Silver crowns, often called stainless steel crowns (SSCs), are a common and highly effective solution in pediatric dentistry, primarily used to restore severely damaged or decayed primary teeth. The question of whether these crowns will fall out is a natural concern for parents. These durable, pre-formed metal caps are cemented over the entire surface of a compromised tooth to provide full protection and maintain the tooth’s function until it is naturally replaced by the permanent tooth beneath it.
What Are Silver Crowns and Their Intended Lifespan
Stainless steel crowns serve a dual purpose: restoring a primary tooth that has suffered extensive decay or damage, and acting as a placeholder. Primary teeth, especially the back molars, must remain until a child is around 10 to 12 years old to guide the permanent teeth into their correct positions. If a primary tooth is lost too early due to decay, other teeth can shift, potentially causing alignment issues for the emerging adult teeth.
The SSC is a prefabricated shell that is carefully contoured and cemented onto the prepared tooth structure. This method offers a more reliable, longer-lasting restoration than a large traditional filling when significant tooth structure has been lost. Once properly placed, the stainless steel crown is engineered to last for the entire remaining lifespan of the primary tooth.
The crown’s longevity is tied directly to the underlying tooth’s natural schedule. The crown will remain firmly in place until the root of the baby tooth naturally dissolves, a process called resorption. This biological process allows the adult tooth to push out the baby tooth. SSCs boast a high success rate, demonstrating their durability and reliability when placed correctly.
Common Causes of Premature Crown Loss
While SSCs are highly durable, they can occasionally come loose before the primary tooth is ready to exfoliate, a condition known as premature crown loss. One main reason is the breakdown of the dental cement used to bond the crown to the tooth. Over time, the cement may slowly erode or dissolve, especially if exposed to high levels of moisture or temperature changes, causing the retention seal to fail.
Recurrent decay, or new decay forming beneath the crown margin, is another common biological factor leading to failure. If bacteria accumulate at the crown’s edge due to inadequate hygiene, decay can weaken the underlying tooth structure holding the crown. As the supporting tooth material is lost, the crown no longer has a stable base and may become loose.
Mechanical factors also play a significant role in dislodgement, particularly involving diet. Chewing on hard, sticky, or chewy foods like taffy, caramels, or hard candies can exert a pulling force that overpowers the cement bond. Additionally, an improper initial fit or a crown that is not perfectly adapted to the tooth margins may not create a strong initial bond, increasing the likelihood of early loss.
Immediate Steps If a Crown Becomes Loose or Falls Out
If a silver crown feels loose or completely falls out, immediately contact the child’s pediatric dentist. The exposed tooth structure underneath is vulnerable to sensitivity, infection, and further decay, so prompt attention is important. If the crown is retrieved, clean it gently with water and store it safely, as the dentist may be able to re-cement it if it is undamaged.
Avoid attempting to glue the crown back on using household adhesives like superglue, which are not safe for oral tissues. If necessary for temporary comfort, the dentist may advise using a small amount of toothpaste or over-the-counter temporary dental cement to hold the crown in place until the appointment. The primary goal is to protect the underlying tooth and maintain the necessary space in the arch. The remaining tooth should be kept clean by gentle brushing and avoiding sticky foods until the dentist can examine the situation.
Natural Process: When the Tooth Comes Out
The natural loss of a primary tooth, or exfoliation, is a process distinct from premature crown failure. This event is triggered by the permanent tooth developing directly beneath the primary tooth, which causes the primary tooth’s root to slowly dissolve through root resorption. The root structure holding the tooth in place is gradually weakened as the adult tooth moves closer to the surface.
When the primary tooth is ready to shed, the silver crown will come out along with the small remaining portion of the baby tooth. This is the intended endpoint for the stainless steel crown, confirming that it has successfully protected the tooth for its entire required lifespan. The crown has served its function of preserving the space and chewing ability until the permanent successor was ready to erupt.