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Dental Temporaries: Lost / Broken / Painful

Select Your Current Condition:

Intro

At our office we make a special effort to properly shape and adjust our patient’s temporaries. As a result, our patients are as comfortable as possible while they are waiting for the final restoration (usually two weeks).

Please note that your temporary is “just that” a temporary. It is made for a temporary period of time (2wks). The purpose of a dental temporary is to reduce tooth Post Visit sensitivity and hold the tooth in position. Holding the remaining tooth structure in position is necessary since the final restoration is being fabricated to fit onto your tooth in the position the tooth was in when the impression was taken. It’s not usually strong enough to eat on and floss will usually dislodge or loosen temporaries.

Unlike permanent restorations, temporaries are purposely made with flexible acrylic-plastic and cemented with very weak temporary cement. In other words, it is made so that the doctor can remove the temporary and cement. With this technique, there is no trauma to the underlined tooth structure and minimal discomfort for the patient. A rigid crown or permanent type of cement, on the other hand, can not be used. Permanent cement will permanently adhere to the prepared tooth structure and be very uncomfortable to remove. Additionally the removal of the more permanent type of cement could damage your tooth and/or affect the accuracy of the final seating of the permanent dental restoration.

 
 
#1 If Your Bite Feels High

Firstly check with your fingernail to make sure that no excess temporary cement or dental acrylic is on your upper or lower teeth. Please check both upper and lower. If you find cement, don’t be shy scratch it off.

Once the anesthetic wears off you may notice that your bite is a little different. The chewing surface of your final restoration will be properly equilibrated and adjusted in your bite.

To test your bite, try the following test. Bite only on the teeth on the left side. The right side should not interfere. Then bite only on the right side. The left side should not interfere. Finally, bite on both sides at the same time. All posterior teeth should occlude with equal force. The new restoration should not hit first or interfere with your bite.

When patients are numb, they can’t always find the proper orientation of their jaw and may bite in the wrong position. This gives your dentist a false marking and occasionally results in a temporary which is too high or interferes with your bite. Please return to the office after the anesthetic has completely worn off. It is less likely you will bite improperly when your not numb! Please don’t underestimate symptoms that could result from a high bite. This could be quite uncomfortable. Call for an appointment as soon as your sure your bite is too high.

 
 
#2 Broken Braces and Wires

If a broken appliance can be removed easily, take it out. If it cannot, cover the sharp or protruding portion with orthodontic wax, cotton balls, gauze or sugarless chewing gum. DO NOT remove it. Take the child to a dentist immediately. Loose or broken appliances that do not bother the child usually do not require emergency attention.

 
 
#3 Reasons Patients with Temporaries Have After Visit Discomfort

Usually It’s One Of The Following Reasons

  • Initially your gums will be very sore from the tooth preparation process. It’s likely the tissue around your tooth was shaped during tooth preparation. Crowns are needed when there is allot of missing tooth structure either from decay or breakage at or near the level of the gum tissues. Since Dr. Landers is very careful to remove this weakened tooth structure near your gums, you will likely experience gum tissue tenderness. The tenderness is similar to gum tissue soreness that results after contact with hot food. It will heal in a few days.
  • Gum tissue soreness from a dental impressions. Dental retraction cord is usually packed between the tooth and gum collar to keep the area of the tooth near the gum tissues dry for accurate dental impressions. This is important since saliva and blood will interfere with the accuracy of impression material.
  • Also note it’s normal to have post operative tooth sensitively from dental drill or shaping procedure. Remember, a non root canal treated tooth is alive. With deeper decay or the need to remove deep fillings near the nerve, it makes sense that there will be more post operative sensitivity. Once your final restoration has been placed, this sensitivity may continue for a few days or even weeks. Remember as long as the sensitivity is continually getting better, this is a normal healing process. You should not experience a night wakening type of pain.
  • If you have continuous throbbing pain and/or awakening at night from the pain, call our office ASAP!
  • You notice a sharp part of the tooth. This is common when Dr. Landers has prepared Porcelain Onlays or 3/4 Crowns. Your best option is to purchase orthodontic wax at your local drug store. Just take a small piece of wax and cover the area.
  • It’s normal to have dental injection soreness. Though it is not very common, occasionally patients may experience difficulty opening after a dental procedure. If you have difficulty opening, please call our office as soon as you get a chance.
  • Your new temporary tooth could be too high when you bite, chew or grind.

