As a dentist who treats countless children each year, I get many questions about pediatric crowns, or crowns on baby teeth. Pediatric dental crowns are made from medical grade stainless steel and can restore your child’s tooth from further decay and damage. This restoration can help your little one chew, speak, and maintain the space for an adult tooth to come in. While every case is different, it is possible that your child will need a pediatric crown to strengthen the form and function of their smile.
If your child is four years old or younger, their tooth decay can rapidly worsen if left unchecked. Poor oral hygiene, a natural defect in the tooth, and severe teeth crowding can all cause cavities and tooth decay to occur.
Sometimes a cavity becomes so large that the supporting walls are not strong enough to support a filling. Using a full-coverage restoration like a crown can greatly increase the probability of the tooth not needing further restorations.
There can be situations where a natural crack is formed, or the enamel (the tooth's outer layer) is weak or porous. Trying to fix one small tooth area while the rest of the tooth is defective will only lead to patchwork dentistry and will need to be redone. Sealing in the whole tooth a crown can better protect the healthy tooth structure underneath.
If the decay or cavity has reached the nerve, this suggests a few things. First, the cavity is huge, so there is less tooth structure that could support a filling. Second, a crown is a much better long-term solution to seal up the exposed nerve after a pulpotomy is done many times. I have seen many fillings in patients come in with a restoration directly on the nerve that has failed. This leaves the child in pain, and many times the tooth needs to be extracted. If a proper pulpotomy and crown were done, the tooth would have been saved most likely.
To properly place a white or composite filling, the prepared tooth must remain dry. If this area becomes wet, the filling can lose its bonding with the tooth. Bacteria will work their way in and behind the filling, causing more tooth destruction. Depending on the decayed area or the child’s behavior in the dental chair keeping the tooth preparation dry can not be achieved. This moisture will cause the filling to debond and cause future problems.
Whenever you consider sedating a child for treatment, you want to make sure that you are sedating them a few times as possible. For this reason, the treatment option that will have the longest long-term success rate should be utilized. This is why sometimes a full-coverage restoration like a crown should be used compared to other more conservative approaches.
If the tooth decay is deep enough, a tooth extraction may be a better treatment plan for your child than a pediatric crown or other restoration. By restoring the tooth, however, you allow your child to chew with ease and maintain the space they need for adult teeth to erupt. Removing a tooth early can allow the other teeth to shift and tip, closing space for the adult teeth to come in.
While it is uncommon, a crown on a baby tooth can loosen and come out. This usually occurs if your child has experienced trauma to the face, such as an accidental fall or sport injury. Sticky foods or candies can also cause damage to your child’s crown. The crown works well with the downward force of chewing on a slice of meat or a hard vegetable like a carrot. But sticky snacks like caramels or gummies can weaken the cement over time.
The first thing to do if the crown comes off the tooth is to contact your dentist as soon as you can. Usually, the tooth can be re-cemented. If you wait too long, the uncovered baby tooth could get a new cavity or the surrounding teeth could shift. Don’t hesitate to call your dentist to see how they can help restore and protect your child’s smile.