Why is silver a good option for crowns on primary molars?

My child has a tooth with a big molar cavity and I was told she will need a silver crown (stainless steel crown)! Why is this necessary?

Unfortunately when a dental cavity destroys a large part of a primary molar, it is difficult to restore the tooth with regular fillings. Metal nickel-chromium stainless steel crowns (SSC) often referred to as silver crowns for their shiny surfaces have been proven to be a very effective treatment for restoring badly damaged primary molars (back teeth). SSC’s have been time tested and shown to have the best long term results in many clinical studies. This allows the child to have form and function back in their mouth for proper eating and mastication. A tooth with SSC will often naturally exfoliate or fall out at the appropriate time which usually can be anywhere from 10 to 13 years of age. A SSC is particularly indicated if the tooth has had a pulpotomy or nerve treatment (see the question on baby root canal). Such a tooth requires the best protection and seal which is effectively provided by a SSC. Of course many parents are upset about the appearance of SSC’s in their child’s mouth and they often seek out other options. Such options may be a white filling (see resin composite and resin modifiend glass inonomer), or a white crown (see white crown options for primary teeth). These treatment options are relatively newer and have not yet been shown to be as effective as SSC treatment. This means they are more likely to fail requiring need for re-treatment and or infection and loss of the tooth. Of course each case will vary and your child’s dental provider will need to thoroughly review the risks benefits and alternatives for each treatment option as they relate to your child’s specific clinical situation.
Crowns that appear to be made of silver are probably made of a material called amalgam. Amalgam is a word that in the dental world means that mercury (a metal) is mixed with one or more other metals, including silver, tin, and copper. A crown made of amalgam will look like it's made of silver but is actually a combination of at least two metals.

This type of crown can be especially good for primary molars (the baby teeth at the back of a child's mouth) because it is very strong and will be able to handle the force of chewing with the back teeth. Unlike other types of materials used in fillings and crowns, amalgam is more resistant to food and bacteria leaking in-between the crown and the tooth, so tooth decay is less likely to develop.

Another reason why silver-containing amalgam is a good option is that in many cases, the area that is getting the crown or filling must be totally dry. But with amalgam, the crown can be placed even if the area is wet. When treating young children, the ability of amalgam to work even when placed in a wet environment is a major advantage. Finally, crowns made of silver amalgam are less likely than some other crown materials to need replacement. Talk to your child's dentist to decide on the best choice for your child. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.