 
 
#4 Lost Temporary After Root Canal Therapy

  • It’s normal for your temporary to have a medicinal taste.
  • It is possible that the “clay like” temporary may wear away or seem like it fell out. Don’t be alarmed. Use a well lit mirror, and try to look in your tooth or feel with your finger. In most situations, the temporary has simply worn down and the seal is intact. Keep your scheduled appointment. If you don’t have an appointment, please call, we will help.
  • In general, the “root canal” therapy is completed solely to clean & fill the roots of your tooth. In all situations, after the root canal filling has been placed to seal your roots, you will need a final restoration to replace the chewing surface of your tooth. Dr. Landers usually recommends a Post & Crown. A crown will also help support the remaining tooth and seal out bacteria. With out a final restoration as a seal, the bacteria could eventually break down the root canal cement.

If Your Root Canal Is Complete & You Have Lost Your Temporary
If you are unsure, Dr. Landers usually finishes Root Canal Therapy in a single visit. As long as the root canal is complete, your main concern should be: don’t eat in the area as to avoid tooth breakage. You should though, still make sure you have a temporary. Over time, bacteria will leak into the root canal sealer cement. If this happens you may need to redo the root canal therapy.

If Your Root Canal Is Not Complete & You Have Lost Your Temporary
If your Root Canal therapy is not complete and you have lost your temporary, call our office as soon as you get a chance. Don’t be mislead because you are not likely to experience pain, since the nerve has been removed. On the other hand, the temporary seals in medicine and seals out bacteria. If the access is to remain open, the bacteria will travel through your tooth into the surrounding bone. If the temporary is not professionally replaced in a timely fashion, the bacterial leakage could affect the success of your root canal therapy. If the seal is broken for more than a few days, it is likely that you will need to use an antibiotic and have a new temporary & dental medicaments placed by Dr. Landers.

If you have Pain or Old Temporaries
Do Not Replace The Temporary If You Have Pain!
If you have pain there is a possibility that your tooth may have cracked. If you suspect a broken tooth, see the section on: broken teeth.

Do Not Replace The Temporary If The Temporary Is More Than A Few Months Old!
The intention of dental temporaries is to last for a two weeks maybe a month or so at the most. Often patients will think their old temporary simply fractured from chewing pressure and will not realize that bacterial decay has invaded the understructure of the tooth. The subsequent weakened decayed tooth structure is in many cases the reason you lost your old temporary. In this situation, if you replace your temporary, it may lock in bacterial and may serve little benefit. A temporary can also lead to a false sense of security and a delay your needed professional treatment.

Suggestions For Your Situation:

  • As a rule of thumb, do not let a tooth go more than a couple days without a temporary to cover it, as you may be risking tooth movement, micro leakage, and possible tooth breakage.
  • If you have any rough or sharp edges which are cutting your cheek or tongue and you are unable to get to our office, you can use orthodontic wax to cover it. Do not smooth or alter a sharp tooth which your dentist has already shaped for a final restoration.
  • In all cases, rinse your mouth with warm water, keep the area clean. Yes, if it’s not too sensitive you can brush the area. Tooth paste is good for the exposed tooth structure.
  • Finally, do not eat in the area! This could result in tooth fracture and tooth loss! Additionally, eating could result in food impaction and a gum tissue infection.

Your Options Only If your root canal therapy is complete and you don’t have pain.

First Option
Often you can save yourself an immediate trip to the office if you can simply clean the area around the tooth and place orthodontic wax, or Vaseline. If you don’t have an appointment we recommend that you call us for an appointment.

Second option
If your temporary comes out a few days before your appointment it’s “OK” just to keep your scheduled appointment. Under no circumstances should you allow any chewing on the tooth without a temporary. The tooth will break!

Third option
If the previous does not resolve your situation, please know that our assistants are trained to help you. Please call and set up a convenient time to have your temporary replaced.

Finally
If the latter is not stable enough, and/or if you can not make it conveniently to our office, there is temporary material available over the counter. Generally, if you are unable to reposition your temporary it is not an urgent situation.

Steps to consider if you decide to place your temporary using an over the counter temporary product.

  1. Read and follow the directions for the temporary carefully.
  2. Remove any loose old temporary material from your tooth and/or any food.
  3. Dry the tooth. Make sure you tooth is not broken or painful.
  4. Place Vaseline on the teeth opposite the temporary.
  5. Mix the temporary material. Please try not to overfill since you will need to clean the excess cement.
  6. Hint: use a cotton tip applicator wet with water to mold and shape or remove excess.
  7. Place the temporary into the tooth in question. While the temporary is setting, Bite down on both sides on the back teeth and occasionally grind your teeth side to side. If the temporary seems high in your bite, remove excess immediately. It’s actually better if the surface of the temporary does not touch in any direction when you bite.
  8. Clean off excess temporary. Gently use a tooth pick in a horizontal sweeping direction. We do not recommend flossing or any force that could lift the temporary up.

