What is a crown, and when are they necessary in primary teeth?

A dental crown is a tooth-shaped covering cemented to the tooth for the purpose of restoring the tooth to its original shape and function. Crowns are recommended by pediatric dentists when it is necessary to repair and restore a primary (baby) tooth found to have a large cavity or cavities, broken tooth, or a primary tooth which has not developed correctly.

Severely decayed or fractured teeth are beyond the scope of repair by a filling because of the risk of the filling falling out, breaking, or wearing out. This results in additional future dental procedures. Crowns are much more durable than fillings, and usually last until the baby tooth falls out.

It is very important to repair and restore primary teeth. Although children begin to lose a few baby teeth by about six, they won’t lose their baby molars until age 12 or 13. So keeping these teeth healthy until they fall out naturally helps the permanent teeth grow into their proper position, reducing the chances that they’ll need extensive orthodontic treatment later. Since the enamel of baby teeth is thinner than that of permanent teeth, decay can spread rapidly between teeth. Crowns can be used not only to save the decayed tooth but can also help prevent the spread of decay and infection to other areas of the mouth or body.

What are the steps to restoring primary teeth with a crown?

In most dental crown procedures, there are a few universal steps.

  1. First the dentist will numb the area around the tooth to be restored
  2. Put a dental dam in place
  3. Remove decay
  4. Shape the tooth to fit the crown

Unlike crowns for adults, which often require several visits to the dentist, most crowns for children can be placed in a single procedure.

The Stainless Steel Solution

When a baby tooth is extensively decayed and using other filling materials isn’t likely to be successful, the American Academy of Pediatric Dentistry (AAPD) recommends restoring the tooth with a stainless steel crown. After removing the decay, your dentist will fit and cement a prefabricated crown made of stainless steel over the tooth. Here are some advantages of stainless steel crowns:

  • Durable but inexpensive
  • Full coverage protection for the tooth
  • Very little sensitivity
  • Less likely to need retreatment
  • More successful than metal fillings in children under four years old
  • Good choice for children who need general anesthesia
  • Often used as an attachment for a space maintainer

If the pulp of the tooth is involved, the dentist may also need to perform a procedure known as pulpal therapy before placing the crown. Rest assured it is quite common, even for young permanent teeth.

What should I expect after my child’s dental crown procedure?

It is normal for your child to experience some discomfort caused by irritation of the tooth’s pulp or soft tissue around the tooth for up to 24 hours after the procedure. Over the counter medicines such as acetaminophen or ibuprofen will help with the discomfort. It is important to contact your child’s dentist should the pain last longer than 24 hours.

It is very important to discourage eating until your child’s numbness has completely worn off. This prevents accidental bites of the lip or cheek, which can cause injury.

Healthy Smiles for a Lifetime

While crowns are an important tool in restoring little mouths to health, remember to keep providing good oral care at home.  Brushing and flossing daily, visiting your dentist every six months, and avoiding sugary snacks can all help to keep decay away!