How to look after a temporary crown so it lasts until the real one arrives

Patients often assume a temporary that comes loose was badly made. Usually the opposite is true.

The cement used for a temporary is chosen so that the crown can be removed later without damaging the prepared tooth underneath. When the definitive crown arrives, the temporary has to come off cleanly, in one piece if possible, without vibration, without drilling and without stressing a tooth that has already lost a good deal of its structure. A cement strong enough to make the temporary bombproof would make that removal an ordeal.

So the fixing is a compromise, chosen in your favour. It also means the temporary sits in a slightly different category from your own teeth for two or three weeks: something to be looked after actively rather than used without thinking.

Two further consequences worth knowing:

• The fit at the gum line is good, not perfect. A laboratory-made definitive crown is finished to a precision a chairside temporary cannot match. There is a microscopic step where it meets the tooth, and plaque collects there faster than it does anywhere else in your mouth.
• The material is softer. Temporary resins wear, stain and chip more readily than ceramic. That is acceptable over three weeks. It is not acceptable over three months without a plan, which is why long-term temporaries are built differently.

The instinct after a crown preparation is to leave the area alone. That instinct is wrong, and it is the most expensive mistake in this whole article. A prepared tooth has had its enamel removed. Underneath is dentine, which decays faster and more quietly than enamel does. If plaque sits undisturbed along the margin for three weeks, the tooth that is about to receive an expensive crown can be worse off than it was before treatment started.

Brushing. Twice a day, as usual, including the temporary. Use a soft brush and moderate pressure, and angle the bristles towards the gum line rather than scrubbing horizontally across the crown. An electric brush is fine — hold it against the surface and let it work rather than pressing. On the first day, while the anaesthetic (Betäubung) is still wearing off, be careful: you cannot feel how hard you are pushing.

Flossing — the technique that matters. This is the one thing to get right.

1. Slide the floss down between the teeth as normal, gently. 2. Clean the side surfaces with the usual up-and-down motion against each tooth. 3. Do not pull the floss back out upwards. Let go of one end and pull it out sideways, horizontally, so that it slips through the contact without lifting.

That single adjustment prevents a large share of all lost temporaries. It takes one demonstration to learn and it applies for the whole time the temporary is in place.

Interdental brushes. If you normally use them, keep using them, but insert gently and do not force a size that catches on the edge. If a brush snags every time in the same spot, the margin probably has a small overhang worth adjusting — mention it rather than working around it.

Mouthwash. Optional, useful if brushing near the gum is uncomfortable in the first days. It does not replace mechanical cleaning; nothing does.

Water flossers. Fine on a normal setting. Do not aim a high-pressure jet straight at the margin of a temporary from close range.

Eating with a temporary has its own article, so here is only the part that belongs to care.

The real enemy is sticky, not hard. Toffee, chewing gum, caramel, soft nougat and sticky dried fruit grip the temporary and pull it off in one motion. Hard food — crusty bread, nuts, ice — is the second problem, and it breaks the material rather than unseating it.

Chew on the other side for the first day at least. After that, use the side with the temporary for ordinary food if it is comfortable, and keep the demanding items on the other side.

Very hot and very cold drinks can produce a brief sensitivity through a temporary, which says nothing bad about the tooth. It usually settles within days.

Coffee, tea, red wine, curry, berries. Temporary resins stain considerably faster than ceramic. Over three weeks it is cosmetically irrelevant on a molar; on a front tooth it is worth moderating. The definitive crown will not stain the same way.

More detail: Eating with a temporary crown: what is allowed.

Very few temporaries fail because of one dramatic event. Most fail because of something repeated.

Grinding and clenching (Bruxismus). Night grinding puts loads on a temporary that it was never designed for, and it is the reason some patients break two in a fortnight. If you know you grind, say so before the preparation appointment — the temporary can be built more robustly, and a night guard (Knirscherschiene) may be worth discussing.

Tongue and finger. Everyone probes a new temporary. Constant pushing with the tongue loosens the cement seal over days. Notice yourself doing it and stop.

Using teeth as tools. Opening packaging, biting thread, holding hairgrips. Not with a temporary in place.

Pens, pencils, fingernails, ice. Habitual chewing that your own teeth tolerate will crack a temporary resin.

Toothpicks jammed into the margin. They lever the crown. Interdental brushes and floss, used properly, do the job without the leverage.

Smoking. Stains temporary material quickly and does the gum around a freshly prepared tooth no favours while it heals.

A little tenderness in the first days is expected — the gum was retracted during the preparation and there is a new object sitting against it. What you want to watch for is the difference between settling down and getting worse.

The most common cause of an angry gum around a temporary is not infection but plaque sitting at a margin nobody dares to clean. The treatment is usually gentle, consistent brushing of exactly that spot — the thing patients are most reluctant to do.

Cold sensitivity. Common, especially in the first week, and usually a sign of a living tooth reacting to having been prepared. It should fade. Sensitivity that grows steadily, wakes you at night or lingers for minutes after the cold has gone belongs in a phone call — occasionally a prepared tooth needs root canal treatment (Wurzelbehandlung) before the crown goes on, and it is far better to discover that now.

A sweet or unpleasant taste. Often the temporary cement washing out at one edge. Not an emergency, but get it re-cemented rather than waiting — an open margin lets bacteria straight onto prepared dentine.

A rough edge or an irritated tongue. Easy to polish smooth in a two-minute appointment. There is no need to endure it for three weeks.

The bite feels high. If the temporary feels like it hits first when you close, do not wait to see whether you get used to it. A high temporary makes the tooth ache, disturbs the muscles, and can be adjusted in minutes.

A colour that does not match. Expected on a temporary, and one of the reasons front teeth often get a laboratory-made version. The definitive crown is shade-matched properly.

A long-term temporary. If yours is in place for months — during implant healing, while gum treatment settles, while a bite is being tested — the care regime is stricter, not looser. Add an interdental cleaning routine you actually keep to, and expect a review appointment in between rather than silence until the final fitting. How long can you wear a temporary crown? covers the timeline properly.

Travelling. Do not fly out for two weeks the day after a preparation without knowing who you would call. Take the practice’s number, and find out before you go whether a re-cementing appointment locally is straightforward.

Contact sport. A mouthguard is sensible with a temporary in place, particularly at the front.

Pregnancy. Restorative treatment is often planned around a pregnancy, and gums are more prone to inflammation during it. Tell the practice — it changes what is scheduled when, not how you clean.

If you are new to Germany or your German is limited. Ask for the aftercare instructions in writing, in English, before you leave the surgery — nobody retains a spoken list while their lip is still numb. Make sure you know the practice’s number and how the out-of-hours service (Notdienst) works in your city, and ask directly what to do if the temporary comes off at the weekend. For expats living in Düsseldorf, Cologne or Bonn, 20 to 30 minutes of travel to a practice where all of this is explained in your own language is a trade most people are happy to make: English-Speaking Dentist in NRW. Our approach to crown and bridge work is described here: Crowns and bridges – service page (EN).

Calling about something that turns out to be harmless costs a two-minute conversation. Waiting three weeks with an open margin can cost the tooth its crown appointment.