What This Guide Covers
This guide explains why children get dental crowns, how the procedure works, and what parents can expect before, during, and after the visit.
A dental crown is a cap that fits over a damaged tooth. It restores the tooth's shape, strength, and function. In children, crowns are most often placed on baby teeth (also called primary teeth). These teeth still play a critical role in chewing, speech, and holding space for adult teeth. [1]
You may have heard a dentist recommend a crown for your child and wondered whether it was truly necessary. Baby teeth do eventually fall out, so the idea of capping one can feel like overkill. But leaving a badly damaged baby tooth untreated can lead to infection, pain, and loss of the space that the permanent tooth needs to come in correctly. [2]
This guide is written for parents and caregivers of children who have been told their child needs a crown, or who want to understand the procedure before a dental visit. Whether your child sees a general dentist or a pediatric dentist, the information here applies to most crown procedures performed on children.
Why Children Need Dental Crowns
Children need crowns when a tooth is too damaged for a regular filling to hold up over time.
Common Reasons a Crown Is Recommended
The most common reason is a large cavity. When decay removes a significant amount of tooth structure, a filling alone may not be strong enough to protect what remains. The filling could crack or fall out, leaving the tooth vulnerable to further decay or fracture. [2]
Crowns are also placed after a pulpotomy, sometimes called a "baby root canal." During a pulpotomy, the dentist removes infected tissue from the inner part of the tooth (the pulp). Because the tooth is weakened after this treatment, a crown is placed on top to seal and protect it. [1]
Other reasons include teeth that are broken from trauma, teeth with developmental defects in the enamel, and teeth at high risk for further decay. In some cases, a child with very high cavity risk may receive crowns to prevent problems rather than just treat them.
- Large cavities that are too big for a filling to restore reliably
- After a pulpotomy (nerve treatment) to seal and strengthen the tooth
- Fractured teeth from falls or injuries
- Enamel defects that make the tooth weak or prone to decay
- High cavity risk in children who may benefit from added protection
Types of Crowns Used in Children
The two main types are stainless steel crowns and tooth-colored (white) crowns. Each has advantages depending on where the tooth is located and what the family prefers.
Stainless steel crowns (SSCs) are the most commonly used crowns in pediatric dentistry. They are pre-made metal caps that the dentist selects by size and cements over the prepared tooth. SSCs are extremely durable. They rarely break or fall off, and they can be placed in a single appointment. For back teeth (molars), stainless steel crowns are typically the recommended choice because strength matters more than appearance in that area. [1]
White crowns, also called tooth-colored crowns, are used mainly on front teeth where a metal crown would be very visible. Several options exist. Resin-based crowns (strip crowns) are shaped directly on the tooth. Pre-made zirconia crowns are another option; they are strong and look natural. However, zirconia crowns require more tooth reduction (removal of tooth structure) and are less forgiving if the fit is not exact.
A hybrid option called a pre-veneered stainless steel crown has a metal back and a white front facing. This provides the strength of metal with better appearance. However, the white facing can chip off over time, leaving the metal exposed.
- Stainless steel crowns: Durable, low cost, single-visit placement. Best for back teeth.
- Resin strip crowns: Tooth-colored, shaped on the tooth. Used on front teeth. Less durable than metal.
- Zirconia crowns: Strong and natural-looking. Require more tooth reduction. Higher cost.
- Pre-veneered SSCs: Metal with a white facing. Good balance of strength and appearance. Facing may chip.
Why Saving Baby Teeth Matters
Baby teeth are not just placeholders. They serve critical functions until the permanent teeth are ready to come in, which can be as late as age 12 for some molars. [2]
Each baby tooth holds space in the jaw for the adult tooth forming beneath it. If a baby tooth is lost too early from decay or extraction, the neighboring teeth can drift into the empty space. This can block the permanent tooth from erupting properly, leading to crowding or misalignment that may require orthodontic treatment later.
Baby teeth also help children chew food effectively and develop clear speech. Front baby teeth play a role in pronouncing certain sounds. Losing them early can affect a child's speech development and self-confidence.
Practical Details for Parents
Knowing what to prepare for helps reduce stress for both you and your child.
Age Recommendations and Timing
There is no minimum age for a dental crown. Children as young as one or two years old may need one if decay is severe. The American Academy of Pediatric Dentistry recommends that children have their first dental visit by age one or within six months of the first tooth appearing. [1] Early visits can catch problems before they grow serious enough to need a crown.
Timing depends on the severity of the problem. A tooth with deep decay near the nerve may need a crown quickly to prevent infection. A tooth with moderate decay may allow more scheduling flexibility. Your child's dentist will advise you on how urgent the treatment is.
Baby molars typically do not fall out until ages 10 to 12. A crown placed on a baby molar at age four may need to last six to eight years. This is one reason durability matters when choosing a crown type for back teeth.
Sedation and Anesthesia Options
Many young children cannot sit still long enough for a crown procedure, which typically takes 20 to 30 minutes per tooth. Sedation helps keep the child comfortable, still, and safe. [1]
Nitrous oxide (laughing gas) is the mildest form of sedation. The child breathes it through a small nose mask and feels relaxed but stays awake. It wears off within minutes after the mask is removed.
