Silver crowns, formally known as Stainless Steel Crowns (SSCs), are pre-formed metal caps used in pediatric dentistry to restore and protect severely damaged primary (baby) teeth. These durable restorations are typically recommended when a primary tooth has extensive decay, significant structural damage from trauma, or has undergone a pulp treatment where a filling would be inadequate. The crown fully covers the entire tooth structure, preventing further decay and maintaining the tooth’s function until it is naturally shed. The main goal of placing an SSC is to keep the primary tooth healthy and in place, ensuring the child can chew and speak normally while holding the necessary space for the permanent tooth to erupt correctly.
The Expected Lifespan of Silver Crowns
The intended lifespan of a stainless steel crown is directly tied to the natural cycle of the primary tooth it covers. Ideally, the crown remains securely cemented until the underlying baby tooth naturally exfoliates. This natural process occurs when the permanent tooth begins to push against the roots of the primary tooth, causing the roots to dissolve and the tooth to loosen. Depending on the child’s age and the specific tooth involved, the crown may stay in the mouth for several years. When the crown falls out with the tooth, this is considered a successful completion of the restoration’s function, having preserved the tooth until the permanent successor was ready. Premature dislodgement, occurring long before the tooth is due to be shed, signals a technical failure.
Common Reasons Silver Crowns Become Dislodged
While SSCs are highly durable, they can sometimes become prematurely dislodged due to a breakdown in the bond or the underlying tooth structure. The most frequent cause of premature failure is the deterioration or wash-out of the dental cement used to secure the crown. Over time, the constant presence of saliva and the mechanical forces of chewing can erode the cement, weakening the seal between the crown and the tooth.
Another significant factor is the progression of recurrent decay beneath the crown margins. Although the crown covers the tooth, bacteria can sometimes accumulate at the edges, leading to new decay that weakens the remaining tooth structure. As the tooth underneath becomes compromised, the crown loses its foundation and is more likely to pop off.
External forces also contribute to dislodgement, particularly trauma or excessive biting pressure. Chewing on hard items like ice or non-food objects, or consuming very sticky foods such as taffy or caramels, can exert a pulling force that breaks the cement seal. Even habits like teeth grinding, known as bruxism, can place undue stress on the crown, accelerating the breakdown of the adhesive.
Finally, technical issues related to the initial placement can lead to early failure. If the crown was not fitted perfectly, or if the tooth preparation did not provide sufficient surface area for retention, the crown may not have been securely attached from the start. An improper initial fit can create tiny gaps, known as microleakage, which allow bacteria and fluids to infiltrate and compromise the bond.
Immediate Action When a Crown Falls Out
If a silver crown comes loose or falls out, immediately locate the crown. If found, clean it gently with water and store it safely to prevent damage. Do not discard the crown, as the dentist may be able to re-cement it.
The exposed tooth should be handled with care, as it may be sensitive to temperature changes or air. Contact the pediatric dentist immediately to schedule an appointment, explaining that the crown has come out. The underlying tooth structure is now unprotected and susceptible to decay or damage, and the tooth’s position can shift quickly if the crown is not replaced.
While awaiting the appointment, avoid chewing on the side of the mouth where the crown fell out. If the exposed tooth has sharp edges that irritate the cheek or tongue, covering the sharp spot with a small piece of dental wax can provide relief. Do not attempt to use household adhesives to reattach the crown, but a temporary dental cement kit can be used if instructed by the dentist.