The familiar sight of a “silver cap” on a child’s back tooth is common in pediatric dentistry. This metallic covering is officially known as a Stainless Steel Crown (SSC), a pre-formed restoration designed specifically for primary, or “baby,” teeth. The main function of the SSC is to provide a comprehensive shield for a compromised tooth, protecting it until it is naturally replaced by the permanent tooth underneath. While occasionally used temporarily on adult teeth, their primary application is limited to children’s primary dentition.
What Stainless Steel Crowns Are Made Of
The term “silver cap” is slightly misleading, as the restoration is not made of pure silver but a durable alloy. Stainless Steel Crowns are primarily composed of stainless steel, a mix of iron, chromium, and nickel. This composition is selected for its strength, resistance to corrosion, and ability to withstand strong chewing forces.
The crowns are manufactured in various pre-formed sizes and shapes, contributing to their cost-effectiveness and ease of placement. Because they are a single, prefabricated unit, they provide full coverage that encases the entire tooth surface. This full coverage makes the SSC a more reliable and long-lasting restoration than a traditional filling when damage is extensive.
Clinical Reasons for Using Silver Caps
The primary use of the stainless steel crown is for primary teeth too severely damaged for a conventional filling. SSCs are the preferred treatment when decay involves multiple surfaces of a back tooth or when a large cavity has weakened the tooth structure, as a standard filling would be susceptible to fracture. Crowns are also indicated after a tooth has undergone pulp therapy (pulpotomy), as the tooth becomes structurally weaker and requires full coverage to prevent breaking. Furthermore, SSCs are chosen for children with developmental defects like enamel hypoplasia, where the tooth structure is poorly formed and needs protection. Preserving the baby tooth with an SSC ensures it holds the necessary space for the permanent tooth to erupt correctly, preventing potential alignment issues.
How They Are Placed and Removed
The placement of a stainless steel crown is typically a quick, single-visit procedure, unlike the multi-visit process required for adult porcelain crowns. The dentist first prepares the tooth by removing decay and making a minimal reduction to the tooth’s circumference and chewing surface. This minimal preparation is possible because the crowns are thin and pre-made, which helps preserve the remaining natural tooth structure. After preparation, the correct size SSC is selected, trimmed for a precise fit, and cemented permanently onto the tooth.
The crown is not actively removed by a dentist. Instead, it remains in place until the natural process of exfoliation occurs. When the permanent tooth is ready to emerge, it dissolves the roots of the baby tooth, and the silver cap falls out naturally along with the primary tooth.