Back in 1947, Engel introduced one of the most used dental prosthesis worldwide: Stainless Steel Crowns.
Dental caries is a common disease that affect children. In fact, according to WHO, 60-90% of children are affected by caries worldwide. This raises a concern not just about their future oral and dental health, but also about the deleterious effect this disease has on overall health and quality of life.
That’s why we as dentists love stainless steel crowns.
These prefabricated, metallic silver caps are reported to protect baby teeth from decay with a great success rate that exceeds 90% over a period of 4 years.
At this point, you may still have a lot of questions about stainless steel crown, that’s why I tried my best to create this guide for you with as much relevant and valuable information as possible.
Without further notice, let’s start!
What Are Stainless Steel Crowns?
Stainless steel crowns are dental prosthetics (like a cap) that are made from high-quality stainless steel material.
| Iron | 67% |
| Nickel | 10-13% |
| Chromium | 17-19% |
| Other elements | 4% |
These crowns are designed with precision to cap and encase a damaged or weakened tooth closely, with the primary purpose of restoring the structural integrity and function of a compromised tooth.
You can view them as protective shields, preventing further damage or decay, and offering support to the tooth’s natural structure.
Scientifically speaking, stainless steel crowns are biocompatible, meaning they are safe for use in the human body and don’t typically cause allergic reactions or adverse tissue responses.
While stainless steel crowns may not be the most aesthetically pleasing option due to their metallic appearance, their unmatched strength and resilience make them ideal for posterior (back) teeth, which endure significant biting forces.
Stainless steel crowns are often used in children, but can be used also in adults when a tooth requires substantial restoration, such as in cases of extensive decay, fractures, or after a root canal treatment.
Durability and advantages of stainless steel crowns
Stainless steel crowns offer several notable advantages, with durability being one of their most prominent features.
Here’s other advantages of stainless steel crowns:
1. Resistance to Corrosion: Stainless steel is highly resistant to corrosion, which is a crucial factor in the oral environment. Saliva and food particles can be corrosive to certain materials, but stainless steel remains unaffected, maintaining its integrity over time.
2. Strength and Stability: Stainless steel crowns are robust and stable. They do not fracture or chip easily, ensuring that the tooth underneath is well-protected. This strength is especially advantageous for teeth with extensive decay or those that have undergone root canal treatment.
3. Cost-Effective: Stainless steel crowns are cost-effective compared to many other crown materials. This affordability makes them a practical choice for both patients and dental practitioners, particularly in cases where insurance coverage may be a concern.
4. Quick and Efficient Placement: The process of placing stainless steel crowns is typically quicker and less complex compared to some other crown materials.
Dentists can often complete the procedure in a single visit, which can be more convenient specially with anxious kids.
5. Temporary and Permanent Use: Stainless steel crowns are versatile and can serve as both temporary and permanent solutions. They are commonly used as temporary crowns in pediatric dentistry, protecting primary (baby) teeth until they naturally fall out. For adults, they can also serve as permanent crowns when aesthetic concerns are not a priority.
6. Reduced Sensitivity: Stainless steel crowns provide a protective barrier that can help reduce tooth sensitivity, especially in cases where the tooth’s enamel has been compromised.
7. Minimal Tooth Preparation: Unlike some other crown materials that require more extensive tooth preparation, stainless steel crowns often necessitate less removal of healthy tooth structure, promoting tooth preservation.
In summary, the durability and advantages of stainless steel crowns make them a valuable option in modern dentistry.
They are particularly well-suited for situations where strength and functionality are needed, and they provide an effective, cost-efficient, and reliable solution for extensive caries cases.
When do we use them?
Here are some of the dental conditions and situations where stainless steel crowns are recommended:
Extensive Decay
SSCs are frequently used to restore primary (baby) molars that have extensive decay or cavities. These crowns are durable and can withstand the biting forces in the back of the mouth, making them an excellent choice for children who may not have the best oral hygiene habits.
After Pulp Therapy
In cases where a child’s primary tooth requires pulp therapy (pulpotomy or pulpectomy), a stainless steel crown is often placed over the tooth to protect and strengthen it after the procedure.
Teeth with Structural Defects
If a child has primary molars with structural defects like enamel hypoplasia or hypomineralization, stainless steel crowns can provide the necessary protection and stability for those teeth.
This is particularly important in syndromes like molar-incisor hypominerlization.
You can read more about it here.
Fractured Teeth
Severe Fractures: When a primary tooth has a severe fracture that cannot be adequately restored with a filling, an SSC may be used to cover and protect the remaining tooth structure.
