What to do if you’ve swallowed your dental crown. –

Swallowed dental crowns- What to do.

A Common scenario.

Consider this set of events. While you’re eating dinner, you have a crown come off your tooth. But before you realize that it has, you’ve gone ahead and swallowed it along with your mouthful of food.

If you’ve had this happen, this page explains DIY retrieval options we’ve found mentioned in dental literature as a solution, and really there are only three. You can either …

1. Make yourself throw up and look for the crown in your vomit.
2. Start looking for your crown in your bowel movements (poop).
3. Make no attempt to retrieve the crown and arrange for your dentist to make you a new one.

This page discusses each of these three scenarios. And gives you an idea of what to expect with each one. However, despite the DIY nature of the information on this page, in all cases, you should report your incident to your dentist so they can decide how your situation should be monitored and managed.

What about swallowing a temporary crown?

Swallowing a temporary crown adds a slight twist to what we discuss on this page. As objects, temporaries have almost no value, other than the time invested in making them. Making a new one for your tooth should be no problem for your dentist.

The main reason to be concerned about a swallowed temporary crown is the issue of knowing where it went, that it has caused no harm, and, ultimately, that it is no longer inside you. Just like with permanent crowns.

So, if you swallow a temporary, it’s important to let your dentist know. They can then decide how your incident should be monitored and managed.

Remedies for swallowed crowns –

1) Regurgitate the contents of your stomach and look for the crown.

As disagreeable as having to throw up may seem, using this option does have the advantage that, if it works, you’ll have your crown back immediately.

That can provide peace of mind for a person because dental crowns aren’t cheap. Crown fees. And having yours back in hand promptly can help to alleviate your concerns about having to undergo the time and expense associated with having it replaced.

It also means that you can have your dentist recement it promptly before any tooth shifting that may affect your crown’s fit has had a chance to occur. (A process that can render an otherwise perfectly fine crown useless. This important topic is discussed further below.)

However, before using the regurgitation technique, please read on because there are important issues and concerns to consider.

▲ Section references – Diamond

Important issues and considerations about attempting to orally purge (throw up) a swallowed crown.

In researching this topic, it dawned on us that the sources we found that suggested attempting to regurgitate a swallowed crown tended to be more “popular press” type articles rather than formal dental literature.

In fact, a review of this subject that we’ve relied heavily on titled “Accidental aspiration/ingestion of foreign bodies in dentistry: A clinical and legal perspective.” (Yadav 2015) doesn’t mention this technique at all.

Why trying to throw up a swallowed crown can make a bad idea.

As an explanation for this omission, and as you’ll read about below, once an object, like a crown, has entered a person’s stomach there is a high likelihood that the swallowed object will pass on through their digestive system uneventfully.

In contrast, regurgitating an object creates the potential that gastric contents or the object itself will be aspirated (enter into the person’s lung), an event that has the potential to be life-threatening. So, the prudence of using this technique seems questionable.

As a side note, we’ll mention that in the comments section at the bottom of this page we see zero reports where trying to vomit up the crown has worked.

▲ Section references – Yadav

Tips and pointers.

In the case that regurgitation is attempted, the following should be kept in mind.

• It’s best to throw up into a container, like a plastic dishpan. Or better yet, a colander-held-over-a-dishpan combination.

  Vomiting straight into a sink makes a poor choice because the crown may inadvertently escape down the drain.

• After washing the crown off thoroughly, you can disinfect it by soaking it in a household bleach solution  Disinfection instructions.
• After that, it’s a good idea to periodically wear the crown Directions. until that point in time when your dentist can permanently recement it for you.

  Doing so can prevent tooth shifting, help to keep your tooth comfortable if it has air or thermal sensitivity, and allow you to maintain a normal appearance for some events if that is needed.

2) Looking for your swallowed crown in your stools.

When compared to the first method, this method of retrieval seems to be the one most discussed in dental literature, and therefore in our mind the preferred technique.

You may find the process of looking for your lost crown in your poop objectionable. As you do, however, just keep in mind that your efforts have the hope of saving you the cost of having a new crown made, which can be substantial.

How long will it take the crown to pass through your digestive system?

Just to play it safe, it makes a good plan to start looking for your crown in your very next bowel movement. But more realistically, here are some statistics that apply:

• The restoration probably won’t show up for at least 12 to 14 hours.

  (But starting to look before that, if nothing else, gives you an opportunity to establish a routine. One that helps to ensure that you don’t overlook or inadvertently lose the crown when searching later on.)

• The remainder of the meal that you were eating when the event occurred may not finish passing for 36 to 48 hours. (This event on its own may or may not hold much bearing on the amount of time that it ultimately takes for your crown to pass through.)
• If by that point you still haven’t found your crown, there’s no reason not to keep searching your stools for an extended number of days. (See below for more details about how long it may take it to pass.)

