Most parents are surprised to learn that dental crowns are sometimes recommended for children, including for baby teeth. It can seem counterintuitive to invest in a restoration for a tooth that will eventually fall out, but preserving baby teeth matters more than many parents realise. Baby teeth hold space in the jaw for permanent teeth, support speech development, and allow children to eat comfortably — all of which make their preservation genuinely worthwhile in many situations.
The types of crown used for children differ from those used in adult dentistry, and the reasons for recommending them also have their own particular context. Understanding when and why a dentist might suggest a crown for your child’s tooth can help you feel confident in any treatment decisions you are asked to make on their behalf.
Why Baby Teeth Matter More Than You Might Think
Baby teeth, also known as primary teeth or deciduous teeth, begin to appear from around six months of age and are gradually replaced by permanent teeth from around age six onwards. However, some baby teeth, particularly the back molars, are not replaced until a child is 10 to 12 years old or even later. This means a badly damaged molar in a five-year-old may need to last another five to seven years — a significant period of time.
When a baby tooth is lost prematurely due to untreated decay or extraction, the neighbouring teeth can drift into the gap, reducing the space available for the permanent tooth that should eventually erupt there. This can lead to crowding and orthodontic issues that are far more difficult and expensive to address later. Preserving the baby tooth, even with a crown, is often the more sensible long-term approach.
When Are Crowns Recommended for Children?
Dentists do not recommend crowns lightly, and the decision is always made in the child’s best interest based on the clinical situation. Common scenarios where a crown may be appropriate include:
- Extensive decay: When a cavity is too large to be restored with a filling, a crown is needed to hold the remaining tooth structure together and prevent the tooth from breaking.
- Tooth fracture: A tooth that has cracked or broken due to an injury or from biting something hard may require a crown to protect the remaining structure.
- Following pulp treatment: If a child requires a pulpotomy or pulpectomy (similar to a root canal in adults) to treat infected nerve tissue, a crown is typically placed afterwards to protect the weakened tooth.
- Developmental defects: Some children are born with enamel defects such as hypomineralisation or amelogenesis imperfecta, which cause the enamel to be soft, thin, or poorly formed. These teeth are highly susceptible to decay and damage, and crowns are often needed at an early age.
- Multiple decayed teeth: In cases where a child has widespread decay affecting multiple teeth, crowns may be recommended to restore several teeth at once, sometimes under general anaesthetic.
Types of Crown Used for Children
The most commonly used crown for children’s back teeth in the UK is the stainless steel crown (SSC). These are prefabricated metal crowns that come in a range of sizes to fit different teeth. According to patient information from Cambridge University Hospitals NHS Foundation Trust, stainless steel crowns are highly durable, easy to place, and more successful at protecting decayed or damaged baby teeth than large fillings in most cases.
Two main techniques are used to place stainless steel crowns in children:
- Conventional technique: The tooth is prepared by removing decay and shaping the tooth before the crown is cemented in place. Local anaesthetic is used.
- Hall technique: The crown is placed over the tooth without any drilling or decay removal. The crown seals off the decay and stops it progressing. This technique is particularly well-suited to anxious children as it avoids drilling entirely.
For front teeth, tooth-coloured crowns made from composite resin or strip crowns are sometimes used for aesthetic reasons, though these are generally less durable than stainless steel and are more commonly used for front teeth where appearance is a priority.
Comparing Crown Types for Children
| Crown Type | Best Used For | Advantages | Limitations |
|---|---|---|---|
| Stainless Steel Crown (SSC) | Back teeth (molars) | Very durable; long-lasting; high success rate | Metal appearance; not suitable for front teeth |
| Strip Crown (composite) | Front teeth | Tooth-coloured; better aesthetics | Less durable; more technique-sensitive |
| Zirconia Crown | Front and back teeth | Tooth-coloured and strong; good for anxious children | More expensive; not always available on NHS |
| Hall Crown (SSC, no prep) | Decayed back teeth | No drilling required; ideal for anxious children | Metal appearance; slight bite change initially |
What to Expect During the Appointment
The process of placing a stainless steel crown is generally straightforward and can usually be completed in a single appointment. For the conventional technique, your child will receive local anaesthetic to numb the area before any preparation. The Hall technique does not require any anaesthetic or drilling at all, which many children find considerably less daunting.
The dentist will select the appropriate size of crown for the tooth, check the fit, and then cement it in place. The whole process typically takes between 15 and 30 minutes per tooth. Your child may notice that their bite feels slightly different immediately afterwards as the crown is slightly thicker than the natural tooth, but this normally settles within a few days as the bite adjusts.
Will the Crown Fall Out When the Baby Tooth Does?
Yes. When the time comes for the baby tooth to be shed naturally, the crowned tooth will come out in the same way as any other baby tooth. The stainless steel crown will simply come out along with the tooth. The permanent tooth that replaces it will erupt normally and will not be affected by the fact that the baby tooth had a crown. There is no need for the crown to be removed separately before the tooth is ready to fall out.
What About Crowns on Permanent Teeth in Children?
While stainless steel crowns on baby teeth are the most common scenario, children can also require crowns on their permanent teeth. Teenagers who have experienced significant trauma to a front tooth, or whose permanent molars have severe enamel defects such as molar-incisor hypomineralisation (MIH), may need a crown to protect and restore the affected tooth. In these situations, the approach is similar to that used in adult dentistry, though the dentist will take the child’s age and stage of dental development into account when planning treatment.
It is also worth being aware that for younger children whose permanent teeth have only recently erupted, the nerve of the tooth is larger and the roots may still be developing. This influences the treatment options available and means that careful monitoring is particularly important in the years following crown placement on a young permanent tooth.
Keeping Crowned Baby Teeth Healthy
Even after a crown has been placed, good oral hygiene remains essential. The gum tissue around the crown can still be affected by plaque build-up, and other teeth in the mouth continue to need careful brushing and a diet low in sugar. Encourage your child to brush twice daily with a child-appropriate fluoride toothpaste, and help younger children until they are able to manage independently. Regular dental check-ups every six months allow the dentist to monitor the crown and all the surrounding teeth.
If you are concerned about your child’s teeth or would like to discuss whether a crown might be appropriate, our practice at Tarbert Dental Surgery offers a friendly, caring environment for children and families. Our team is experienced in treating children of all ages and will always explain the options clearly so that you can make an informed decision. Call us on 01880 820 387 to arrange an appointment for your child.