Space Maintenance
SSCs can be used as space maintainers to hold space for permanent teeth when primary teeth are lost prematurely. This helps ensure proper alignment of permanent teeth as they erupt.
Special Needs Patients
Stainless steel crowns are often used in cases involving children with developmental or behavioral issues who may have difficulty maintaining good oral hygiene or cooperating during dental procedures.
Limited Appointment Time
SSCs are relatively quick and easy to place compared to more complex restorations, making them suitable for situations where a speedy solution is needed.
It’s important to note that stainless steel crowns are typically used in pediatric dentistry for primary teeth due to their durability and ease of placement. For permanent teeth in adults, other types of crowns, such as porcelain-fused-to-metal or all-ceramic crowns, are more commonly used for esthetic and functional reasons.
The Stainless Steel Crown Procedure for Primary Molars
Getting a stainless steel crown involves several steps, and here is a detailed step-by-step process:
Certainly! Here’s a step-by-step explanation of the prefabricated stainless steel crown procedure for primary molar teeth, explained as if I’m talking to parents:
Step 1: Initial Evaluation
Before we start the procedure, your child’s dentist will carefully examine their primary molar tooth that needs the stainless steel crown. This examination helps the dentist assess the extent of the problem, which could be severe decay, a structural issue, or a fractured tooth. The dentist will also ensure that a stainless steel crown is the best treatment option.
Step 2: Local Anesthesia
To ensure your child doesn’t experience any pain during the procedure, the dentist will use local anesthesia to numb the tooth and the surrounding area. This will keep your child comfortable throughout the process.
Step 3: Tooth Preparation
With the tooth numbed, the dentist will start by removing any parts of the tooth that are decayed or damaged. This is important to create a stable and clean surface for the crown to fit properly. The dentist will reshape the tooth to make room for the stainless steel crown.
Step 4: Crown Selection
Stainless steel crowns come in various sizes to fit different tooth shapes and sizes. The dentist will select a prefabricated stainless steel crown that matches the size and shape of your child’s prepared tooth. These crowns are specially designed to fit primary molars.
Step 5: Crown Placement
The dentist will carefully place the selected stainless steel crown over the prepared tooth. The crown will cover the entire tooth to provide maximum protection and durability. It’s important to note that these crowns are silver in color, which is normal for stainless steel crowns.
Step 6: Crown Adjustment
After placing the crown, the dentist will check your child’s bite to ensure it aligns correctly with the other teeth. They may make minor adjustments if necessary to ensure a comfortable and functional fit.
Step 7: Final Cementation
Once the crown fits perfectly and your child’s bite is correct, the dentist will use a special dental cement to bond the stainless steel crown securely in place. Any excess cement will be carefully removed.
Step 8: Post-Procedure Care
Your child’s dentist will provide you with instructions on how to care for the stainless steel crown. It’s important to follow these guidelines to maintain the crown’s longevity and the health of the underlying tooth. Usually, your child can resume regular eating and drinking shortly after the procedure.
Step 9: Follow-Up Appointments
Your child’s dentist will schedule follow-up appointments to monitor the condition of the stainless steel crown and check for any issues. These appointments are essential to ensure that everything is healing correctly.
Stainless steel crowns are durable and can protect your child’s primary molar for several years. They are an excellent option for restoring the health and function of a decayed or damaged primary tooth, allowing your child to chew, speak, and smile comfortably.
If you have any concerns or questions about the procedure, don’t hesitate to discuss them with your child’s dentist during the initial consultation or follow-up appointments. Your child’s dental health is a top priority, and the dentist is there to address your specific needs and concerns.
Cons
While stainless steel crowns (SSCs) offer numerous advantages, they also have some drawbacks and limitations. Here are some of the cons or disadvantages associated with stainless steel crowns:
- Esthetics: SSCs have a silver color, which can be highly visible in the mouth. This makes them less esthetically pleasing than tooth-colored restorations like porcelain or composite fillings. For this reason, they are typically used on posterior (back) teeth, where esthetics are less of a concern.
- Non-Reversible: The preparation of a tooth for an SSC involves removing a portion of the tooth’s structure. This process is irreversible, meaning that once an SSC is placed, the tooth will always require a crown or restoration of some kind.
- Thermal Sensitivity: Some patients may experience increased sensitivity to hot and cold temperatures initially after the placement of an SSC. This sensitivity usually subsides with time but can be uncomfortable for a short period.
- Risk of Allergic Reactions: While rare, some individuals may have allergies or sensitivities to the metals used in stainless steel crowns. Dentists typically inquire about allergies or sensitivities before placing an SSC.