A) Retrieval times for swallowed crowns reported in dental literature.

Here are some real-life examples of how long it took for swallowed crowns to pass through the person’s digestive tract and be found in their stool.

Kharbanda reports on a case involving a crown that took 5 days to pass. A paper by Khouri reports on a case involving a dental bridge that took 2 days.

But longer “egestion” periods are common too.

A paper by Obinata makes specific mention of a crown that took 9 days to pass, as well as additional cases where all of the objects had egested within 10 days.

Absi states that objects that make it into the stomach can be expected to pass through the gut over a 7 to 10-day period.

▲ Section references – Lehrer, Kharbanda, Khouri, Obinata, Absi, Yadav

B) Retrieval times for swallowed crowns reported in our comments section.

People choosing to post in our comments section at the bottom of this page have reported passage times ranging from 4 to 21 days.

Can a swallowed crown get stuck in your digestive system?

a) Is there any question that if you’ve swallowed a crown it will eventually come out?

In the vast majority of cases, yes, you will eventually “poop out” your swallowed crown. But, infrequently, injury or complications may occur such as intestinal perforation, obstruction, or impaction may occur.

Factors that affect how easily your swallowed crown can pass.

In theory, this sharp edge might lead to intestinal perforation (penetration of the walls of the intestine). Or, its configuration may allow it to get hung up on an intestinal irregularity that results in or compounds some type of intestinal blockage.

Crown with post and core.

b) Should you consider taking a laxative to help your crown pass through more quickly?

As a blanket statement, and without specific instructions from your medical or dental professional, no you should not.

The general concern is that taking a laxative or purgative causes an increase in peristaltic contractions (wave-like muscular contractions of the digestive tract). And this increased motion raises the potential that the swallowed object might cause injury such as intestinal perforation (damage to the intestinal wall).

Additional tips and pointers about allowing a swallowed crown to pass.

• As silly as this seems, once you know you’ve swallowed your crown you might eat some corn. Food won’t necessarily pass through your system at the exact same rate as your restoration. But it can act as a rudimentary marker of sorts.

• The safest step that can be taken is to have your dentist make a temporary crown for your tooth to wear while waiting for its permanent one to reappear. This will restore your tooth’s function and its appearance.

  It will also, very importantly, prevent your teeth from shifting. Beware. (Crowned teeth, and their neighbors, will tend to shift during times when the crown is not present. Sometimes to the extent that the retrieved restoration is rendered useless and as such can’t be recemented.)

• Once your crown has passed and has been found, it can be cleaned and disinfected using a household bleach solution  Disinfection instructions.

3) Making no attempt to retrieve the swallowed crown.

Choosing to do nothing clearly has some drawbacks.

a) Cost.

An obvious one is that you’ll have to go to the time and expense of having a new crown made.

b) It’s good to know where the swallowed crown is.

It’s both comforting and necessary to know that the crown has exited your body. We discuss this issue next.

How much supervision do you require if you’ve swallowed your dental crown?

If your crown has disappeared down your throat during a swallow of food (the premise of this page), it has most likely entered your stomach. And in most cases, once reaching that point will ultimately be egested (expelled) uneventfully via a bowel movement some number of days later.

The potential problem – Why contact with your dentist is needed.

As opposed to entering into your stomach and digestive system, there is instead some possibility that the restoration has entered into your respiratory system. This latter situation is referred to as aspiration and is a serious event (sometimes an immediate emergency) that requires medical attention.

In most cases, and as discussed just below, one can develop a firm idea of which event has taken place. But since the latter possibility exists, in all cases you should contact your dentist so they can pass judgment on your situation and make a recommendation about what treatment is indicated.

Understanding where the crown is is key.

In performing research for this page, we couldn’t help but notice a sentence in a paper by Glen that stated “A patient that has swallowed a crown would not be expected to require any intervention.” But this seems to be in reference to objects, like crowns, that have been unquestionably identified (by X-ray evaluation) as residing in the person’s stomach or further along in their digestive tract.

So at least initially, your dentist may feel that identifying the location of your crown via radiographic examination is needed before any sort of treatment plan in response to the event is devised.

And even after that initial confirmation, a dentist may feel that the restoration should continue to be monitored via X-rays until it has exited the digestive system. (First 3 days later, then weekly). (Glen)

▲ Section references – Glen

Can a crown that has been swallowed be reused?

Yes, if you can retrieve your crown, in most cases it can be cemented back onto your tooth. However, there can be instances where the condition of your crown or its tooth makes this impossible.

a) Times when the condition of the crown prevents recementation.

If your crown has simply come off, was then swallowed, and then later on retrieved, there’s a very good chance it is still in fine condition and suitable for cementing back onto your tooth, permanently. However, if the crown has sustained any damage, then a new crown will need to be made.