 
 
#5 If Your Temporary Crown Comes Off

Temporary crown off –

  • As a rule of thumb, do not let a tooth go more than a couple days without a temporary to cover it, as you maybe risking tooth movement and increasing the chance that the final restoration may not fit.
  • If you have any rough or sharp edges which are cutting your cheek or tongue and you are unable to get to our office. You can use orthodontic wax to cover it. Do not smooth or alter a sharp tooth which your dentist has already shaped for a final restoration.
  • In all cases rinse your mouth with warm water, keep the area clean.
  • Finally, do not eat in the area! This could result in tooth fracture and tooth loss! Additionally, eating could result in food impaction and a gum tissue infection.

First Option
Often you can save yourself a trip to the office if you can simply clean the inside of the temporary off and reposition it back in place. It may remain in place without any cement. (Rule of Thumb: Do not eat on a tooth with a temporary, and do not eat on  a tooth with a lost temporary!) If the temporary does not snap in securely, or if you feel that it’s not secure, remove the temporary when eating. Then clean the area and replace the temp after you are finish with your meal. Hint: Dental adhesive powder or even a small amount of toothpaste works well to help hold it in place until you can make it to the office. Generally, if you are able to reposition your temporary, and you are careful not to eat on the temporary, brush the tooth and gums near the temporary and keep your scheduled appointment.

Second Option
The usual time period between preparation /impression and delivery of final restoration is 2-3 weeks. If your temporary comes out the last day before your appointment it’s “OK” just to keep your scheduled appointment. Under no circumstances should you allow any chewing on the tooth without a temporary. The tooth will break! If the temporary comes out between 2-4 days before your scheduled delivery appointment, please call our office first. There is a chance your final restoration has returned to our office early. If the restoration is available, our scheduling coordinator may be able to move your appointment to an earlier date.

Third option
If the previous does not resolve your situation, please know that our assistants are trained to help you with the recementing process. Please call and set up a convenient time to have your temporary recemented. Try not to loose the temporary and don’t forget to bring it with you for your recement appointment.

Finally
If the latter is not stable enough, and if you can not make it conveniently to our office, there is temporary cement available over the counter. This product is Dentemp, Demparin or the like.

Steps to consider if you decide to recement using an over the counter temporary cement.

    1. Read and follow the directions for the temporary cement carefully.
    2. Using a wooden toothpick (or a similar type pick), thoroughly remove any food or old cement from both the temporary and your tooth. Be careful around your tooth as not to poke your gums and cause bleeding. Spend some time on this step, as many of the cements are very difficult to see and hard to remove. Even the smallest piece of cement or food particle can interfere with full close-fitting snug fit. Tip -completely drying the Temp will help you to see remaining particles inside of the temp. Cemented Temps that do not benefit from the friction gripping of a snug fit will easily come loose. 
    3. After 100% of the old cement has been removed, do a dry fit try in first. In other words, put the temporary back in without cement first to ensure proper fit. During this dry fit, leave the temp in position and check to see if your bite feels normal. Bite down on both sides on the back teeth. If your bite feels different then normal, its very likely that a small piece of cement is still remaining inside of the temp. Be smart, don’t skip this step -This dry fit try-in is essential to success and must be done before final mixing of and securing the temp with cement!
    4. Hint: During trial seating, observe the correctly seated position: Cheek side Vs. Tongue side. To help you orientate during final seating, you may wish to mark the temporary on the cheek side i.e. with a small piece of tape. Or at the least observe the surfaces of the temp while its fully seated.
    5. Dry both the tooth and the temporary. If gums are bleeding rinse and delay final seating until the bleeding stops: usually 10-15. Bleeding gum will most certainly interfere with the ability of the temporary cement to hold the temp.
    6. Thoroughly dry the intaglio (inside) of the temp, mix the cement and fill temporary. Try not to overfill since you will need to clean the excess cement.
    7. Orientate and seat the temporary firmly with strong finger pressure. Remove your finger and bite down on both sides on the back teeth. The goal to seat the temporary until the cement is set. If the temporary seems high in your bite, quickly remove it and start over at step #2.
    8. You must wait at least 5-10 minutes before you begin to remove the cement. Then clean off excess cement with a tooth pick. Be excessively careful and use tiny lateral sweeping movements to remove cement. Again, If you are not careful you will dislodge the temp. Gently use a tooth pick directing the forces laterally or in a direction towards the gums. We do not recommend flossing or any force that could lift the temporary up (away from the gums. Rinse away excess cement and gently brush with a manual tooth brush (avoid Electric tooth brushes near dental temporaries). Do not use string floss in front or back of your temp. Its a good idea to hold the temp in place while using a Waterpik water flosser. We recommend the Cordless version to be used in the shower. Hope this helps!

