Why are stainless steel crowns used in kids?

[TSDentSurg]

This question has always bothered me, and I've never been able to get a good answer: why are stainless steel crowns used in kids and not PFMs? Is it simply cost?

For the record, I know I wouldn't like pedodontics. The dentistry is relatively boring to me, and I don't like working with kids and their parents. Don't get me wrong, I love kids, I just don't like working on them. They always seem to be scared of me, no matter how friendly I am (I'm TS, I look strange without makeup, my voice is low and raspy...I am SO hoping I can make enough money to get facial feminization surgery, so I can look more natural; I pass 90% of the time though), and that just makes working on them more difficult.

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[Koalafied]

This question has always bothered me, and I've never been able to get a good answer: why are stainless steel crowns used in kids and not PFMs? Is it simply cost?

For the record, I know I wouldn't like pedodontics. The dentistry is relatively boring to me, and I don't like working with kids and their parents. Don't get me wrong, I love kids, I just don't like working on them. They always seem to be scared of me, no matter how friendly I am (I'm TS, I look strange without makeup, my voice is low and raspy...I am SO hoping I can make enough money to get facial feminization surgery, so I can look more natural; I pass 90% of the time though), and that just makes working on them more difficult.

Coverage. To protect primary dentition from further caries reaching to the permanent, I suppose?

 

[TSDentSurg]

Coverage. To protect primary dentition from further caries reaching to the permanent, I suppose?

My question isn't about why crowns are used at all, it's why *stainless steel* ones are used, as opposed to PFMs.

 

[Koalafied]

My question isn't about why crowns are used at all, it's why *stainless steel* ones are used, as opposed to PFMs.

Koalaty of the materials? Longevity of materials?

 

[suarez 7]

Just touched on SSC's recently, so I am not an expert but to answer your question

- SSC are really cheap (prefab's run around 6 bucks), no lab work needed.
- Prepping for a SCC isn't labor-intensive and very minimal
- SCC prep and crown seating takes very minimal time

There's really no reason to use PFM or gold crowns on primary teeth since they will fall out rather soon. Plus I don't think kids can tolerate long crown preps. And no parent wants to spend $900 to fix a baby tooth.

 

[TSDentSurg]

Koalaty of the materials? Longevity of materials?

I'm guessing it's cost, since the crown only has to last long enough until the tooth falls out, as opposed to a crown on a permanent, which has to last forever (well, 10-15 years).

 

[Koalafied]

I'm guessing it's cost, since the crown only has to last long enough until the tooth falls out, as opposed to a crown on a permanent, which has to last forever (well, 10-15 years).

Dude/Dudette, I ain't even a dental student, yet.

 

[TSDentSurg]

Just touched on SSC's recently, so I am not an expert but to answer your question

- SSC are really cheap (prefab's run around 6 bucks), no lab work needed.
- Prepping for a SCC isn't labor-intensive and very minimal
- SCC prep and crown seating takes very minimal time

There's really no reason to use PFM or gold crowns on primary teeth since they will fall out rather soon. Plus I don't think kids can tolerate long crown preps.

Well, we've settled that question. Now, do have any advice how I can make myself...idk...less "scary" to kids. Little kids are fine, they don't know any better, but older kids find me freaky.

 

[Koalafied]

Well, we've settled that question. Now, do have any advice how I can make myself...idk...less "scary" to kids. Little kids are fine, they don't know any better, but older kids find me freaky.

Here.

Thanks me later.

 

[TSDentSurg]

Dude/Dudette, I ain't even a dental student, yet.

Well, I spent most of my time assisting in a bone graft today and dictating the operative report, and researching bone grafting and implantology literature.

I kinda forgot that very simple reason for SSCs, lol.

BTW, I'm an MTF, so it's dudette. Just don't use "he/she" when talking about me, and we'll be cool.

 

[TSDentSurg]

Here.

Thanks me later.

That might make me look more scary...I'm an adult and those frighten me.

 

[Koalafied]

Well, I spent most of my time assisting in a bone graft today and dictating the operative report, and researching bone grafting and implantology literature.

I kinda forgot that very simple reason for SSCs, lol.

BTW, I'm an MTF, so it's dudette. Just don't use "he/she" when talking about me, and we'll be cool.

Comprender.

 

[Koalafied]

I am (I'm TS, I look strange without makeup, my voice is low and raspy...I am SO hoping I can make enough money to get facial feminization surgery, so I can look more natural; I pass 90% of the time though), and that just makes working on them more difficult.

Well, we've settled that question. Now, do have any advice how I can make myself...idk...less "scary" to kids. Little kids are fine, they don't know any better, but older kids find me freaky.

