Stainless Steel Crowns for Kids: Why Dentists Put Silver Caps on Baby Teeth

Stainless Steel Crown for Kids

What You’ll Learn

• What is a stainless steel crown for kids (“silver cap”)
• Why dentists protect baby teeth that will fall out anyway
• When a crown is recommended over a filling, and when it isn’t
• How stainless steel crowns are fitted, including the no-drill Hall Technique
• The alternatives, including white zirconia crowns
• What happens when the crowned tooth gets wobbly and falls out

If your child’s dentist has suggested a Stainless Steel Crown (otherwise known as a “silver cap”) on one of their back baby teeth, you’re probably wondering why so much effort is going into a tooth that will eventually fall out. It’s one of the most common questions we hear from parents in Five Dock and across the Inner West.

The short answer: a stainless steel crown is a pre-made metal cap that covers the whole of a baby molar. Dentists recommend it when a back baby tooth has a large cavity, has had nerve treatment, or didn’t form properly — because the research shows crowns protect these teeth far more reliably than big fillings, right up until the tooth falls out naturally. When it does, the crown simply comes out with it.

Here’s everything you need to know, explained simply.

What Is a Stainless Steel Crown?

A stainless steel crown — also called a preformed metal crown, a silver cap or a silver tooth — is a ready-made cap shaped like a baby molar. Crowns come in a range of sizes, and the dentist selects the one that fits your child’s tooth snugly before fixing it in place with a special dental cement.

Unlike a filling, which plugs a hole, a crown covers the entire part of the tooth that sits above the gum. They’re made of stainless steel containing nickel and chrome, and they’ve been used in children’s dentistry since the 1950s, so they have one of the longest track records of any treatment for baby teeth.

They’re used almost always on the back teeth (molars). For front baby teeth, white options are normally used instead.

Why Bother Protecting a Baby Tooth?

It’s a fair question. But baby teeth do some important jobs while they’re here:

1. Chewing and nutrition. Healthy back teeth help kids eat a full range of foods comfortably.
2. Speech. Teeth help shape sounds as children learn to talk.
3. Holding space for adult teeth. Each baby tooth saves a spot for the adult tooth growing underneath. If one is lost early, neighbouring teeth can drift into the gap, which can lead to crowding later on.
4. Comfort and health. A decayed tooth left unprotected can become painful or infected, and an infection in a baby tooth can affect the developing adult tooth below it.

And timing matters. While front baby teeth usually fall out around 6–7, the back baby molars often stay in place until somewhere between 10 and 13 years of age. That means a cavity found at age four may need to be protected for six to eight years or more. That’s where crowns come into their own.

Why Do Dentists Recommend a Stainless Steel Crown Instead of a Filling?

Baby teeth have thinner enamel than adult teeth, so decay can spread quickly. Once a cavity is large or spreads across more than one surface, there may not be enough strong tooth left to hold a filling securely for years of chewing.

A stainless steel crown solves this by wrapping the whole tooth. It holds the remaining tooth together, seals it so decay can’t sneak in around the edges, and is very hard to break or wear out.

This isn’t just a preference — it’s backed by good-quality research. A Cochrane review (one of the most respected types of medical evidence) found that baby molars restored with crowns were less likely to develop problems such as abscesses or pain in the long term than those restored with fillings. Crowns are recommended by specialist children’s dentists in the UK, Australia and internationally as the go-to option for badly decayed or damaged baby molars.

When Is a Stainless Steel Crown Recommended?

Every child is different, but your dentist may suggest a crown when a back baby tooth has:

1. A large cavity, or decay on more than one surface (for example, between two teeth and on the chewing surface).
2. Had nerve treatment. After a “baby root canal” (pulpotomy or pulpectomy), the tooth is weaker and a crown helps protect it.
3. Enamel that didn’t form properly. Some children have soft, chalky or crumbly molars due to developmental conditions. A crown protects these teeth from breaking down and can reduce sensitivity.
4. Broken or cracked, for example after a fall.
5. A long time to go before it falls out, especially in younger children who are prone to cavities, where a filling might not last the distance.
6. Treatment planned under sleep dentistry or general anaesthetic. Using crowns in this situation helps lower the chance that your child needs to go through it all again.

