A pediatric dental crown is a protective cap placed over a primary (baby) tooth that has been severely damaged. This restoration saves the compromised tooth until it is naturally ready to fall out. Unlike a small filling, the crown covers the entire visible portion of the tooth, restoring its shape, strength, and function. Preserving primary teeth is important because they maintain the necessary space for the permanent teeth to erupt correctly. Losing a baby tooth too early can lead to crowding or misalignment issues.
Specific Dental Conditions Requiring Crowns
A crown is needed when tooth damage is too extensive for a standard filling to provide lasting support. This usually occurs when decay has progressed significantly, affecting multiple surfaces. If a cavity is extremely large, the remaining tooth structure is too weak to withstand chewing forces and would likely fracture beneath a filling. The crown’s full-coverage protection prevents structural failure and seals the tooth from further bacterial invasion.
A crown is almost always recommended after a tooth has undergone pulp therapy (a baby root canal). This procedure, known as a pulpotomy or pulpectomy, involves removing the infected nerve tissue. Removing the pulp makes the remaining tooth structure brittle and susceptible to breakage. The crown acts as a durable shield, providing the support the weakened tooth requires until its natural exfoliation.
Crowns are also used to treat teeth fractured due to trauma or those with developmental defects. A chipped or broken tooth involving a large portion of the enamel and dentin needs more than a simple repair to prevent sensitivity and further damage. Children born with conditions like amelogenesis imperfecta have weak, poorly formed enamel, making their teeth vulnerable to rapid wear and decay. The comprehensive coverage of a dental crown protects these compromised teeth from daily stress.
Materials Used for Pediatric Dental Crowns
Pediatric dentists primarily use two types of materials for crowns, chosen based on the tooth’s location. The most common option is the stainless steel crown (SSC), a prefabricated, silver-colored shell. These crowns are durable, cost-effective, and provide excellent strength to withstand the heavy biting forces on back teeth (molars).
Stainless steel crowns are used almost exclusively on posterior teeth where aesthetics are less of a concern. Their pre-formed nature allows for quick placement in a single appointment, which is beneficial when treating young children. For visible teeth, such as incisors and canines, aesthetic options are available. These include tooth-colored crowns, typically made from zirconia or a resin material.
Zirconia crowns are a popular tooth-colored choice, offering strength comparable to stainless steel crowns and a natural appearance. They are often used for both front and back teeth when a metal look is undesirable. While they are more expensive and may require more chair time, they satisfy the need for a durable and aesthetically pleasing restoration.
What Happens During the Crown Procedure
The process of placing a pediatric crown begins with the removal of all decay from the affected tooth. After cleaning, the dentist carefully shapes the remaining structure. This preparation involves reducing the tooth’s size around its edges to create a small ledge, ensuring the crown fits securely without creating an awkward bulge in the gum line.
Next, the dentist selects a prefabricated crown matching the size and shape of the original tooth. The crown is adjusted slightly to ensure it fits snugly over the prepared structure and does not interfere with the child’s bite. It is then cemented into place using a strong dental adhesive.
Local anesthesia is administered to numb the area, ensuring the child does not feel pain during decay removal and tooth preparation. Depending on the child’s age or anxiety level, mild sedation may be used to help them remain calm and cooperative. The procedure is designed to be completed efficiently, often in a single visit, so the tooth is protected immediately.
How Long Do Pediatric Crowns Last
A pediatric crown is intended to serve as a long-term, temporary restoration for the primary tooth. The crown’s lifespan is directly linked to the natural lifespan of the baby tooth it covers. It is expected to remain firmly in place until the permanent tooth underneath begins to push it out.
This natural process is called root resorption, where the root of the primary tooth slowly dissolves as the permanent tooth develops. The crown is designed to fall out along with the baby tooth when the permanent tooth is ready to erupt, usually between the ages of 10 and 12 for back molars. Crowns are durable enough to last for several years, fulfilling their purpose of holding the space until natural shedding.
Although crowns are durable, parents should encourage children to maintain good oral hygiene, including regular brushing and flossing, to protect the gums around the crown. Occasionally, a crown may become loose or come off prematurely, often due to sticky foods. If this happens, the crown should be kept safe and the dentist contacted immediately to have it re-cemented or replaced.