Comedy is your greatest tool. Not superficial charm. Comedy worked on me as a child.

 

[TSDentSurg]

Comedy is your greatest tool. Not superficial charm. Comedy worked on me as a child.

I'm quite funny! I do make jokes about my transition all the time as a coping mechanism, which pisses off some of my other tranny friends (I use that word, and occasionally shemale, but only for myself...it's what I am...I'm both guy and girl, just prefer to present myself to the world as a girl), and I enjoy telling patients some funny stories that happened to me.

My consultant tells me I'm one of the funniest chicks he's met, and I love making friends.

I just speak to the kids in a relaxing manner, e.g. "your tooth is dirty [carious], can I clean it with my special toothbrush [handpiece]? I can? Well, before I make it nice and shiny again, I need to give it some medicine first [lidocaine], and it'll sting for just a second, is that okay? No? Well, if I don't, it could hurt a bit, and we don't want that."

 

[Koalafied]

Perfect! If I ever become a parent, I will entrust you to be my kid's/kids' dentist.

"Stay true to your principles."

 

[TSDentSurg]

Perfect! If I ever become a parent, I will entrust you to be my kid's/kids' dentist.

"Stay true to your principles."

Yay! But are sure you want someone who looks like a goth tranny porn star to be your kids' dentist? I love wearing heavy, dark, glittery makeup and 7" stiletto knee-high boots, and I have long blood-red hair. No complaints so far, and most say I'm quite pretty; a young girl once said she loved my look.

I'd rather do perio and see the occasional kid with juvenile-onset periodontitis.

I've always wondered why most of these children's dentists in my hometown area (even though I'm in Prague, I'm from California) always talk about preventing cavities and have no cavity prizes. IMHO, cavities are nothing. Caries can be filled, and if it gets down to the pulp, emergent pulpotomy and SSC. Though if infection spreads to the roots, we can't do an RCT, since GP would interfere with eruption of the permanent, so the tooth would have to be extracted and a space maintainer placed.

They never talk about preventing periodontitis...some people never get cavities, yet they've got alveolar bone slowly melting away. Like myself. I wasn't too keen on oral hygiene when I was a little boy, and I've never had a restoration, but my average pocket depth is 4-5 mm.

I'd rather have a bunch of restorations, then have perfect teeth that are mobile and falling out. I'd take a RCT over a GBR any day.

Maybe kid's dentists should have a "no BOP" award or "no pocket > 3 mm" award.

 

[Koalafied]

Don't worry, I don't judge using the naked eye. As long as you appear professional that's the most important part.

I'd rather do perio and see the occasional kid with juvenile-onset periodontitis.

I've always wondered why most of these children's dentists in my hometown area (even though I'm in Prague, I'm from California) always talk about preventing cavities and have no cavity prizes. IMHO, cavities are nothing. Caries can be filled, and if it gets down to the pulp, emergent pulpotomy followed by RCT and SSC, maybe an apicoectomy if it's bad enough to cause an apical abscess. Tooth saved. It's better not to have a cavity, though.

It's probably not profitable. And it's too much effort.

This is what you/children find in the 'treasure chest' these days:

The last time I've ever seen these was over a decade ago:

They never talk about preventing periodontitis...some people never get cavities, yet they've got alveolar bone slowly melting away. Like myself (I wasn't too keen on oral hygiene when I was younger, and I've never had a restoration, but my average pocket depth is 4-5 mm).

Once again, that's because it's probably not profitable. Implant(s) is/are not fully covered. Dentures is where they get ya.

I'd rather have a bunch of restorations, then have perfect teeth that are mobile and falling out. I'd take a RCT over a GBR any day.
Maybe kid's dentists should have a "no BOP" award or "no pocket > 3 mm" award.

I'd rather have my real teeth, if any. I prefer to eat my Doritos® when I'm 80-years-old. Some dentists are just that lazy to do the pocket checks. Some never even mastered occlusion; trial-and-error it is.

 

[TSDentSurg]

Don't worry, I don't judge using the naked eye. As long as you appear professional that's the most important part.
It's probably not profitable. And it's too much effort.

This is what you/children find in the 'treasure chest' these days:

The last time I've ever seen these was over a decade ago:

Once again, that's because it's probably not profitable. Implant(s) is/are not fully covered. Dentures is where they get ya.
I'd rather have my real teeth, if any. I prefer to eat my Doritos® when I'm 80-years-old. Some dentists are just that lazy to do the pocket checks. Some never even mastered occlusion; trial-and-error it is.

