A dental cap, or crown, is a tooth-shaped cover placed over a tooth in a child’s mouth. It restores the tooth’s shape, size, and strength by completely encasing the visible portion of the tooth. The purpose of a pediatric crown is to preserve the compromised primary (baby) tooth until it naturally exfoliates. This measure ensures the tooth continues to function for chewing and speaking, while maintaining the necessary space for the permanent tooth to erupt correctly.
The Dental Conditions Requiring Caps
A crown is recommended when a tooth is too damaged for a filling to provide adequate restoration. Fillings are suitable for small to medium-sized cavities, but they cannot provide the comprehensive protection needed for extensive decay or structural damage. When a cavity is large or affects multiple surfaces, there may not be enough healthy tooth structure remaining to support a filling long-term.
A cap is also necessary for teeth that have undergone a pulpotomy or pulpectomy. These procedures significantly weaken the tooth structure, requiring a full-coverage crown to prevent fracture and seal the tooth from future bacterial invasion. Additionally, teeth with developmental defects or those fractured from trauma often require a crown to restore their integrity and function.
Preserving the primary tooth guides the alignment of the permanent tooth. Protecting the damaged tooth with a cap ensures it remains in place, acting as a natural space maintainer until exfoliation. Opting for a crown over a filling in high-risk cases provides a more durable, long-term solution, reducing the need for repeat treatments.
Understanding the Types of Pediatric Crowns
Pediatric dentists use two types of crowns, each with distinct properties and cosmetic considerations. Stainless Steel Crowns (SSCs) are the common choice, especially for back molars. These pre-formed, silver-colored metal caps are durable, highly resistant to wear, and can withstand the chewing forces of a child.
SSCs are cost-effective and allow for a quick, straightforward placement procedure requiring minimal tooth preparation. While their metallic appearance is not aesthetically appealing, this is not a concern for less visible posterior teeth. For front teeth or when prioritizing a natural look, aesthetic options like zirconia crowns are available.
Zirconia crowns are made from a ceramic material that can be matched to the child’s natural tooth color. These crowns offer better aesthetics and are recommended for visible teeth. However, zirconia crowns require more tooth reduction for proper fit and may be more costly than their stainless steel counterparts.
The Process of Placing a Crown
The procedure for placing a pediatric crown is often completed in a single dental visit. The process begins with administering a local anesthetic to ensure the tooth and surrounding area are numb, keeping the child comfortable throughout the restoration.
Next, the pediatric dentist removes all existing decay and shapes the tooth structure. Shaping, or trimming, is necessary to create a foundation that accommodates the thickness of the pre-formed crown. Once the tooth is prepared and cleaned, the pre-sized crown is selected and fitted.
For stainless steel crowns, the edges are often crimped to ensure a tight seal around the tooth base. Finally, the crown is cemented into place using a biocompatible dental adhesive. The dentist then checks the child’s bite to confirm a comfortable fit before polishing away any excess cement.
Lifespan and Care for Capped Teeth
A dental cap is intended to remain in the mouth until the natural process of exfoliation occurs. The crown is designed to last for the remaining lifespan of the baby tooth, which could be anywhere from a few years up to ten years, depending on the child’s age when the crown was placed. The permanent tooth developing beneath the cap eventually dissolves the baby tooth’s root, causing the crowned tooth to loosen and fall out normally.
Maintaining the cap requires good oral hygiene, including brushing twice a day and flossing daily. Focus on the area where the crown meets the gum line to prevent plaque buildup and secondary decay. Parents must also monitor the child’s diet to ensure the longevity of the restoration.
Sticky or hard foods, such as caramels, taffy, or ice, should be avoided because they can loosen or dislodge the crown. If a crown becomes loose or falls off, the tooth is left vulnerable, and a pediatric dentist should be contacted immediately for evaluation and replacement.