Stainless Steel Crown

Baby teeth are naturally smaller than adult teeth. Compared to a large adult tooth, neglected caries, damage the small structure of the tooth a bit faster.

Dental caries is a common infection in baby teeth. Restoration is necessary because it can affect aesthetics, speech, mastication and ultimately the overall health of your child. Important factors for the treatment of a decayed primary tooth depends on:

• The stage of decay
• Age of the patient
• Cooperation of the patient

Stainless Steel Crowns are also called SSC or SS crown.

A severely decayed primary tooth can sometimes be restored. Dental procedure for kids can be challenging for both the patient and their dentists. Therefore, it is desirable to use a restoration method with an expected high success rate to avoid exposing children to frequent dental procedures. Stainless steel crowns are the most popular restoration technique for the baby teeth. The application of stainless-steel crowns for baby teeth has become very common because it can be placed in a single appointment and it has a relatively high success rate.

Some kids maybe allergic to Nickel and stainless steel crown may not be a suitable option. Some parents don’t like the look of silver crowns because they are not aesthetically pleasing. For alternative treatments refer white Zirconia crowns for Kids in Brisbane.

The structure of a baby tooth is relatively small. Baby tooth does not have enough space to hold restorative material. Stainless steel crowns are the best choice for the restoration of baby teeth. With SS crowns, recurrent or further caries are highly unlikely. They are economic, durable and have a low rate of complications during their lifespan. Stainless steel crowns have a good record of protecting the tooth from further carious attacks. For more than 40 years dentists have consistently reported a high success rate for the restoration of primary molars and once placed, they rarely require any replacement.

Baby teeth have known life expectancies. The restoration of a baby tooth should last as that remaining of the tooth. Stainless steel crowns have been used traditionally to fix a badly damaged baby tooth or when the remaining tooth structure is minimal e.g. restoration of large multi-surface cavities or restoration of grossly broken-down teeth. The great thing about Stainless steel crowns is that it can be prepared and placed at a single appointment and they are sufficiently durable and relatively low cost (because there is no need for them to last that long compared to a dental crown for adults).

Because of the size of the tooth itself, the impact of caries of the same size is more significant on baby teeth compared to adult teeth. Let’s say that caries has damaged 0.5 grams of the tooth tissue and an adult tooth is say 2 grams and a baby tooth is 1 gram. In this case, 0.5/1 =50% of the baby tooth is damaged while the same amount of caries has only damaged 25% of the adult tooth (0.5/2=25%). Because of the smaller structure of primary dentition, the damage to primary teeth structure would be consequently more significant.

Young children, in general, have behaviour that is not conductive to a textbook-based dental restoration.  Therefore, technique-sensitive procedures are not appropriate for young children when the child is not able to cooperate with dental treatment under local anaesthesia. In such cases dental treatment under sedation or general anaesthesia will be required. Dental treatment under general anaesthesia necessitates the highest standards of dentistry possible. A high standard dentistry is required to reduce the need for dental treatment for high-need children. Including:

• Non-cooperative children
• Children with special needs

Stainless steel is meant to provide a provisional cover. They usually last until the primary teeth are replaced with permanent teeth. SS crowns can also be used when permanent first molars have severe developmental defects. SS crowns may be used in permanent molar where the entire crown of the tooth is severely damaged due to developmental problems. In this case, the SS crown would be used as a temporary fix until the patient (or parents) can decide whether the tooth should be restored or removed for a dental implant or other suitable artificial teeth. Sometimes SS crowns are placed until a permanent cast crown can be made for the tooth.

SS crown is commonly used as a semi-permanent restoration solution for some adolescent patient. SS crown would be replaced with a porcelain when adequate secondary dentine has formed.

SS crown is indicated when extensive decay exists in primary teeth (baby teeth). E.g. when two or more cusps are damaged by caries. It is commonly found in the first molars when the distal interproximal carious lesion is untreated.

SS crown is also indicated after pulp therapy because the tooth becomes more brittle after a pulp therapy procedure. Placing a stainless-steel crown prevents post op tooth fracture.

SS crown is also used as a preventative restoration and is a considerable alternative for fillings. With SS crown tooth fracture or filling failure is avoided. Application of SS crown can prevent development of caries in other parts of the tooth. SS crown has an indication when oral hygiene is physically challenging e.g. for a disabled child

SS crown can be used to mask the developmental defects of a tooth because a bad anatomy can encourage plaque accumulation and consequently the tooth would be more susceptible to caries.

Pulpotomy / Pulpectomy procedure on a primary tooth is a clear-cut indication for use of stainless-steel crowns.

Pretrimmed stainless steel crowns: they have straight sides but undergo festooning to follow a line parallel to the gingival crest. These crowns should be trimmed and contoured to fit the tooth

Pre-contoured stainless-steel crowns: they are festooned already and contoured. Some additional trimming and contouring may be necessary, but this need is usually minimal

Stainless steel crowns (SS crown) is without doubt, the most durable restoration for baby teeth. SS crown is also the restoration technique of choice for a high caries mouth or when a high level of reliability of the restoration is required.

• Stainless steel crowns can be used for both primary and permanent teeth.
• Well-tolerated by the gingiva of young patients
• Less costly compared to cast restorations
• Available in variety of sizes

Stainless Steel Crowns (SSC) can protect teeth from future decays because SSC provides full coverage for the teeth and has increased durability and longevity. Therefore, strong consideration is given to the use of Stainless-Steel Crowns to the kids who require dental treatment under general anaesthesia. In terms of cost, it is strongly argued that SSC is the most cost-effective solution because of its durability and longevity.

• Stainless Steel Crown following a Pulpotomy / Pulpectomy
• Fractured primary teeth
• Primary teeth with developmental defects
• Primary teeth with large carious lesions involving multiple surfaces (where fillings may fail)

Children with oral conditions below, should be treated with SS crowns:

• Extensive decays
• Large lesions
• Multiple surface lesions in primary molars

Risk assessment and judgment is required in situations with less clear-cut indications for use of SSC. In such situations these needs to be considered:

• Caries risk factors
• Restoration longevity
• Cost of the treatment

Children at high caries risk, exhibiting with decays in front teeth or caries in back teeth may benefit from SSC.

One of the advantages of the ss crowns is that it can be easily changed into a new shape. Stainless steel crown is required to restore a young permanent molar.

The process is as follows:

1. The crown is selected, and the tooth is prepared for fit
2. The ss crown is properly sized to fit snugly on the tooth
3. Cement the selected crown with a specific adhesive.

1. Rubber dam or cotton rolls are placed after local anaesthetic has taken effect
2. The dentist uses the high speed to prep the tooth for the crown
3. The height and the circumference of the tooth is reduced
4. Caries are removed

SS crowns can be used as a space maintainer. Crown and loop space maintainer is an example.

One of the indications to use stainless steel crown is for teeth with developmental defects of the enamel. Kids with chalky teeth (MIH) may also benefit from stainless steel crowns.