When a crown might not be the right choice

A crown isn’t always needed. Your dentist may suggest something else if:

• The cavity is small and can be reliably managed with a filling or other approach.
• The tooth is already wobbly or likely to fall out within about 6–12 months.
• The tooth is infected or abscessed, or too damaged to save — in which case removal (and sometimes a space maintainer) may be better.
• Your child has a known nickel allergy (see the safety section below).

How Is a Stainless Steel Crown Fitted?

There are two main ways to fit a crown, and your dentist will recommend the one that suits your child’s tooth.

1. The conventional technique

The tooth is numbed, the decay is removed and the tooth is gently shaped. The crown is then trimmed and adjusted to fit and cemented in place. If the nerve is affected, a pulpotomy may be done in the same appointment before the crown goes on. It’s usually done in a single visit, much like a filling.

2. The Hall Technique (no needles, no drilling)

The Hall Technique was developed in Scotland and has been studied extensively, including in Australian public dental clinics in Victoria and Sydney. Instead of drilling out the decay, the dentist fills the crown with cement and simply presses it over the tooth.

It sounds surprising, but it works because the crown seals the decay in. Cut off from sugars in the diet, the bacteria can’t keep growing, so the cavity stops progressing.

Many children find it much easier to cope with:

• No injection and no drill — it often takes just a few minutes.
• The Cochrane review found Hall crowns caused less discomfort at the appointment than fillings.
• In a large UK trial, around 7 in 10 children preferred the Hall Technique to a standard filling, and most parents and dentists did too.

Sometimes a small rubber “spacer” is placed between the teeth a few days beforehand to make room for the crown. The Hall Technique is only suitable for teeth that show no signs of infection, so your dentist will check with an X-ray first.

What to Expect After a Crown Is Fitted

• The crown may feel tight or “high” for a day or two. The bite usually settles on its own within a few days as the teeth adjust.
• If numbing was used, watch that your child doesn’t chew their lip or cheek until the feeling comes back.
• The gum may look slightly grey or blue right at the edge of the crown. This is just the metal showing through and isn’t a problem.
• Gums may be a little tender for a few days. Keep brushing gently along the gumline.
• Go easy on very sticky lollies and chewy treats, which can pull on the crown.
• Brush the crown just like a normal tooth, twice a day with fluoride toothpaste. When flossing next to it, slide the floss out sideways rather than snapping it upwards.

One important point: a crown protects only the tooth it covers. The neighbouring teeth can still get cavities, so regular check-ups and good daily habits still matter. Our guide to [LINK: Cavities in Kids] has practical, realistic tips.

What Are the Alternatives to a Silver Crown?

Parents often ask about options that look more natural. Here’s an honest overview:

Research comparing white zirconia crowns with steel crowns is promising, and zirconia generally does well for gum health and appearance. Overall, though, reviews still describe stainless steel as the “gold standard” for back baby teeth, mainly because of its toughness and long track record. The right choice depends on the tooth, your child’s age, and what matters most to your family — we’re always happy to talk through the options.

Are Stainless Steel Crowns Safe?

Yes. Stainless steel crowns have been used safely in children for more than 60 years. They contain no mercury.

Because the steel contains nickel, parents sometimes ask about allergies. Reviews of the research have found that the amount of nickel released from a crown is smaller than what we’re all exposed to every day from other sources, and true allergic reactions are rare. If your child has a known nickel allergy (for example, reacting to earrings or belt buckles), let us know, and we’ll recommend a nickel-free option.

What Happens When a Crowned Tooth Falls Out?

This is the part that surprises many parents: nothing special needs to happen.