For example, a porcelain crown may be chipped or broken if it was bitten on before swallowing. Or dropping or crushing the restoration after it’s been retrieved might conceivably alter its shape and render it unusable. (Once you’ve found your crown, place it in a safe place, like wrapped in tissue and placed in a medicine bottle.)

b) Times when the condition of your tooth prevents recementation.

1) Tooth damage.

Dental crown loss is sometimes associated with tooth fracture or the presence of tooth decay. If so, your swallowed and then retrieved crown may still be in pristine condition but is no longer a suitable restoration for your tooth because of structural changes that have taken place with it.

2) Tooth shifting.

Any tooth that is not in contact with its neighboring and opposing teeth has the potential to shift in position. Even a minuscule amount of change can render a crown unsuitable for its tooth.

This potential complication can be avoided by having your dentist make a temporary crown for your tooth while waiting for its swallowed one to be retrieved. This step also provides the benefit of restoring your tooth to normal function and appearance while you wait.

Also, once you’ve found your crown, be prompt about getting back to your dentist’s office to have it recemented. Each day that passes allows more opportunity for tooth shifting.

Wearing a lost/retrieved crown periodically can help to prevent tooth shifting. We discuss this solution in greater detail on this page –  Lost crown tooth shifting.

How about resuing a swallowed temporary crown?

It’s most likely that upon hearing that you have swallowed your temporary crown your dentist will just go ahead and make you a new one.

That’s because usually at this point in your treatment the final impression for your new crown has already been taken. If your tooth then shifts shift while the new crown is being made, there’s a significant risk that it won’t fit correctly. And that constitutes a large inconvenience and expense as compared to just making you a new temporary.

That doesn’t mean that it’s not important to monitor your situation to confirm that the swallowed temporary has finally exited your body. But as far as reusing it, by the time you find it it will probably already have been replaced.

How do you sterilize a swallowed crown you’ve recovered from a bowel movement?

Having retrieved your crown from your stool (poop) presents the problem of how to clean it up so it is safe to handle.

Thorough sterilization is no problem for your dentist. And they will do so before recementing your crown back on your tooth. But there’s an at-home solution too.

How to disinfect a crown you’ve retrieved from a bowel movement.

• Put on some disposable gloves and wash the crown off with dish cleaning detergent and water. Use a discarded toothbrush to make sure you remove any solids from its inside surfaces. When finished, rinse the crown thoroughly.
• You can now disinfect the restoration by soaking it in a 1:10 dilution of household bleach (5.25% sodium hypochlorite) and water for 10 minutes. (OSHA)

▲ Section references – OSHA.gov

A swallowed dental crown is usually shunted into the stomach.

Possible outcomes for crowns that have disappeared down your throat. –

a) The swallowed crown has ended up in your digestive system.

Statistics about swallowed crowns.

• The textbook on dental medical emergencies by Malamed states that more than 90% of swallowed foreign objects that enter the stomach pass completely through the person’s GI tract without complications.
• Somewhat similarly, a paper by Khouri suggests that 10 to 20% of swallowed-object cases require non-operative intervention and, at most, 1% of cases require surgery.
• A paper by Glen cites a research study that suggests that “ingested foreign bodies that get through the esophagus (meaning into the stomach) will pass in the person’s stool in 99% of cases.”

▲ Section references – Malamed, Khouri, Glen

b) The lost crown has ended up in your respiratory system (aspiration).

It’s much more common for a person who is awake, alert, and upright to “swallow” their crown rather than have it enter their respiratory system. But the latter can happen and is referred to as having “aspirated” the crown or “aspiration”.

What are the signs of having aspirated your crown?

• In most cases, aspiration is associated with some obvious characteristic signs such as a sudden episode of coughing, choking, wheezing, and/or shortness of breath.
• In 90% of cases, these signs occur immediately to within 1 hour of the aspiration event. However, with others, they may not be displayed until some hours later.

• The aspiration of a crown can be a life-threatening event. Basic emergency life support techniques, like those taught in American Heart Association classes to counter airway obstructions, may need to be implemented immediately (back blows, abdominal thrusts, chest thrusts).
• If the crown is stuck to the extent that can’t be dislodged and expelled noninvasively, medical intervention will be needed to remove the object before further complications occur.

▲ Additional page reference sources – Diamond

Video transcription.

Hello. Welcome to Animated Teeth.com and our page that discusses what to do if you’ve swallowed your dental crown.

The scenario we address in this video is this. You were eating a meal. While chewing, possibly you detected a hint of the loose crown in your mouth, or maybe you didn’t, but then, without realizing what had occurred you went ahead and swallowed. Now, the crown is missing and clearly no longer on its tooth. Your conclusion is that you’ve swallowed it.

