Advice on Caps/Crowns for a Four Year Old Boy.

Updated on April 24, 2010
S.C. asks from Parkersburg, IL
20 answers

We took our youngest son to the dentist yesterday expecting bad news. We were not dissapointed. His teeth are in horrible shape. I was almost sick when they read off the list of things they need to do to his teeth (many, many crowns & fillings). Luckily they could work him in immediately & start fixing some of his teeth. He now has three metal crowns & one porcelain crown on his right side.

My question is about procelain crowns/caps. He has to have a filling done between his top front teeth. They're hoping that will take care of the problem, but if it doesn't they're going to have to cap his front teeth. The filling will be white, but if they have to cap them, they wanted to use metal crowns. My husband & I were horrified at the suggestion.

The dental hygienist said she suggests metal crowns for little boys because they're so rough & tumble but porcelain crowns for girls because they're calmer. She said the porcelain can chip away & boys are too active for it.

The thought of him spending the next 3-4 years with metal caps on his top front teeth was not something we were comfortable with (we don't want him teased at school or feeling that different from his siblings who have great teeth). We're OK with metal for the back teeth, but not the front.

I'm wondering if any other moms of active little boys have any advice on this, any experience with porcelain caps on front teeth.

Edited to add: Most of your responses have been wonderful, but I do have a requst to make. Please do not attack me for my son's dental problems. He has had his teeth taken care of in the exact same manner as his two older siblings both of whom have perfect teeth. My children are not allowed lots of sugar, candy, or sweets. They have never been allowed to drink soda. They VERY rarely drink anything other than milk, water, or the occasional (not daily) small cup of juice. His teeth are brushed twice daily. His dental problems are likely genetic (my teeth are not good).

As to why it's taken this long to have him treated, we live in a very rural community. No one near us sees children before they turn four. I took him to a dentists days after his fourth birthday and he refused to let them examine him. I told them of my concerns about his teeth (we could see decalcification on some of them at the gum line) and I was told to reschedule in six months & they'd try to examine him again.

I spent the next few months attempting to find a dental practice that would not only see him & clean his teeth, but could treat him if needed (many dentists in our area do not fill young children's teeth at all), take our insurance, and could offer slight sedation if needed. As soon as I found one (the first I'd heard of a pediatric dentist in our area), I scheduled him for their earliest appointment. I have to drive an hour & a half to get him there.

Hopefully a filling will take care of his front teeth issues. The teeth need to last him at least 3 more years. His rear teeth (the ones that must be capped) will need to last until he's 12, so not treating them is not an option. Not treating baby teeth will lead to decay in the permanent teeth below.

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N.V.

answers from Columbus on

My husband has resin caps on two of his front-side teeth because they grew in smaller than usual. He's had the same caps on for 12 years now, with no problems. He tells me that they're starting to crumble as of now, but he was a teen when they were put in.

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M.P.

answers from Cincinnati on

Hi S.,
My son also had to have cap/crowns (when he was 3 going on 4).....if not it was going to effect the growth of new teeth, so we didn't have a choice. He has metal in the back and porcelain in the front. Knock on wood, we have not had any issues whatsoever. I too was concerned about him having metal on his front teeth - he started kindergarten this past fall and kids can be really cruel.
Anyway, like I said, we haven't had any problems at all and they are very easy to take care of.
Good luck!!

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D.B.

answers from Indianapolis on

Hi S....
I would definitely get a second opinion. I have seen many girls who are just as rough (if not worse) than boys. I would not take that as an excuse for putting the metal on your son's front teeth. Our six year old son had extensive dental work done with Dr. Michelle Edwards at the Children's Dental Center in Fishers. Visit their website www.babytoothcenter.com or contact them at ###-###-####. The staff there is wonderful! We have always taken our children to the dentist every six months for cleanings, limited the sugar intake, brushed twice a day and even use fluoride at night before going to bed. The dentist told us that some children have a certian PH balance in their saliva that causes dental problems. We are now working hand in hand with the dentist and having a sealant placed on each of our son's adult teeth as they come in to prevent any future problems. I know it sounds crazy to spend so much money on baby teeth that are going to fall out, but think about the damage that will be done to the adult teeth if you don't fix the problem now. After working with Dr. Michelle Edwards, our son just had his six month cleaning last week and no cavities! Best of luck!