 
 
#6 Lost White “Clay-Like” Dental Temporary

 If you have Pain or Old Temporaries

Do Not Replace The Temporary If You Have Pain!
If you have pain the tooth may have cracked. If you suspect a broken tooth see the section on: broken teeth.

Do Not Replace The Temporary If The Temp Is More Than A Few Months Old!
The intention of dental temporaries is to last for a two weeks maybe a month or so at the most. Often patients will think their old temporary simply fractured from chewing pressure and will not realize that bacterial decay has invaded the understructure of the tooth.  The subsequent weakened decayed tooth structure is in many cases the reason you lost your old temporary. In this situation, if the missing tooth is filled with temporary “OTC” (over the counter) filling it may lock in bacteria and may serve little benefit. A temporary can also lead to a false sense of security and a delay in needed professional treatment.

 

Suggestions For Your Situation:

 

      • As a rule of thumb, do not let a tooth go more than a couple days without a temporary to cover it, as you may be risking tooth movement, micro leakage and possible tooth breakage.

 

      • If you have any rough or sharp edges which are cutting your cheek or tongue and you are unable to get to our office, you can use orthodontic wax to cover it. Do not smooth or alter a sharp tooth which your dentist has already shaped for a final restoration.

 

      • In all cases, rinse your mouth with warm water, keep the area clean. Yes, if it’s not too sensitive you can brush the area. Tooth paste is good for the exposed tooth structure.

 

      • Finally, do not eat in the area! This could result in tooth fracture and tooth loss! Additionally, eating could result in food impaction and a gum tissue infection.

 

Your Options

 First Option
Often you can save yourself an immediate trip to the office if you can simply clean the area around the tooth and place orthodontic wax, or Vaseline. If you don’t have an appointment we recommend that you call us for an appointment.

Second option
If your temporary comes out a few days before your appointment it’s “OK” just to keep your scheduled appointment. Under no circumstances should you allow any chewing on the tooth without a temporary. The tooth will break!

Third option
If the previous does not resolve your situation, please know that our assistants are trained to help you. Please call and set up a convenient time to have your temporary replaced.

Finally
If the latter is not stable enough, and/or if you can not make it conveniently to our office, there is temporary material available over the counter. Generally, if you are unable to reposition your temporary it is not an urgent situation.

 

Steps to consider if you decide to place your temporary using an over the counter temporary product.

      1. Read and follow the directions for the temporary carefully.
      2. Remove any loose old temporary material from your tooth and/or any food.
      3. Dry the tooth. Make sure you tooth is not broken or painful.
      4. Place Vaseline on the teeth opposite the temporary.
      5. Mix the temporary. Please try not to overfill since you will need to clean the excess cement.
      6. Hint: use a cotton tip applicator wet with water to mold and shape or remove excess.
      7. Place the temporary into the tooth in question. While the temporary is setting, Bite down on both sides on the back teeth and occasionally grind your teeth side to side. If the temporary seems high in your bite, remove excess immediately.
      8. Clean off excess temporary. Gently use a tooth pick in a horizontal sweeping direction. We do not recommend flossing or any force that could lift the temporary up.

 
 
#7 Patient With Dental Temporaries Should Avoid Or Note The Following

    • Hard Foods that could potentially crack the temporary. With anterior temporary crowns don’t bite into sandwiches or other foods. Please use a fork and knife and cut your food into bite size pieces.
    • **Sticky Foods** will easily remove the temporary (please be careful this is what usually happens). No gum please!
    • Avoid Flossing immediately in front or back of the temporary. If you absolutely need to floss the temporary, only move the floss through the tooth contact towards the gum tissues. Then pull the floss out to the side. Under no circumstances should you pull the floss upward or away from the gum tissues! This will certainly dislodge the temporary.
    • Brush as usual avoiding the sore gum tissue for a few days. There after, brush gently in a circular motion. No proxy brushes or tooth picks around temporaries.
    • Don’t eat while you are numb. Please watch young children until the anesthetic wears off! Children commonly bite their cheeks, lips and tongue after dental visits with anesthetic.
    • Avoid eating on the tooth that was just worked on. We all have the sensation of pain for a reason. Our senses are telling us to leave the area alone so that it can heal! You can eat on the other side or go to a soft nutritious diet.
    • If your tooth was not root canal treated, remember, the tooth is alive! Hot – Cold- Salty – Sweet- Sour, or Spicy foods or liquids will cause sensitivity. Hypersensitivity is normal and is usually the result of the drilling or shaping process! Also, temporaries often will not fit as well as the final restoration. Additionally, temporaries will not always completely cover the newly shaped tooth structure.
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