As a first issue, there’s the simple yet very important question of where the missing crown has gone.

When a solid object passes down your throat, there are two paths it can take. Under ordinary circumstances, the item is delivered into your esophagus and ultimately passed into your stomach.

However, in a minority of cases it may be that your throat’s protective reflexes have failed and the crown has instead entered your trachea or possibly even your lungs. Under this scenario, at minimum, the object will need to be expelled or retrieved. This situation may create a medical emergency. Our page’s text explains in greater detail.

As a general rule, if swallowing your crown was uneventful, then the odds favor that it took the normal route and has entered your digestive system. If instead you experienced an episode of coughing, choking, or wheezing, well, those can be signs that your crown went into your windpipe.

Although accurate more often than not, this simple evaluation unfortunately isn’t a definitive one. And, in fact, the only way to know for sure where your crown has ended up is to have medical imaging performed, such as taking X-rays.

So, at this point, you should go ahead and get your dentist involved. Let them know what’s transpired so they can determine what need and opportunity exist for evaluating your situation and then advise you accordingly.

Following on with the assumption that your swallowed crown has made it into your stomach, you now have two options to consider. Either doing nothing or trying to retrieve it.

The do-nothing approach has some significant drawbacks. For starters, surely you realize how expensive your crown will be to replace, not to mention how much appointment time will once again be needed.

The other big disadvantage is not really knowing your case’s status or outcome. As our page explains, even if the odds greatly favor a swallowed crown’s uneventful passage through a person’s digestive system, knowing that it has, versus wondering if some possible complication has occurred, is certainly worth some effort.

With your crown in your stomach, there are only two ways for it to come out, either up or down.

There is some potential that you might regurgitate it up, as in vomit. And an advantage of this method is that you get your crown back promptly. However, and as detailed on our page, there are some drawbacks to this approach such as the possibility of inhaling some of the vomit, thus creating the same medical complication mentioned previously about objects entering your trachea and pulmonary system.

More basic than that, our page outlines reasons why we don’t find much evidence that this method works all that well. So, consult with your dentist on this issue and make a plan. If you do try, be smart. Purge into something like a bowl or colander. Getting your crown out only to then lose it down your sink’s drain won’t serve any purpose.

There’s a fair amount of published dental literature that addresses the issue of just letting swallowed crowns go ahead and pass naturally.

Our page provides statistics and discusses potential complicating issues but, generally, the odds vastly favor, in the range of 90% and higher, the uneventful passage of a swallowed crown. And with that, your dilemma then just becomes an issue of time, inconvenience, and messiness.

To play it safe, it makes a good plan to start looking for your crown in your very next bowel movement. Realistically however, the earliest it’s likely to show up is more on the order of at least 12 to 14 hours. But keep in mind, it’s important to practice and have a routine established so you don’t overlook your crown early on due to deficiencies with your methods.

Actually, even expecting your crown to show up in your stool within the first 24 hours is a bit of a pipe dream. Our accompanying page cites published case reports that range from 2 to 10 days. Instructive dental literature tends to suggest an end range of about two weeks before further medical evaluation should be pursued. Reports volunteered in this page’s comments section range from 4 to 21 days.

So, if you don’t find your crown early on, there’s no reason not to keep searching. And throughout this whole process, you should keep your dentist posted so they can continue to pass judgment on your situation.

In case you’re wondering, once found, cleaning up your crown isn’t that big of a deal. This page describes how you can disinfect it using household bleach. Your dentist can then sterilize it once you get it to their office.

Once retrieved and cleaned, the hope is that your crown can then just be cemented back into place. Doing so will in part depend on the status of your tooth, which can be evaluated by your dentist early on during your waiting process. For example, they’ll check for complications like decay or tooth breakage.

The condition of your crown will also be a factor, as well as an unknown. But if it came off your tooth passively and wasn’t bitten on before being swallowed, there’s a very good chance that it’s still just fine.

A very important last point to make is this. Your crown was made to fit your tooth while occupying a very precise location in your jawbone. If your tooth shifts, which all teeth tend to do if they aren’t locked into position by their contact with neighboring and opposing teeth, a criterion that a tooth that’s lost its crown cannot meet, the original crown may no longer fit correctly.

So, very early on, your dentist must be advised about what’s going on. They can then advise you about the need to make your tooth a temporary crown to prevent it from shifting. A temporary may also be needed for comfort, function, or appearance reasons. So, make sure you reach out.

With that, we’ll wrap this video up. We’d be remiss in not mentioning that our page contains additional and more detailed information so be sure to give it a read. Good luck with your search and we wish you a successful outcome. Goodbye.

Comments.

This section contains comments submitted in previous years. Many have been edited so to limit their scope to subjects discussed on this page.