A dental crown in pediatric dentistry functions as a full-coverage cap that is placed over a primary, or baby, tooth that has been structurally compromised. This protective measure is designed to restore the tooth’s original shape, strength, and function until it is naturally lost. Unlike a standard dental filling, which repairs a smaller area of decay, a crown is necessary when the damage is so extensive that a filling would likely fail or cause the tooth to fracture under normal chewing forces. The primary goal of crowning a baby tooth is not merely to fix a cavity, but to save the tooth and maintain its correct position in the jaw until the permanent tooth is ready to erupt.
When Pediatric Crowns Are Necessary
A child can technically receive a crown as soon as primary teeth erupt and develop significant decay or damage, which can happen as early as three or four years of age. However, the procedure is most commonly performed on children between the ages of five and eight, when the primary molars are often heavily affected by decay and still need to remain in the mouth for several years. The decision to place a crown is not based on age alone, but on the clinical condition of the tooth and its remaining lifespan before natural exfoliation.
One of the most frequent reasons for a crown is extensive tooth decay that covers multiple surfaces of the tooth, leaving insufficient healthy structure to support a standard filling. A crown provides comprehensive coverage that seals the tooth completely, preventing further bacterial invasion and protecting the remaining tooth structure from breakage. Crowns are also routinely necessary following a pulpotomy, a procedure where the infected nerve tissue is removed from the crown portion of the tooth. Because this treatment weakens the tooth significantly, a full-coverage crown is required to shield the compromised structure from fracturing.
Beyond decay, a crown may be recommended for primary teeth that have suffered significant structural damage from trauma, such as a severe fracture or chip. The cap stabilizes the broken pieces, allowing the child to chew normally without pain or risk of further injury. Furthermore, children with developmental defects, such as enamel hypoplasia or dentinogenesis imperfecta, may require crowns to protect teeth with naturally weak or malformed enamel.
Materials Used for Children’s Crowns
The crowns used in pediatric dentistry are typically prefabricated, meaning they are ready-made in various sizes and shapes, which allows the dentist to complete the restoration in a single appointment. The selection of material is usually determined by the tooth’s location and whether aesthetics are a concern. Stainless Steel Crowns (SSCs) are the most common and widely utilized option, especially for molars in the back of the mouth.
Stainless steel crowns (SSCs) are favored for their superior durability, ability to withstand strong chewing forces, and cost-effectiveness. They are highly resistant to wear and fracture, which is important for teeth that must remain functional for several years. Although they have a noticeable metallic appearance, this is generally not an issue for back teeth that are out of sight.
For teeth that are visible when the child smiles, such as the front teeth and sometimes the first molars, tooth-colored aesthetic crowns are available. Zirconia crowns, made from a strong ceramic material, offer a highly natural appearance and are metal-free, making them suitable for children with metal sensitivities. While they are more expensive and may require more tooth reduction than SSCs for proper placement, they provide an excellent aesthetic solution that closely matches the child’s surrounding teeth. Composite strip crowns are also used on front teeth but can be more prone to chipping than Zirconia or stainless steel.
What to Expect During the Crowning Procedure
The procedure to place a pediatric crown is often completed in a single visit. The process begins with administering a local anesthetic to numb the tooth and surrounding gum tissue. For highly anxious children, the dentist may also use nitrous oxide, or “laughing gas,” to help them relax throughout the appointment.
Once the area is numb, the dentist removes all decayed or damaged material and shapes the remaining tooth structure. This preparation is necessary to create a proper foundation, ensuring the crown can fit over the tooth without being bulky or interfering with the child’s bite. A prefabricated crown of the appropriate size is then selected, fitted over the prepared tooth, and checked for a precise fit at the gumline.
After the fit is confirmed, the crown is cemented permanently onto the tooth using a strong dental adhesive. Following the procedure, a child may experience minor soreness in the gums for a day or two, which can typically be managed with over-the-counter pain relievers. When the primary tooth is finally ready to fall out naturally, the crown will simply come off with it, as the tooth’s root dissolves beneath the restoration.