- Visible Margins: In some cases, the margin where the SSC meets the natural tooth may be visible, especially if the crown is not properly seated or if gum recession occurs over time. This can affect the appearance of the restoration.
- Difficulty in Monitoring: The metallic nature of SSCs can make it challenging to monitor the underlying tooth for potential issues, such as recurrent decay or changes in the tooth’s health, without the use of X-rays or other diagnostic tools.
- May Require Replacement: While SSCs are durable, they are not permanent solutions. They are commonly used in pediatric dentistry because they are expected to serve for the duration of primary teeth. However, in some cases, they may need to be replaced due to wear or damage.
- Not Suitable for All Teeth: SSCs are primarily used for molars and premolars due to their strength and durability. They may not be suitable for front teeth or teeth with extensive esthetic demands.
- Potential for Complications: As with any dental procedure, there is a small risk of complications, such as improper fit, cementation issues, or bite problems. Regular follow-up appointments are necessary to monitor the crown’s condition and address any potential problems.
Caring for Stainless Steel Crowns
- Maintain regular oral hygiene by brushing and flossing around the stainless steel crown daily.
- Avoid sticky or hard foods that could damage the crown.
- Schedule and attend regular dental check-ups to monitor the condition of the crown and underlying tooth.
- Address teeth grinding or clenching habits with your dentist if applicable.
- Keep an eye out for any changes in the crown or surrounding gum tissue and contact your dentist if you notice any issues.
- Limit sugary snacks and drinks in your diet to reduce the risk of tooth decay.
- Consider fluoride supplements or mouth rinses if recommended by your dentist.
- Consult your dentist for any special care or precautions needed for children with special needs who have SSCs.
- Promptly replace loose or damaged SSCs to maintain oral health.
Cost and Insurance Coverage
The cost of stainless steel crowns (SSCs) and insurance coverage can vary based on several factors, including your location, the specific dental practice, your insurance plan, and whether the crown is for a primary (baby) tooth or a permanent tooth. Here’s an overview of the cost and insurance considerations for SSCs:
Cost
- Primary Teeth (Pediatric Dentistry): The cost of an SSC for a primary tooth is typically lower than that for a permanent tooth. On average, you can expect to pay between $300 and $800 per SSC for primary teeth. However, prices may vary widely depending on the region and the specific dental practice.
- Permanent Teeth: For permanent teeth, the cost of an SSC is generally higher than for primary teeth. The price range can vary between $700 and $1,500 or more per crown. The cost may increase if additional procedures, such as root canal therapy, are required.
- Additional Costs: It’s important to consider any additional costs, such as the initial consultation, tooth preparation, and follow-up appointments, which may be included in the overall cost.
Insurance Coverage
- Dental Insurance: Dental insurance plans often cover a portion of the cost of dental restorations like SSCs. The coverage percentage varies depending on the specific insurance plan. Generally, pediatric dental coverage may be more comprehensive, while adult dental coverage may be less so.
- Preauthorization: Before proceeding with the placement of an SSC, it’s advisable to contact your dental insurance provider and inquire about coverage. They can provide information on whether the procedure is covered, the extent of coverage, and any preauthorization requirements.
- Out-of-Pocket Costs: Even with insurance coverage, there may be out-of-pocket expenses for the patient. These costs can include deductibles, copayments, and any fees for services that exceed the maximum coverage provided by the insurance plan.
- Alternative Treatments: Some insurance plans may have limitations on the type of dental restorations they cover. Your dentist may recommend alternatives to SSCs based on clinical considerations, but the insurance coverage may vary for these options.
- Provider Networks: Check if your dentist is in-network with your insurance plan. In-network providers often have negotiated rates, which can result in lower out-of-pocket costs for the patient.
- Prior Authorization: In some cases, your dentist may need to obtain prior authorization from the insurance company before proceeding with the SSC placement. This process ensures that the treatment is deemed medically necessary and covered by the insurance plan.
- Claim Submission: Your dental office will typically handle the submission of insurance claims on your behalf, simplifying the process for you. Be sure to provide accurate insurance information to facilitate claim processing.
It’s important to communicate openly with your dentist and your insurance provider to understand the cost implications and insurance coverage related to stainless steel crowns.
Your dentist’s office can often assist in navigating insurance matters and provide you with a treatment plan that outlines the expected costs and coverage details.
Keep in mind that dental insurance plans can vary significantly, so it’s essential to review your specific plan’s terms and conditions to determine the extent of coverage for SSCs.
