A dental crown is a tooth-shaped covering cemented to the tooth for the purpose of restoring the tooth to its original shape and function. Crowns are used in paediatric dentistry for various reasons, namely when it is necessary repair and restore a primary (baby) tooth found to be extensively decayed; a tooth has been fractured due to trauma; or a primary tooth has not developed correctly. Crowns are much more durable than fillings, and usually last until the baby tooth falls out at about age 12.
In addition to repairing a badly decayed tooth, It is very important to repair and restore primary teeth for the following reasons:
- Since the enamel of baby teeth is thinner than that of permanent teeth, decay can spread rapidly between teeth. Crowns can be used not only to save the decayed tooth, but can also help prevent the spread of decay and infection to other areas of the mouth or body.
- Crowns restore a tooth’s shape, size, and function. Since one main function of primary teeth is to hold the spacing for the permanent teeth and help guide the permanent teeth into position, crowns are a very important part of oral health and development.
- Crown restorations aid in the normal development of a child’s jawbone and muscles.
- Crown restorations allow for proper speech development.
- Crown restorations are imperative for the chewing of food.
- Crown restorations cover the entire tooth, and therefore prevent the tooth from further decay.
TYPES OF CROWNS:
STAINLESS STEEL CROWNS
Stainless steel crowns are more cost effective and are the treatment of choice for large areas of decay.
Preformed (stainless steel) crowns have been used over 50 years to save teeth that otherwise would be lost or when other treatments would fail. One of the strongest and most durable services in dentistry, they last longer than fillings and cost less than other types of crowns. Their greatest disadvantage is that stainless steel crowns are not the colour of teeth, but the colour of polished silver.
The treatment process is the same for stainless steel crowns as for tooth coloured crowns. First, the decay is removed from the tooth. Next, the tooth is made smaller so the crown can fit over it. The crown is cemented into place.
Strip crowns consist of a clear shell which is filled with tooth-coloured composite (filling) material and fitted over the tooth. Once the composite material ‘sets’, the plastic covering is removed, leaving behind the tooth-coloured material. Strip crowns are the more aesthetic option and are often used on front teeth. They are also moderately priced.
Zirconia crowns are made of a hard tooth-coloured material similar to ceramic and are pre-made to specific sizes. They are also virtually indestructible stronger and more durable than natural enamel and are arguably the most aesthetically-pleasing of all crowns. Zirconia crowns are resistant to plaque accumulation and decay and are also biologically-inert do not initiate an allergic response when introduced to biological tissue
Steps to restoring primary teeth with a crown?
In most every dental crown procedure, there are a few universal steps. First the dentist will numb the area around the tooth to be restored, put a dental dam in place, as well as remove decay and shape the tooth to fit the crown. Unlike crowns for adults, which often require several visits to the dentist, most crowns for children can be placed in a single procedure.
We evaluate each patient to ascertain which type of filling is most appropriate. We also avoid the use of Mercury fillings that may cause any damage or be a risk for our children. We mostly work with Composite White fillings, an advanced dental material that allows us to match the natural color of the patient’s teeth with a life span of 6 to 12 years.
To treat a cavity, the first step is to remove the decayed part of the tooth. Paediatric dentistry now offers three choices for decay removal: the traditional dental ‘drill’, microabrasion and laser treatment.
- The dental ‘drill’, called a handpiece, remains the technique of choice for removing tooth decay. High-speed handpieces make treatment quicker and more comfortable than in the past, although children still may feel vibrations during the process.
- Microabrasion is different than cosmetic forms of microabrasion, a high-pressure instrument cuts away decay by blowing a stream of tiny particles at the tooth. Microabrasion is comfortable for children and free of the vibrations of the drill, although it cannot be used for all types of cavities.
- A dental laser light can cut through the decayed part of the tooth to remove it. It is usually comfortable and is free of the vibrations felt with the drill, however laser treatment may take longer than the other two approaches and cannot be used on teeth that already have fillings. Because this approach is relatively newer than more traditional approaches, many paediatric dentists are taking a ‘wait and see’ attitude on the practicality and effectiveness of lasers.
Once the decay is removed, the next step is filling the hole where the decay was. Talk to a paediatric dentist about which of the many choices of filling materials is best for the child.
ROOT CANAL TREATMENT & PULP THERAPY IN CHILDREN
The pulp in your child’s teeth is the tissue, nerves and blood vessels filling the interior cavity and root canals of a tooth. The function of the pulp is to provide a blood supply with oxygen and nutrients for the tooth. Teeth affected by cavities, traumatic injury, or other causes can lead to pulp exposure, pain and inflammation. When this occurs the primary objective of pulp therapy is to maintain the integrity and health of the tooth and the supporting tissues. This is especially important in young permanent teeth with immature roots as the pulp is integral to normal development of the apex of the root.
Signs of injured or damaged pulp
Teeth, which are damaged by either traumatic injury or decay, can lead to pulp exposure that causes severe pain and swelling to the affected area. Signs of inflamed or infected pulp include:
- Constant or unexplained pain
- Nighttime pain
- Sensitivity to hot or cold food temperatures
- Swelling around the infected tooth
Steps in pulp therapy
Pulp therapy is a procedure in which the dentist will maintain the tooth so it is not lost. The two most common forms of pulp therapy are pulpotomy and pulpectomy. A pulpotomy removes the diseased pulp within the crown of the tooth. The pulp root remains healthy and unaffected. Once the diseased portion has been removed an agent is placed in the tooth to prevent bacteria growth and infection and calm the nerve of the tooth. Finally, a crown is placed on the tooth. The crown strengths the tooth and minimizes the risk of future fractures.Pulpoptomy can be used a treatment on baby or permanent teeth.
Pulpectomy is necessary when the entire pulp is involved from the crown to the root canals of the tooth. The diseased pulp is completely removed from the tooth. The canals are then cleansed, disinfected and packed with a reabsorbable material. If the tooth is a permanent tooth, a non-reabsorbable material is used. Final step is place a crown over the tooth to provide strength and support to the tooth.