Hi Seaangel,
DocVikingo gave me the heads up. My son's been hogging the computer lately.
First, I can't tell you how many people report breaking teeth on bread, pasta, crackers, etc. Unless there is a really hard crust, bread and pasta is not the culprit!. The tooth was already cracked and the sticky paste made up of the pasta and spit (uggg!) pulls the broken pieces out.
Most of the time the offending tooth has had a previous silver/amalgam filling in it since the "Big Bang". As silver fillings get older, they react chemically and begin to corrode and expand. Some appear to be squeezing out of the tooth and other expand laterally--sideways. This creates rather high stress within the cusps and a fracture usually begins within the filling preparation at the junction of the verical and horizontal walls of the preparation.
If you brux or clench your teeth, chew ice, chew a lot of gum or just TALK TOO DARNED MUCH...oops, you add to the stress and finally the tooth breaks.
Some patients report sensitivity to biting pressure, and release of biting pressure (rebound sensitivity) ONLY WHILE CHEWING FOOD. Without food between the teeth, they can squeeze as hard as they want and there is no pain. Also reported may be sensitivity to cold, sweets--especially, chocolate and rarely hot foods. For reasons that totally befuddle me, a few patients report sentivity to.....ready for this....lettuce...really. It must be something in the juice. Some patients even report that all their pain goes away after the broken piece comes out!
A cap is usually recommended because so much tooth is lost to the break and if the fracture goes deeper into the tooth, it can affect the nerve or even split the tooth in half...and that's a gonner. The cap rebuilds lost structure and can reinforce the tooth.
The temorary crowns are for both protection from stuff in the mouth AND the edges of the temporary support the soft gum tissues around the prepared margin. If you lose the temporary and leave it out even a few hours, it might not go on without first trimming the gum. So first...don't do anything to lose it and second, if it comes out try to wear it unless it follows you finger out of your mouth and get in to see your dentist.
The easiest way to lose a temporary is to eat sticky candy. If you don't know what this is, I'll enlighten you with a list I have compiled over the years. I used to say "No gum or sticky candy." and the patient would then ask, " How about gummy bears?" Duh! So here's the list....No sticky candys like gum, caramels, gummy bears, juju bees, tootsie rolls, gum drops, raisins, craisins, licorice, milk duds, coffee candy, taffy, grilled onions (they caramelize), hard candys (they start out with a sticky coat). No ice, nuts, unpopped popcorn (old maids).
If you can think of another I would love to hear it because I'm sure that someone out there will think to themselves...Hmmm...not on the list, must be ok to eat.
On to temporary cement. Awap is correct, you can buy a two part cement kit at most pharmacys. It can be used as a cement if mixed to the consistency of sour cream or as a temporary filling if mixed very stiff. Rinse your mouth out with slightly warm water and then try to blot the tooth dry. Make sure you figure out how the temporary goes on first before mixing the cement---you only get one try...mess it up and the cement is hard...bummer. I recommend and carry one when I go out of the country.
OK...now here's the really important thing to know about temporary cement....IT CAN ONLY BE USED IN TEMPORARIES FOR PERMANET CROWNS THAT WILL BE CEMENTED WITH NON-BONDING CEMENT. Many all porcelain crowns are bonded to the tooth so if you are not sure what is being used, simply slip the temporary on again and leave it alone--get to your dentist.
Any plastic resin bonding cement will fail to set properly if it come into contact with clove oil--one of the basic ingredients of OTC temporary cement. Clove oil compromises the bond, can make for a sensitive permanent tooth and lead to a cementation failure later on.
Now, you're wondering "How about Superglue?" Don't you dare. First, it won't work long except when you want to get the darned thing off. It's adhesion fails in a moist environment. It may be toxic to the pulp tissue--which is Ok if you really want a root canal.
Finally, temporary crowns stay on because of a snug fit. The temporary cement is there to prevent PULLING it off. So biting on the temporary usually won't loosen it...the operative word is, USUALLY. A properly cemented temporary crown won't have any bubbles under it nor are those bubbles the real problem in barodontalgias. About the only thing a bubble might do under a temporary crown while diving is create a potential space into which the plastic may be compressed--this could loosen the crown.
Oh, yeah...Flossing temporaries...slip the floss through to clean and then let go of one end and slip the floss out. Both sides. If you pop it out, it might go ballistic.
All this being said, diving with a temporary, while possible, poses an aspiration risk. Even more so if it is already loose and you've put it back into your mouth. Also, barodontalgias seem to be associated more with a dead or dying nerve than with a simple bubble. The tooth preparation for the cap may set up those conditions. The temporary cap probably does NOT add any liablility.
My professional advice it to avoid the dive with a temporary crown. If you inhale it, it won't show on an x-ray and it poses both a choking hazard and a real pain in the a** to remove from your lungs. If you're lucky and swallow it, most times it will pass...but one never knows, do one?
Lastly, just in case you take me seriously:
Disclaimer
(No representations are made that in any way offer a diagnosis, treatment or cure for any illness or condition, either discussed or implied. Answers to questions are offered as information only and should always be used in conjunction with advice from your personal diving physician/dentist. I take no responsibility for any conceivable consequence, which might be related to any visit to this site.)
Safe diving,
Larry Stein
:doctor:
