Crown Fell Off With Tooth Attached – What To Do?

Written & Reviewed by Dr David Chen

If your crown falls off with the tooth attached to it, that is a precarious condition which needs to be urgently taken care of. However the treatment will differ depending on how much of your tooth is attached to the crown. Is it just a piece of your tooth or is the whole tooth in it?

Let us explain what all of that means and what you should do about it.

How much tooth is attached?

When the crown falls out of your mouth, varying amounts of your tooth could be attached to it. You can have a piece of the tooth inside of it or it could be the entire tooth with the root in it. Of course the larger the attached piece of tooth, the more severe your condition is.

We will do a comparison table and explain how to tell which one you have.

Piece of tooth attached vs entire tooth attached

These are some common signs and symptoms for each condition. Its also not unusual for the tooth to look black as well.

Piece of tooth attached to crown

  • Underneath of the crown doesn’t look completely hollow.
  • Tooth bits and pieces look embedded inside of the cap.
  • Part of the tooth is still inside your mouth.
  • Pain present.

Whole tooth attached to crown

  • Underneath of crown completely filled.
  • Entire tooth root sticking out of the cap.
  • Empty tooth socket inside of mouth.
  • Socket may be bleeding.
  • May be extremely painful.

Regardless of which one you have, both of them will require a visit to the dentist. Only they can rectify your condition but the treatments will differ.

Treatment to expect

Both conditions will require different treatments but depending on how severe it is, it may also different from within each condition as well.

Treatment for crown that fell off with tooth attached
Decision tree for what to expect

Small piece of tooth attached to cap

If only a small piece came out, the prognosis is considered good. You can save the tooth by getting a core build up and then making a new crown. The old one won’t fit after the dental build up with core material. This is the best case scenario.

Large piece of tooth attached to cap

If a large piece of the tooth came out, the prognosis worsens. There is a good chance too much of the tooth has broken off and it can no longer be saved. In that case you would need the rest of the root tip extracted. Afterwards you can get either an implant or bridge to replace the missing tooth.

This is especially true if there is no tooth left after the cap is off. That is the absolute worse prognosis that you could have.

Whole tooth attached to cap

If your entire tooth comes out with the cap, you’ve a periodontal disease problem which means you’ll need gum treatment first. This may include a deep cleaning or even gum surgery. After the gums have stabilized, you can replace the missing tooth with an implant or crown.


The treatment for each condition is different because the cause of the crown coming off are also different. Both of them are often thought of as variations of the tooth cap falling off but they actually have completely different etiologies.

  • A part of the tooth coming off with the crown is due to a tooth fracture.
  • The entire tooth coming off with the crown is due to severe periodontal disease.

As you can see, the root causes share no similarities at all.

Tooth fracture

Pieces of the tooth that are still stuck inside of the fallen off crown is a tooth fracture. It didn’t fall off because the crown glue came loose but rather the tooth couldn’t handle the chewing stress and it fractured off.

Essentially the tooth underneath of the restoration could not withstand the forces of everyday life. That includes chewing during meals or simply grinding your teeth together.

Periodontal disease

If the entire tooth comes out with the cap, it has nothing to do with the crown glue nor the tooth fracturing. The only condition which can cause this to happen is severe gum disease. In this case it is severe periodontitis which is the advanced stage of periodontal disease.

effect of periodontitis on periodontium
Credit: Shahrzad Torabi; Abhinandan Soni

The tooth came out because untreated periodontitis results in gradual bone loss over time. If you lose enough of the periodontium, your teeth will start becoming loose. Eventually they will fall off on their own.

In this case, the tooth that fell off happen to have a crown on it.


If your crown falls out with a part of or all of the tooth in it, you need to see a dentist. It’s not as simple as the crown glue having dissolved and that is why it came loose. Both of these situations are much more dire because one is a tooth fracture while the other is severe gum disease. Neither of which can be treated with at home remedies. In other words, give your dentist a call right away!


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Long Island City, NY 11101

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