Lazy GPs will be my main source of income as a perio, it seems. "Well, Dr. Tooth, you've never checked Joey's pockets, so he now has severe alveolar bone loss. His lower left anterior quadrant is going to fall out if someone looks at them wrong. He's only 16, and he does not look fierce like this." "I can extract the teeth and give him a really nice partial, Dr. Bloody." "Dr. Tooth, Joey actually enjoys eating. And I absolutely refuse to let him get further bone loss by removing otherwise healthy teeth because you didn't do your job. I need to do GBR immediately."

 

[Koalafied]

I don't know much about the TS culture, but I was raised not to judge a book by it's cover. And to be honest, success in this field is really contingent to the trust built upon your patients/clienteles.

So if you still want to work with children, then a professional attire/appearance is necessary, since you're a health professional. What this attire/appearance looks like is entirely up to your discretion.

Sometimes it may not be about profits though. I'm really sad when expensive treatment is the only option to treat oral health problems to those who can't afford such treatments/procedures.

 

[TSDentSurg]

I don't know much about the TS culture, but I was raised not to judge a book by it's cover. And to be honest, success in this field is really contingent to the trust built upon your patients/clienteles.

So if you still want to work with children, then a professional attire/appearance is necessary, since you're a health professional. What this attire/appearance looks like is entirely up to your discretion.

Sometimes it may not be about profits though. I'm really sad when expensive treatment is the only option to treat oral health problems to those who can't afford such treatments/procedures.

I dress professionally. I'm clean, neat. And I also said I do not want to work mainly with kids. I'd be happy seeing the occasional kid who needs eval and tx of juvenile periodontitis.

It's sad when a few extra minutes during an exam could've prevented thousands of dollars of work.

 

[Mackchops]

Well, we've settled that question. Now, do have any advice how I can make myself...idk...less "scary" to kids. Little kids are fine, they don't know any better, but older kids find me freaky.

It's not the raspy voice, TS part of you that freaks the kids out. It's the DDS part...

And SSCs are used because they are fabricated chairside - they're an indirect/direct restoration. When it comes to kids you want to get the kid in and out as quickly as possible. Skilled practitioners can do a full-mouth rehab on a kid in the OR in 1-2 hours - a full mouth of PFMs are going to take a lot longer PLUS a delivery appointment. Temps, impressions, ick... PLUS they cost a ton more. PLUS they aren't necessary - everything in kid dentistry is about keeping the kid out of pain and preventing problems down the road. Prevent, extract, maintain space. SSCs maintain space. Plus they can be a reminder to mom and dad that they should brush little Jimmy's teeth better the next time around...

 

[Koalafied]

I dress professionally. I'm clean, neat. And I also said I do not want to work mainly with kids. I'd be happy seeing the occasional kid who needs eval and tx of juvenile periodontitis.

It's sad when a few extra minutes during an exam could've prevented thousands of dollars of work.

Perhaps one day you'll shed light to that TS kid's dream that anything is possible/achievable because you were that 'childhood dentist' of theirs.

 

[TSDentSurg]

It's not the raspy voice, TS part of you that freaks the kids out. It's the DDS part...

And SSCs are used because they are fabricated chairside - they're an indirect/direct restoration. When it comes to kids you want to get the kid in and out as quickly as possible. Skilled practitioners can do a full-mouth rehab on a kid in the OR in 1-2 hours - a full mouth of PFMs are going to take a lot longer PLUS a delivery appointment. Temps, impressions, ick... PLUS they cost a ton more. PLUS they aren't necessary - everything in kid dentistry is about keeping the kid out of pain and preventing problems down the road. Prevent, extract, maintain space. SSCs maintain space. Plus they can be a reminder to mom and dad that they should brush little Jimmy's teeth better the next time around...

That's why I just wouldn't like pediatric dentistry. Not enough treatment options, and I do enjoy the art that goes into restorations.

How do kids even get to the point where they need multiple crowns? I haven't done a formal pediatric dentistry rotation yet.

And Koalafied, yeah, I've imagined inspiring young TS kids. "You don't have to grow up to become a prostitute! You can become a dentist and cause excruciating pain with power tools! And when its all over, that someone can eat and smile again." For the record, I hate causing pain to patients...I hate it when a patient has an abscess, and I can't get them numb because the acidity deactivates the articaine. Then I have to do a pulpotomy while the tooth is still sensate.

 

[goffdent]

It's not the raspy voice, TS part of you that freaks the kids out. It's the DDS part...

