What to know if your child needs dental crowns

Parents usually take their children to a dental checkup hoping for a good report. But sometimes they discover that their child has cavities — and serious ones, at that. The good news is that there’s something parents can do to help.

While smaller cavities can be filled, larger ones may need more extensive work. That’s where dental crowns come in. A crown is a sleeve-like covering that goes over a damaged tooth to preserve it.

You may be wondering if baby teeth are worth treating, since they’ll eventually fall out. Dentists say yes. Baby teeth save space for permanent teeth to come in correctly, explains Irina Kessler, D.D.S., co-founder of New York Family Dental Arts in New York City. Kids need their baby teeth for chewing and speaking clearly too, until they begin to fall out.¹

If a pediatric dental crown is in your child’s future, it’s good to know the basics — and what to consider when the dentist recommends one.

Cavities in children are common. Almost half of kids experience tooth decay by age 19, according to the American Academy of Pediatrics.² And nearly 1 in 4 kids will get a cavity by age 5.¹

Whether the cavity is tiny or big, it’s important to treat it. When there’s a problem, dentists often want to save a child’s tooth, rather than pull it out, notes Dr. Kessler.

Here are 4 reasons why your child may need a dental crown, according to Dr. Kessler:

• The cavity is too large to be filled with a traditional filling, or the tooth is too weak to hold the filling³
• The tooth is infected
• The tooth is cracked or broken
• The tooth is weak
  

Whatever the reason, the procedure looks the same. After the dentist cleans and removes the decay, a crown will cover the tooth like a cap. This will make the tooth stronger if it’s been cracked or broken.³ A crown will also protect against the spread of decay in your child’s mouth.⁴

The dentist will advise you about the best course of action. But there are several decisions you’ll need to make.

According to the American Academy of Pediatric Dentistry, there are 3 types of dental crowns for kids, and the dentist will probably weigh in based on the specific needs of the tooth. Each option has pros and cons and may be better for some teeth than others.³

• A stainless steel crown. Also called preformed metal crowns, these tend to be stronger and last longer. According to the American Academy of Pediatric Dentistry. They are also better at keeping bacteria out. But they do look like steel or silver caps.
• Tooth-colored crowns. These are made from plastic-like composites. Because they blend in better, dentists tend to recommend them for the front teeth and canines. They don’t last as long as stainless steel crowns though, and they’re often more expensive.
• Zirconia crowns. Similar to tooth-colored crowns, this option matches your kid’s teeth. They cover the entire tooth, but are often only used if the tooth experiences a greater amount of reduction.

Kids in grade school who are shedding baby teeth may not need crowns that last years. “On adults, we want a crown to last 10, sometimes 20 years,” says Dr. Kessler. For kids, a crown just holds the baby tooth in place until it naturally falls out, she says.

Dr. Kessler advises bringing an orthodontist on board to evaluate how braces would factor into the choice of a crown or any additional spacing needs. “It’s a combined effort to determine when and how the tooth can be saved,” she says.

The aim of any pediatric dental procedure is always to provide the safest, most pain-free option for a child. But what type of anesthesia is used may depend on your child’s age and temperament.

Younger children, who may not be able to stay still during the procedure, may need general anesthesia. An older child may just need to be sedated with medications that make them sleepy but don’t knock them out entirely.⁵

Ask the dentist what type of sedation will be used, and who else will be in the room during the procedure. If your child is undergoing deep sedation or general anesthesia, there must always be an independent observer, such as a certified registered nurse anesthetist or a dentist anesthesiologist, present alongside the dentist to keep an eye on the child.⁵

For children younger than 8, parents may want to consider having the procedure done by a pediatric dentist. These offices tend to be kid-friendly to decrease a child’s anxiety, Dr. Kessler explains. Plus, pediatric dentists have more experience in treating and reassuring kids.⁶

“Having a great experience as a child — even for something like a cavity or crown — decreases the risk that they’ll be scared to go to the dentist as they grow up,” she says. That’s the goal with childhood dental experiences.

Dental crowns save children’s baby teeth so they can go on to have healthier permanent teeth — and stay healthier overall.