Stainless Steel Crowns For Children: A Definitive Guide

Dentists recommend stainless steel crowns for children, based on the condition and how badly is a tooth affected. To make you aware of them, here is an in-depth article that highlights its uses, restoration procedures, types of crowns a dentist might suggest for your kid, options to go with, and much more.

So, let’s gets started.

Quick Guide:

What are Stainless Steel Crowns?

Stainless Steel Crowns (or SSCs) are preformed metal crowns that help in protecting baby (primary) teeth. As the name implies, they are metal crowns, which are made of stainless steel and contain chrome & nickel. 

These prefabricated crowns are adapted to the damaged teeth and cemented with biocompatible luting agents. They are popular in fixing a lost tooth, helping to improve the overall structure of the young teeth. 

They were introduced by Dr William Humphrey & Engel in 1950 as chrome-steel. Later, in 1960s, they were significantly improved by Unitek. Since then, a lot of studies have been conducted and as a result, SSCs have been proven superior when compared to an amalgam restoration, especially for multi-surface cavities in primary molars. 

When are Stainless Steel Crowns Used?

A dentist suggests stainless steel crowns for children during any one of the following:

  • Restore a broken or severely damaged tooth
  • Protect a weak tooth
  • Cover a dental implant 
  • Hold a dental bridge in place
  • Recurring dental caries
  • Rampant dental caries
  • Extensive decalcification
  • Extensive dental caries
  • After a pulp therapy
  • Severe bruxism (or tooth grinding)
  • Acquired or inherited enamel defects
  • Kids with higher rate of dental caries
  • Fractured or broken tooth 
  • Abnormal tooth structure from the birth
  • Abnormal tooth structure due to a disease 
  • For intermediate restoration

When are Stainless Steel Crowns Not Used?

A stainless steel crown is never suggested in any of these cases:

  • Individuals with nickel allergy 
  • Teeth that cannot be restored
  • Mobile teeth
  • Molars with half of the roots or more are resorbed 
  • Primary molars that are next to exfoliation 

Stainless Steel Crowns For Children: The Options

Stainless steel crowns that were used earlier posed issues in technique due to poor anatomy and gingival contours. However, the crowns that are used today, like the ones here, have lesser problems due to their festooned gingival contours, wide range of sizes, and shallow cuspal anatomy. 

When it comes to pediatric dentistry, the most common options used today are as follows: 

  • Pre-trimmed or non contoured stainless steel crowns: These have straight sides and are festooned so that they are parallel to the gingival crest. But they still need contouring as well as trimming. 
     
  • Pre-contoured stainless steel crowns: These are pre-contoured and are festooned to resemble the anatomy of primary molar. They reduce the operating time. However, a little trimming and contouring might be necessary.
     
  • Stainless steel crowns with white facings: In order to make the steel crowns look more appealing, particularly when front teeth are concerned, there are SSCs with pre-veneered plastic facings. These look much better due to the fact they are “white.” But for the white facing to stick to the metal, additional bulk should be added. This ensures that the crown looks rounded or bulbous. Also, note that the white facing can chip off after some time, which in turn, exposes the silver crown beneath. Chipping mostly occurs when kids grind their teeth often. This exerts pressure at the back. 

Benefits of Using Stainless Steel Crowns 

Dentists offer different types of dental crowns like the ones made from zirconium oxide & resin. Though these options are readily available, the classic remains as such. When you compare stainless steel crowns with other restorative materials, their success rate is about 96%. Besides this, the benefits of stainless steel crowns are diverse, which include:

  • Affordability: When compared to others, stainless steel crowns are less expensive and tend to have more perks than them. 
     
  • Durability: According to research, steel caps are highly helpful in keeping even the badly damaged teeth in shape.
     
  • Adaptability: Generally, dentists do not prefer using SSCs for adults. But they could assist in conditions where a patient suffers from a health issue and all the other options are difficult. This sounds ideal during situations like pregnancy and senior citizens.
     