And SSCs are used because they are fabricated chairside - they're an indirect/direct restoration. When it comes to kids you want to get the kid in and out as quickly as possible. Skilled practitioners can do a full-mouth rehab on a kid in the OR in 1-2 hours - a full mouth of PFMs are going to take a lot longer PLUS a delivery appointment. Temps, impressions, ick... PLUS they cost a ton more. PLUS they aren't necessary - everything in kid dentistry is about keeping the kid out of pain and preventing problems down the road. Prevent, extract, maintain space. SSCs maintain space. Plus they can be a reminder to mom and dad that they should brush little Jimmy's teeth better the next time around...

If only that worked... You'd think many parents would get it right on the next kid in line, but often times no.. so sad for the kids.

 

[yggdrasila]

Kids with multiple crowns are basically due to parental neglect. I've seen a 7 year old with 4-5 crowns and a mouth full of restorations. Another kid was being nagged by his mom to brush his teeth while they were in the lobby but I'm pretty sure it was all for show, since we are kinda a small community office. When he came in his teeth were caked with plaque and he was coming in for his first crown at the age of 10. Parents these days refuse to get on their kids backs. Basically you need to do your best to make brushing interesting to kids haha good luck. I dread/anticipate seeing these kids teeth in the future.

Best tool so far for dealing with kids, sparkly stickers. I like it when my office keeps them gender neutral with stuff like animals but fairy princesses and race cars really please the crowd. Also glove fishes (blown up gloves with fish faces drawn on) /bribes/complements. Worst thing is when I hear parents threatening kids with a dental visit, thanks for that Mom/Dad. I also always ask the kids if they want the procedure explained to them, I don't know if I'd do the same for more complex scary things but some of the more curious or older kids like each instrument/step explained to them. Of course I still lower the language a little like I tell them tofflemire bands make their tooth into a little sandbox, sugar bugs etc, etc. Also showing them their xrays if they want, I call them a little monster bc of all the teeth, we laugh hehe. Having cool coloring pages is nice, not boring things likes house but cool current things like Hello Kitty or Iron Man.

I'm only predent/dent assistant though but I think I'm starting to get along with pedo patients, at first I hated most of them haha sorry kids. I have plenty more to see and learn. )

 

[TSDentSurg]

Kids with multiple crowns are basically due to parental neglect. I've seen a 7 year old with 4-5 crowns and a mouth full of restorations. Another kid was being nagged by his mom to brush his teeth while they were in the lobby but I'm pretty sure it was all for show, since we are kinda a small community office. When he came in his teeth were caked with plaque and he was coming in for his first crown at the age of 10. Parents these days refuse to get on their kids backs. Basically you need to do your best to make brushing interesting to kids haha good luck. I dread/anticipate seeing these kids teeth in the future.

Best tool so far for dealing with kids, sparkly stickers. I like it when my office keeps them gender neutral with stuff like animals but fairy princesses and race cars really please the crowd. Also glove fishes (blown up gloves with fish faces drawn on) /bribes/complements. Worst thing is when I hear parents threatening kids with a dental visit, thanks for that Mom/Dad. I also always ask the kids if they want the procedure explained to them, I don't know if I'd do the same for more complex scary things but some of the more curious or older kids like each instrument/step explained to them. Of course I still lower the language a little like I tell them tofflemire bands make their tooth into a little sandbox, sugar bugs etc, etc. Also showing them their xrays if they want, I call them a little monster bc of all the teeth, we laugh hehe. Having cool coloring pages is nice, not boring things likes house but cool current things like Hello Kitty or Iron Man.

I'm only predent/dent assistant though but I think I'm starting to get along with pedo patients, at first I hated most of them haha sorry kids. I have plenty more to see and learn. )

Wow...I had very poor oral hygiene when I was a young boy, and I've never had a restoration, just mild, stable, periodontitis. I guess I must have good genes.

I wonder if you should inform CPS when a kid comes in needing such extensive dental work.

 

[yggdrasila]

Wow...I had very poor oral hygiene when I was a young boy, and I've never had a restoration, just mild, stable, periodontitis. I guess I must have good genes.

I wonder if you should inform CPS when a kid comes in needing such extensive dental work.

Eugh right I think about that too but the kid with the multiple crowns was in a Sunday language class I was volunteering with not a patient, in retrospect maybe I should have brought some educational materials to class and talked to him during recess or something.

Anyway I wish you luck in your future especially with transferring your degrees and such to the US. Dentistry is so conservative sometimes I can't stand it, we need more diversity in the workforce.

 

[DancingKoala]

Honestly, I think it's just for esthetic. Kids can go to school and brag about how their tooth color is gold.

 

[Koalafied]

Honestly, I think it's just for aesthetic. Kids can go to school and brag about how their tooth color is gold.

Honestly, I think you're not Koalafied to make that kind of sweeping generalization aka. A dicto simpliciter. It's platinum BTW.