What are the situations in which Stainless Steel Crowns are required instead of Fillings?

Dental crowns have been in use for a very long time and are part of the dental fraternity as a treatment methodology since the beginning of the 19th century. The earliest use of dental crowns can be attributed to the invention of metal based caps which were later referred to as crowns. These caps or crowns were majorly made from metals such as Gold, silver, titanium and other other amalgams. To make them largely available to the public, precious metals were soon replaced by the common metals such as steel alloys. Stainless steel crowns are seen as one of the earliest types of dental crown in the dental medicine world. Today, there are tens and hundreds of combinations that are used by dental researchers to make different kinds of dental crowns for various requirements and preferences of patients worldwide.

Dental Crowns serve as one of the most basic and yet one of the most effective solutions against a plethora of dental problems. Especially when it comes to older adults and younger children, dental issues need to be addressed more carefully and with precaution as patients rarely have dental and oral hygiene awareness and do not cooperate with dental procedures when it is needed. Dental crowns are a beneficial treatment method which is moderately invasive and is a semi-permanent solution that lasts an average of 10 to 12 years, sometimes even more.

Dental Crowns - Indications and Applications

Dental crowns, as mentioned, are one of the best ways to address a whole lot of dental problems in adults, older adults and young children. Below are some of the indications where dental crown can be an optimum treatment methodology:

  • Broken or Fractured Tooth
  • Misshapen Tooth
  • Discoloured Tooth
  • Tooth plagued with cavities
  • Weak tooth
  • Tooth with pulpal infection
  • As a post operative treatment in case of RCT, pulpectomy and Pulpotomy

These are some of the applications of Dental crowns. Dental crowns are not the only options and in some cases, dental fillings may also be opted for patients on a case to case scenario. In some situations, where there is minimal removal of the original tooth and there is a considerable strength in the tooth, fillings can be a good option and are less invasive than dental crowns. But this completely depends on the situation of the tooth, the procedure that is done on the tooth, the dentists and the patient's preference etc.

Dental crowns are widely used for all kinds of dental issues but they have a specific application when it comes to pediatric dentistry. Most people, parents especially, do not pay much attention to childrens’ oral and dental hygiene until they have a full mouth of teeth and are old enough to brush teeth on their own. Oral care should begin for young children as soon as they sprout their first set of teeth as primary teeth have a thin enamel and can be easily affected by excessive accumulation of germs. Food and even milk from formula or mother’ milk can easily accumulate around the teeth and cause the germs to attack the teeth causing cavities and gingival infections.

At the very first sign of trouble, children should be given dental care. White patches on teeth, sensitivity to hold or cold food, sensitivity to sour or sweet food, pain in the tooth etc are some of the signs of trouble and should be addressed immediately. When ignored, the decay can spread reaching as far beneath as the pulp of the tooth, which in case of primary tooth is more vulnerable and exposed than secondary tooth. Primary teeth have very important roles to play when it comes to childrens’ oral care and development such as:

  • Primary teeth is essential for proper mastication of food
  • Primary teeth is important for proper speech development
  • Primary teeth presence improves self confidence in children
  • Primary teeth hold space for the proper growth of secondary teeth
  • Primary teeth helps in proper alignment when secondary teeth comes in

These are some of the roles that primary teeth play in children and this is why, taking care of teeth from a very young age is necessary. Unnecessary tooth extraction should not be done and the tooth, even if infected, must be treated properly and preserved using techniques such as dental crowns or dental fillings. This rule applies to children as much as to adults.

Dental Fillings v/s Dental Crowns in Primary Dentition

Dental Fillings and Dental Crowns both are techniques that are used when there are issues with the original tooth such as decay, small fractures or cracks etc. Dental fillings are suited for situations when the damage is comparatively less and can be easily fixed with fillings. These fillings are made from a variety of materials such as gold, silver, Composite Resin, Ceramic or porcelain and Glass ionomer, which is the recent addition to this list.

