must be contacted without delay. Even if symptoms are mild or disappear quickly, a medical assessment should still be sought, as an object can be lodged in the lungs without causing immediate distress. If you experience sharp pain in the throat or chest immediately after swallowing, consult a healthcare provider, as this may indicate a scratch or injury.
Passage Through the Digestive Tract
Once a dental crown is ingested, it is highly likely to pass harmlessly through the digestive system. Most crowns are small, relatively smooth, and made of inert, biocompatible materials like ceramic, porcelain, or acid-resistant metal alloys. Since the body cannot digest these materials, the crown will not corrode or release toxic byproducts when exposed to stomach acid, and it will be treated like any other small, indigestible foreign object.
The expected timeframe for the crown to pass is generally between 24 hours and seven days, though most pass within 48 to 72 hours. It is advisable to monitor bowel movements during this time to confirm elimination. While the passage is usually uneventful, rare complications can occur, such as the crown becoming lodged in a narrow part of the intestinal tract, leading to an obstruction.
If severe abdominal pain, persistent vomiting, fever, or blood in the stool occurs after swallowing the crown, immediate medical attention is required. These symptoms may signal a potential obstruction or injury to the gastrointestinal lining, requiring medical intervention, possibly including imaging like an X-ray. For the majority of people, the crown will simply complete its journey and be expelled with stool without causing any noticeable symptoms.
Addressing the Missing Crown and Repair
Once the ingested crown is no longer a pressing medical issue, attention must immediately shift to the exposed tooth. The remaining tooth structure, which has been prepared to receive the crown, is now unprotected and highly vulnerable. This prepared tooth surface, often called an abutment, lacks the protective enamel layer and is susceptible to sensitivity, decay, and fracture.
The exposed tooth can become highly sensitive to hot, cold, or air exposure because the dentin tubules, which lead directly to the nerve, are now open. Leaving the tooth exposed increases the risk of accelerated decay as bacteria easily accumulate on the rough, unprotected surface. A prolonged delay in replacing the crown can also cause adjacent and opposing teeth to shift or gum tissue to grow over the preparation, preventing a new crown from fitting correctly.
Contacting the dentist immediately is necessary to schedule an appointment for repair or replacement. While waiting, a temporary solution like placing a temporary filling material or toothpaste over the tooth can help reduce sensitivity and provide a temporary barrier. The restoration process usually involves the dentist taking a new impression, fitting a temporary crown, and then cementing the final, permanent crown in place.