1. The crown stays on until the tooth is ready. As the adult tooth grows underneath, it slowly dissolves the roots of the baby tooth, just as it would without a crown.
2. The tooth gets wobbly as normal. You may notice the crown moving along with the tooth. That’s expected.
3. The tooth and crown come out together, often while eating or brushing, just like any other baby tooth. Yes — it can still go under the pillow for the tooth fairy!
4. The adult tooth comes through underneath. The crown doesn’t affect the adult tooth; in fact, by holding the space, it helps guide it into place.

When to call us

• The crown comes off but the tooth stays in. Keep the crown and book in so we can check the tooth.
• The crown is swallowed. This usually passes without problems, but please call us for advice.
• The crowned tooth is very loose for weeks but won’t come out, or an adult tooth is coming through behind or beside it.
• Your child has pain, swelling or a pimple-like bump on the gum near the crown.
• The top of the crown wears through, which can occasionally happen in kids who grind their teeth.

How Long Does a Stainless Steel Crown Last?

In most cases, a stainless steel crown lasts for the entire life of the baby tooth. Large studies show very high success rates, and failures are uncommon. That reliability is one of the main reasons dentists recommend them: one well-placed crown can avoid repeated fillings on the same tooth.

Frequently Asked Questions

Does getting a stainless steel crown hurt?

Most children cope very well. With the conventional technique the tooth is numbed first, so it feels similar to having a filling. With the Hall Technique there’s no needle or drill at all, and most children feel only some pressure as the crown is pressed on.

Why does my child need a crown on a baby tooth that will fall out?

Back baby teeth can stay until age 10–13. A crown protects a weakened tooth for all those years, keeps your child comfortable, and holds space for the adult tooth.

Will my child mind having a silver tooth?

Crowns are on back teeth, so they’re rarely noticed. Many kids actually enjoy showing off their “shiny tooth”. If appearance is important to your family, ask us about white crown options.

Can my child eat normally with a crown?

Yes. Once any numbness has worn off, your child can eat normally. It’s best to limit very sticky lollies.

Does a crown fall out with the baby tooth?

Yes. The crown stays attached to the tooth and they come out together when the adult tooth is ready to come through.

Is it covered by the Child Dental Benefits Schedule (CDBS)?

Many basic children’s treatments are covered under the CDBS for eligible families. Ask our team and we’ll check what applies to your child before treatment.

Caring for Little Smiles in Five Dock

At My Kids Dentist, part of Vivid Dental, we take the time to explain every option, answer your questions, and help your child feel relaxed and in control. Whether your child needs a crown, a filling, or just a check-up, we’ll recommend the gentlest approach that will genuinely last.

Have a question about a crown your child has been recommended? We’re happy to take a look and talk you through the options, with no pressure. [LINK: Book an appointment]

📍 7 Garfield Street, Five Dock NSW 2046  |  📞 02 9713 1760  |  🌐 vividdental.com.au

This article is general information only and isn’t a substitute for personalised advice from your dentist.

Sources

• Innes NPT et al. Preformed crowns for decayed primary molar teeth. Cochrane Database of Systematic Reviews 2015 (CD005512).
• Royal College of Surgeons of England / BSPD. Clinical guideline: Stainless steel preformed crowns for primary molars.
• Sapountzis F et al. A retrospective study of the Hall technique for the treatment of carious primary teeth in Sydney, Australia. Clinical and Experimental Dental Research, 2021.
• Dental Health Services Victoria. Hall Technique study results (2015); Stainless steel crowns patient information.
• Innes NP et al. The Hall Technique RCT in general dental practice (child, parent and dentist preferences).
• Zirconia vs stainless steel pediatric crowns — literature reviews and RCTs (University of Padua; PMC9016922; PMC12244821).
• Shafaroudi AM et al. Nickel sensitivity in children due to stainless steel crowns: a narrative review. J Pediatr Rev, 2021.
• NHS patient leaflets: Cambridge University Hospitals, Guy’s and St Thomas’, King’s College Hospital — stainless steel / preformed metal crowns.