  • Ease of Use: Most dental crowns require attaching them to the damaged tooth without bleeding or moisture getting in the way. But SSCs do not have sensitivity to such factors. A dentist can smoothly contour and trim the steel caps for that “perfect” fit.
     
  • Increases Strength: The main goal of using a stainless steel crown is to help restore a tooth’s size & shape, enhance its strength, and make it look much better. Therefore, for patients, who really need them, they make a huge difference for their oral hygiene. 
     
  • Complete Coverage: A stainless steel crown is a wonderful alternate to tooth-colored and silver fillings. Since it is a durable metal cap, it offers complete coverage to the damaged tooth. 
     
  • Easy Maintenance: SSCs have a polished and smooth surface. This feature makes them completely easy to maintain and clean. When well-maintained, they can last for 4 years or even more. 

What Do Stainless Steel Crowns Look Like?

Stainless steel crowns are metallic and bright. They are placed on the back molar teeth, making them less noticeable. Kids will be happy to have a glossy tooth than one with an ugly hole in it.

How Are Stainless Steel Crowns Used? 

Prior to the dental procedure, a dentist will examine the damaged tooth and take an x-ray to check if a crown is really required or not.

If a tooth is damaged severely, especially due to dental decay where the pulp also requires treatment (pulpotomy), then no additional anesthesia (local) is needed while placing the crown, as the anesthesia would’ve been already administered during the pulp treatment. 

But if the process involves placing the crown alone, then local anesthesia is injected to the gums to eliminate uneasiness. A latex sheet (soft), often known as “rubber dam” is then inserted into the mouth in order to separate the tooth, which is being treated. 

Upon doing this, the working space remains free from moisture, debris, and further, ensures that the area is properly visible to the dentist.  

At first, the biting surface is declined by 1.5mm approx. following the tooth’s contours. A wooden wedge is keep between the adjacent tooth and the tooth that is being treated to reduce damage on the adjacent tooth. 

A dentist might use various methods to cut the tooth, based on the preference. Once it is done, an apt crown is chosen whose margins are contoured so that it looks like a tooth. At this stage, the crown will firmly fit on the tooth. 

Both the tooth and the crown are cleaned and dried individually. The cement is mixed and placed on the crown’s inner sides to make sure that it fits the tooth perfectly. Then, the rubber dam is discarded and the kid is asked to bite on the crown really hard so that the extra cement comes off. Finally, the tooth is flossed and ended with a cleaning process.

Stainless Steel Crowns For Children: Aftercare

After a child goes through the dental procedure and has his/her steel crown placed, here’s what aftercare requires:

  • After the numbness from anesthesia is gone, the child might experience some discomfort but the dentist will prescribe a few painkillers to keep things under control.
  • Make sure that the child doesn’t bite the lip, cheek, or tongue.
  • Avoid sticky foods for the next 4-5 days after the dental procedure.
  • To prevent the gums from being irritated, brushing & flossing should be done. Even though the area may swell or bleed, regular brushing & flossing will keep the gums healthy.
  • Rinse the mouth with lukewarm water 2-3 times per day to reduce soreness around the gums.  
  • Steel crowns are glossy and should be maintained in the same way. However, if there is a white line at the bottom or the crown looks cloudy, then it a sign that there is plaque buildup. In this case, brushing should be done promptly. 
  • Since the crown is newly placed in the mouth, the child will experience slurred speech, mild pain while biting and chewing on the cheeks. This is common and it will take about 2 weeks for the child to adjust with it. 

Taking care of stainless steel crowns

Like normal teeth, even stainless steel crowns require proper care. This means that they need to be properly brushed two times a day while paying more attention on where 2 teeth meet or intersect. 

Risks of Using Stainless Steel Crowns

The potential risks of using SSCs include:

  • Unaesthetic or looks unpleasing 
  • Cannot be used if the patient is allergic to nickel
  • Substantial amount of tooth structure is discarded
  • Gingival inflammation because there is unremoved excess cement