Oral sedation involves a liquid medication given before the appointment. The child becomes drowsy and may not remember much of the procedure. The child remains conscious but is much more relaxed and cooperative.
General anesthesia is used for very young children, children with extensive treatment needs, or children with special health care needs. The child is fully asleep during the procedure. General anesthesia is typically administered in a hospital or surgical center by an anesthesiologist. Your child's dentist will discuss which option is appropriate based on your child's age, temperament, and the amount of treatment needed.
Preparing Your Child for the Appointment
Use simple, positive language when talking to your child about the visit. Phrases like "the dentist will put a silver hat on your tooth to keep it strong" can be easier for young children to understand than clinical terms.
Avoid words like "shot," "drill," or "hurt." Pediatric dental teams are trained to use child-friendly language and distraction techniques. Let the dental team introduce these concepts in their own way. [1]
Follow any fasting instructions carefully if your child will receive sedation or general anesthesia. The dentist's office will provide specific guidelines, typically no food or drink for a set number of hours before the appointment.
What Happens During the Crown Procedure
A stainless steel crown is typically placed in a single visit lasting 20 to 45 minutes per tooth, depending on the complexity.
Step-by-Step: The Appointment
First, the area is numbed with local anesthesia (a numbing injection near the tooth). If sedation is being used, it will be started before or alongside the local anesthesia. The child should not feel pain during the procedure. [2]
Next, the dentist removes the decayed portion of the tooth. If a pulpotomy is needed, the infected pulp tissue is removed and a medicated material is placed over the remaining healthy pulp.
The dentist then shapes the tooth to fit the crown. For a stainless steel crown, the tooth is trimmed slightly on all sides so the pre-made cap can slip over it. The dentist selects the correct crown size, tries it on, and adjusts the fit. Once the fit is right, the crown is cemented in place with dental cement.
For a tooth-colored strip crown on a front tooth, the process is slightly different. The dentist fills a clear mold with tooth-colored resin material, places it over the prepared tooth, and uses a curing light to harden the resin. The mold is then peeled away, and the crown is shaped and polished.
Recovery and Aftercare
Your child's lip, tongue, or cheek may be numb for one to two hours after the procedure. Watch your child during this time to prevent them from biting or chewing on the numb tissue, which can cause sores.
Some gum soreness around the crowned tooth is normal for a day or two. Over-the-counter children's pain relievers (such as ibuprofen or acetaminophen, dosed by weight) typically manage any discomfort. [2]
The crowned tooth needs the same care as any other tooth. Brush it twice daily with fluoride toothpaste and floss around it. Your child may notice the crown feels slightly different at first, but most children adjust within a day or two.
The crown will stay in place until the baby tooth naturally loosens and falls out. When the permanent tooth underneath is ready to erupt, the root of the baby tooth dissolves, the tooth gets wiggly, and the crown comes out with it. No separate appointment is needed to remove the crown.
Cost of Dental Crowns for Children
Crown costs depend on the type of crown, sedation used, and your location.
Stainless steel crowns generally range from $150 to $350 per tooth. Tooth-colored crowns, particularly zirconia, may range from $200 to $500 or more per tooth. Costs vary by location, provider, and case complexity. If sedation beyond nitrous oxide is needed, that adds a separate fee. General anesthesia with a hospital facility fee can add $500 to $2,000 or more depending on the facility and length of the procedure.
Most dental insurance plans that include pediatric coverage consider crowns a covered benefit, often classified as a "major" restorative procedure. Coverage typically ranges from 50% to 80% of the allowed amount after any deductible. Check with your insurance plan for specific details, as coverage varies widely.
If your child qualifies for Medicaid or the Children's Health Insurance Program (CHIP), dental crowns and related sedation are generally covered, though the specific coverage and approved crown types may differ by state. [1]
When to See a Pediatric Dentist
A pediatric dentist is a dentist who completed two to three years of additional training focused on treating infants, children, and adolescents. [1]
Many general dentists can place stainless steel crowns on cooperative older children. However, certain situations benefit from the specialized training and equipment of a pediatric dentist.
Consider a pediatric dental specialist if your child is under age three, has multiple teeth that need treatment at once, has behavioral or anxiety challenges in the dental chair, or has special health care needs. Pediatric dentists are also trained to provide sedation in an office setting and often have relationships with hospital facilities for cases requiring general anesthesia.
If your child's general dentist refers you to a pediatric dentist, it typically means the case would benefit from a provider with specialized pediatric training, a child-oriented office environment, or access to sedation options not available at the general dental office.
- Child is under age three and needs restorative treatment
- Multiple teeth need crowns or other treatment in one visit
- Behavioral challenges make it difficult for the child to cooperate during treatment
- Special health care needs require adapted approaches or medical coordination
- Sedation or general anesthesia is needed and not available at the general dentist's office
Find a Pediatric Dentist Near You
If your child needs a dental crown or you want a second opinion about a recommended treatment, a pediatric dentist can evaluate your child and explain all available options. Visit the pediatric-dentistry page to search for a board-eligible or board-certified pediatric dentist in your area who has the training and office environment designed for children.
Search Pediatric Dentists in Your Area