Crowns for baby teeth

When a baby tooth needs a crown

Most cavities can be repaired with a filling. A crown comes in when there isn't enough strong tooth left for a filling to hold, or when the whole tooth needs protection.

Baby molars are small, and their enamel is thin. When decay spreads across several surfaces, a large filling has very little support, so it's more likely to crack or develop new decay around its edges. A crown wraps around the entire tooth and covers every surface at once.

Common reasons we recommend a crown

• Large or deep cavities, especially decay between two baby molars or on more than one side of a tooth.
• After pulp therapy. A baby tooth that has had its nerve treated is more fragile, and a crown seals and strengthens it. Learn more about baby root canals (pulp therapy).
• Weak or defective enamel. Some teeth form with thin, chalky, or pitted enamel that breaks down easily or feels sensitive. A crown can protect them and make chewing more comfortable.
• Broken or badly worn teeth from an injury or heavy grinding.
• High cavity risk. For a child who keeps getting new cavities, a crown may hold up better than a large filling that could need repair.
• Treatment under general anesthesia, when dentists often favor the most durable repair so a child is less likely to need treatment on that tooth again.

If you're wondering whether a baby tooth deserves that much protection, our parent guide Do baby teeth matter? Why cavities in baby teeth need treatment explains the jobs these teeth do and what can happen when decay is left alone.

Types of crowns for baby teeth

Children's crowns usually come pre-made in many sizes, so there are no molds to take and no waiting for a lab. There are three main kinds, each with its own strengths.

Stainless steel crowns

These silver-colored crowns have a long track record on baby molars and are known for being very durable. They need relatively little trimming of the tooth, can be shaped slightly for a snug fit, and tolerate a little moisture during placement, which helps with young children. The main drawback is appearance: they show when your child laughs or opens wide. Some versions have a white facing bonded to the front, which offers a middle ground on certain teeth.

White zirconia crowns

Zirconia is a strong, tooth-colored ceramic that looks natural and resists staining. Because these crowns can't be bent or crimped to fit, more of the tooth needs to be trimmed, and the gums must be healthy with bleeding controlled for the crown to seat well. That means they aren't the right fit for every tooth or every child.

Resin (strip) crowns

For front baby teeth, a dentist may fill a thin, clear form with tooth-colored composite, fit it over the tooth, and harden it with a light. The form peels away, leaving a natural-looking crown. Strip crowns need enough healthy tooth to bond to and a dry working area, and they can chip or wear sooner than other types.

How we help you choose

There isn't one right answer for every child. We'll talk through the options for each tooth and explain why we recommend one over another. We consider:

• Which tooth it is. Appearance matters most on front teeth, while back molars take the most chewing force.
• How much healthy tooth remains, and the health of the gum around it.
• How long the tooth still has to last. A molar with years to go needs a tougher repair than a front tooth that's already loosening.
• Your child's bite and habits, such as heavy grinding.
• How long your child can sit comfortably, since some crowns need a longer, drier working time.
• Your family's preferences and insurance coverage.

Some kids love showing off a shiny "superhero tooth," while others care a lot about matching. Both are perfectly fine.

What to expect at a crown visit

Because pediatric crowns are pre-made, most are placed in a single appointment. If the tooth also needs pulp therapy, that's usually done first, during the same visit.

1. Get comfortable

   We use our tell-show-do approach so your child knows what's coming. Parents are welcome chairside the whole time.

2. Numb the tooth

   A topical gel goes on first, followed by gentle local anesthetic.

3. Shape the tooth

   We clear away decay and reshape the tooth slightly so the crown can slip over it.

4. Find the right size

   We try on crowns until one fits snugly and lines up with your child's bite.

5. Cement it in place

   The crown is filled with dental cement and pressed into position, and the extra is cleaned away.

6. Check the bite

   Your child bites down so we can make sure everything feels even.

For a nervous child, laughing gas can ease worry while they stay awake. For extensive treatment, especially in very young children, we may discuss oral sedation or general anesthesia in a hospital or surgery center. Our sedation and laughing gas page explains how each option works.

Caring for a crown after the visit

The first day or two

The lip, cheek, and tongue on that side may stay numb for a few hours, so watch that your child doesn't nibble on them, and hold off on real meals until feeling returns. The gum around a new crown is often tender and may bleed a little during brushing for a day or two. The crown can also feel tight or "big" at first, but most kids stop noticing it within a few days. For soreness, follow your pediatrician's advice and the directions on a children's pain reliever.

Everyday care

• Brush along the gumline where the crown meets the gum. Plaque collects at that edge, and keeping it clean keeps the gum healthy.
• Floss beside the crown once a day.
• Skip very sticky treats, like taffy, caramels, and chewy candy, which can tug a crown loose.
• Keep up with routine checkups and cleanings, where we check the crown's fit and the gum around it.

If a crown ever comes loose or falls off, put it in a clean bag or container and call us at (916) 770-4567. It can often be re-cemented or replaced.

How long crowns on baby teeth last

A crown on a baby tooth is meant to stay put until the tooth is naturally ready to come out. Children usually lose their baby teeth from about age 6 to 12. As the adult tooth underneath moves up, the baby tooth's roots dissolve, and the tooth loosens and falls out with the crown still attached.

That timing is part of why crowns make sense for baby teeth. A large filling in a baby molar may need repair over the years, while a well-fitted crown usually lasts for the life of the tooth. We'll check it at each visit and let you know if anything changes.

Cost and insurance for crowns

Crowns on baby teeth are usually covered as a restorative service, but plans differ in how much they pay. Some cover stainless steel crowns at a higher rate than white crowns on back teeth, so the type you choose can affect your share.

We accept most PPO plans and verify your benefits before treatment, so you can weigh appearance, durability, and cost with real numbers in front of you. See our insurance and payment details to learn more.