Each kind of filling, just like a dental crown, has their own advantages and disadvantages. Metal based fillings such as Gold and Silver have high lifespan and durability but have a jarring appearance that is not preferred by many. Tooth coloured options such as Composite resin, Ceramic or porcelain have lesser strength and durability but have excellent esthetics. Glass ionomer fillings are made with acrylic and glass and is one of the innovative methods that are used by dentists these days for gum line restorations. They are more suited for gum line fillings as they help in fighting off infections by releasing fluoride.

Inlays and Onlays are also popular methods where the filling is made within the bump of the tooth (cusps) or over the cusps of a few teeth which require restoration. These kinds of fillings are more durable and last longer than most kinds of dental fillings. They do take longer to be affixed on the tooth as they need to be made in a lab after taking impressions of the teeth post the decay is removed and the teeth structure is preserved. Once the structure is made, which is usually done with composite resin or porcelain, the structure is cemented into place after checking for fit and comfort. The procedure takes a few days more than fillings but is more durable, cost effective and helps to preserve the structure and strength of the teeth with minimal damage to the tooth. Temporary filling may also be needed in such a scenario until the inlay/onlay is ready.

There are many advantages to using dental filling while opposed to dental crowns but the most important factor is the strength of the teeth. Only if there is minimal damage to the tooth and the major portion of the tooth is preserved post treatment, only then can a filling be done on the tooth. This is checked and decided by the dentist based on the patients’ situation. If patients do qualify for a filling, then below are some of the advantages of dental fillings over crowns:

  • They are fast and can be done in one seating
  • There are plenty of tooth coloured options for fillings these days
  • If the filling comes off, it can be rectified easily
  • They are more economical than getting a crown
  • Less chances of allergies (especially nickel)

There are some disadvantages of fillings as well that needs to be addressed here:

  • They have a low durability than crowns (5 years at max)
  • Gold, silver or porcelain fillings can cost higher than some types of crowns
  • They are prone to chipping and breakage
  • Care needs to be taken to prevent accidental damage to the filling
  • Not suitable in cases where excessive teeth portion is removed
  • Not suitable in cases where the tooth structure is no longer strong enough

Dental Crowns are the best alternative in all the points aforementioned here. For cases where fillings are not the best option, a dental crown can be a good alternative and sometimes the only option. Stainless steel crowns are the best options for kids who are no longer a good candidate for dental fillings as fillings are mostly done on younger adults and children. Stainless steel crown for Pediatric dentistry has been in use for a long time and has proven efficacy in terms of preserving the original tooth and durability.

Pediatric Stainless steel crowns are one of the best options as they come in factory fit types and patterns. Prefabricated stainless steel crowns are easy to use and come in many different shapes and sizes and can easily be fitted on patients within a single fitting. This is a great advantage as children may not cooperate when it comes to dental procedures. Stainless steel crowns for adults is also a good option in older patients who have low dental hygiene and do not cooperate in dental procedures. Stainless steel crowns have so many benefits when compared to other options. Below are the advantages of stainless steel tooth crowns v/s dental fillings:

  • Perfect for a tooth that has had a large portion of the original tooth removed
  • Applicable for teeth that no longer has the strength to withstand fillings
  • Stronger and more durable than fillings
  • Much more cost efficient than fillings
  • If they come off, crowns can easily be fit back in
  • Not as prone to chipping, breakage or when compared to fillings

There are only a few drawbacks with stainless steel crown tooth when compared to fillings that needs to be addressed here:

  • The non-esthetic metal appearance of the crown
  • May need multiple crowns or bridges if more than one teeth is affected
  • Takes longer in case prefabricated crown did not fit

When compared to the shortfalls of fillings, the drawbacks of stainless steel crowns are much less and therefore, a better alternative to dental fillings wherever applicable. For patients who require a sturdier and more durable option such as kids who lose their primary teeth much early on, stainless steel crowns are a much better option given their durability and stronger nature.