Gleaming Grace: The Artistry of Pediatric Crown Elegance

The history of pediatric crowns can be traced back to 50-60 years from now as more and more dentists started to use crowns that were performed to replace teeth that were structurally compromised. Pediatric crowns, unlike dental crowns, have been around for a shorter duration as the need and awareness towards primary tooth health rose amongst parents and children alike. Dental crowns of all types have been around since the early 1940’s but the popularity of pediatric crowns and especially esthetic pediatric crowns is far more recent. 

Children today are at a high risk of early age caries and dental issues and coupled with the lack of awareness towards the roles and functionality of primary teeth, more and more children are prone to extraction and early loss of primary tooth. It is important to remember that children who are susceptible and patients to early age caries and loss of tooth are also highly susceptible to dental issues such as cavities, tooth damage and malocclusion to name a few, in their future. 

A study in 2019 revealed that one in 4 kids had early age caries and 18% of children below the age of 5 have undergone tooth extraction. The percentage was much higher if you include children until age 8 which stood at a whopping 42%. It can be concluded from this figure that children are at a high risk of losing their primary teeth and given how precious and irreplaceable they are, the need for artistic and fail- proof pediatric dental solution was required. This gave birth to several preformed crown forms for pediatric patients, some of which are still popularly used for pediatric patients.

Modern Pediatric crowns and their types

Pediatric crowns are dental crowns that are used by dentists to support the failing tooth structure by providing a complete, full body restoration option that not only can help in preserving the damaged tooth (post the removal of the damaged/infected portion), but can also retain and retrieve the functionality of a primary tooth which is essential for a young child as he or she learns to chew food, speak and pronounce properly and develops the natural shape of the jaw. Losing out on primary teeth at a very young age interrupts these natural processes and undermines the self confidence of a child as the child may feel incomplete without their tooth.

Pediatric crowns help in covering up the dental flaw either due to infection or early age caries or for cosmetic reasons such as highly discoloured tooth, misshapen or crooked tooth, cracked or fractured tooth etc. Their versatility as a dental restorative option is what makes them the perfect option for their use in paediatric patients. Historically, metal crowns were the most popular type of pediatric crown that was used for children which included the likes of stainless steel crowns. But modern day needs require esthetic options and therefore, there are many new types of esthetic pediatric crowns that have been introduced in the market that mimic the natural shade of the tooth and are super identical to the patients using enamel making them extremely esthetic and natural.

These aesthetically pleasing white pediatric crowns are a great option for the new age kids who are more self aware and no longer care for metallic appearances of SSC crowns. Especially with anterior restorations, paediatric crowns front tooth must look identical to the rest of the teeth to blend in and look perfectly natural. Thanks to the advancements made in pediatric dentistry, parents and children can now choose from a variety of options based on their needs such as features, budget and longevity. 

1. Preveneered stainless steel crowns

One of the most common solutions offered by dentists worldwide for caries and tooth loss in children is by replacing the same with stainless steel crowns. Stainless steel crowns have been around for a very long time and are one of the most reliable, durable and the most pocket friendly options for parents who are looking for a definite but low cost fix. 

Since stainless steel crowns are not ideal when it comes to esthetics, preveneered stainless steel crowns have a white facing or a resin facing which mimics a white, enamel like exterior that looks similar to the natural colour tone of the tooth. Although they do not look exactly like a primary tooth enamel which is slightly yellow, these crowns are an excellent option for those who are looking for a low pediatric crown cost, esthetic fix for posterior restorations, especially for the molars. Preveneered Stainless steel crowns have excellent features including:

1. 1. High strength 
2. 2. High bite force
3. 3. Low maintenance
4. 4. Good esthetics
5. 5. Low cost
6. 6. Perfect for molar restorations

There are also some cons with resin facing stainless steel crowns such as:

• They may require higher space and so, removal of higher tooth are to accommodate the crown structure, posing a threat to the overall structure
• They are sensitive to technique and requires higher chair side time
• Not ideal for patients who have metal allergies

2. Pediatric Zirconia crowns

Zirconia crowns have been around since the late 2000’s and have become one of the most successful solutions to the world's dental problems especially with its impeccable aesthetics. Zirconia offers unmatched esthetics that mimic the natural enamel and with advanced staining and glazing techniques, adult crowns made from zirconia can be shade matched to the rest of the teeth making it one of the best options out there for those looking for high quality, high durability, esthetic crown options. 

When it comes to pediatric crowns, the same applies. Although pediatric crowns are preformed or premade and therefore shade matching is seldom possible, they are still one of the best esthetically pleasing options in the market that look mostly like human teeth. They are extremely strong, very durable and are low maintenance which make them ideal for young children who have lost their primary teeth much earlier in their lifecycle. Zirconia crowns can easily outlast most of the crowns thanks to its unmatched qualities such as:

• 1. High esthetics
• 2. Extremely strong
• 3. Very durable
• 4. Biocompatible
• 5. Resistant to plague and buildup

There are some cons to zirconia crowns as well such as:

• They are definitely more expensive than the other crowns but owing to their qualities, they still make more sense in terms of investment
• They are harder to contour
• Higher chair side time (may not be an ideal option for uncooperative patients)

3. Polycarbonate crowns

Polycarbonate crowns are made from carbonic acid polyesters and mimic the quality of plastic crows. They are milky white and look pretty much like primary teeth and are therefore esthetic in nature and can be used for posterior as well as anterior restorations. They are made with high pressure at a high temperature giving them good moulding ability and therefore easy to create shapes and sizes that make a perfect fit. They are comparatively lower priced to zirconia and porcelain crowns and therefore are a good alternative to these crowns.

However, owing to their polycarbonate resin shells that are prone to fractures and premature crown loss, they are not to be used on patients who have bruxism, have low dental and oral health, have crowded tooth or with a deep and hard bite (all of which are risk factors for crown fracture and loss). They are also technique sensitive as well as high maintenance.

4. Clearstrip crowns

Plastic crowns that are filled with composite material that look and feel just like human teeth is what clearstrip crowns are all about. Using the right filling material and the placing technique, dentists can easily place these crowns, contour and trim them, leaving behind a smooth and soft surface that looks and feels just like human teeth with similar colour gradient. They are cheap and easy to fix and therefore a great option for pediatric patients who are prone to loss of crowns often. 

Some cons of these crowns are that they are extremely technique sensitive and require haemorrhage and moisture control during the time of their placement. Saliva and blood can interfere with the bonding process and can easily discolour the crown owing to its transparent nature. They are also prone to fracture which may pose a risk for patients who have excessive bruxism and a deep bite. Excellent oral health and dental practices must be followed when these crowns are in place as well as their appearance are easily affected with poor oral hygiene.