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D.G.

answers from Columbus on

If you are that concerned about the cosmetic look of the caps ask the Dr. to use the pocelain, however if he does and your son damages it in play you will have to pay for yet another to replace it.You must protect his adult teeth when they do finally come in from having the same problems as his baby teeth. My niece at 3 had to undergo having all of her teeth capped because she had acid reflux so bad as a baby that it affected her baby teeth. We are hoping that our little princess adult teeth come in with no sign of the acid reflux disease.They had to take her to Childrens hospital and knock her out to do it but it was all done in 1 day and about 7 hours asleep.
I understand the metal caps on the front would make his first school pictures look bad when he smiled for them. I have seen so many bad teeth at the grade school where I volunteer as a reading tutor. Cute little boys and girls and then they smile and their litle teeth are rotting from te gums down.Makes you wonder if the parents ever taught them detal hygein.
Good Luck.

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S.F.

answers from Fort Wayne on

I personally would not put metal caps on a child's front teeth. I would go ahead and do the porcelain while knowing there's a possibility that they may need to be replaced. The doctor's suggestion that they don't put them on boys because they are so active is ridiculous. I wouldn't put my child through the ridicule of looking different. Children are so impressionable. I wouldn't want my little one teased or feeling insecure. I want my children to have good feelings and memories of school so they apply themselves and get involved in activities. Children will not be apt to do this if they feel out of sorts.

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K.S.

answers from Dayton on

Hello S.,

I know where you are coming from. I took my daughter to the dentist last year. She was 4 at the time also. The dentist said she also needed some fillings and a couple of crowns. Now she has porcelain crowns on her front 2 teeth. The crowns that are on the front teeth are two different colors. In the front they are colored which match the color of the other teeth but in back they are silver. I also agree with you about the metal crowns in the front just because he is a boy. That sounds ridiculous to me. Maybe thats what they mean about metal crowns,that they are two different colors in front and back just like my daughters,or just that actual metal crowns. If i were you i would make sure what they are really talking about and if they mean what you think they mean then i would say forget it and if he does need crowns in the front then i would say porcelian.
Good Luck,
K.

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A.Z.

answers from Columbus on

hii feel your pain my son has had soooooo many cavities one nurse even tried to blame me for them !! first off if your son was on a lot of medicine i personally think that is what causes bad teeth now there is soo much sugar in medicine, but anyways the metal caps my son has lost one or two from hisback teeth where i had to takehim back and do it again
but also since this is not the best start for your sons teeth i will warn you that last year (at age5) my son actually had to have 2 baby root canals!! i have never even had ONE before!! so good luck and i personally wouldn;ty go with metal front teeth

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S.C.

answers from Kokomo on

my son had to have 14 crowns and 7 root canals at age 3. It was all done at once, in a medical surgical hospital on base. 2 hours. For the 4 top fronts (bottom fronts did not need it), they put metal caps on and then cut out the front portion and filled it with a white resin/porcelian (sp?) filling. So the front of his front teeth were 'white', while the backs were metal. His is 9 and still has several metal teeth in the back. Some of the metal caps have fallen off, but the dentist opted (different dentist) not to replace them (he was age 7 and up) What a awful feeling I had knowing my son's teeth were in that shape. I saw a few lil holes, but when we got in there they were way worse than I had thought. Luckily, my husband was in Iraq at the time, so it was done absoutely free at Great Lakes Naval Base. Otherwise, we were looking at 8 thousand dollars on baby teeth!!!!! Good luck and keep us posted please!

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S.G.

answers from Cincinnati on

Just wanted to share my own experience. As a 3 1/2 year old, I had 8 root canals done and 8 silver caps. I am not sure what was wrong with my teeth exactly, but unfortunately, as much as I take care of them, they have never been all that good, and by now most of them have been filled or capped. Just have your son do his best to keep them healthy in the future. And make sure he always gets good dental insurance.

Another thing was that my permanent teeth came in crooked because the caps didn't fall out when they should have. But this was all in the 70's. I am sure by now dentists are a lot more aware of potential problems :)

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H.C.

answers from Indianapolis on

My son has all 4 top front teeth that are now porcelain crowns and no problems so far!! He had these done just after his 2nd birthday and he will be 4 next month. The dentist says they look great and are in perfect shape. He just has one little nick in the far left one, but the only person that sees it is me when I am brushing his teeth. I would not do metal, no way. I would find a dentist that will do what you want, not what they prefer. The metal is probably easier for them, and I'm sure it is cheaper for them and you, but this is going to affect him when he starts school. My dentist never even once considered doing metal. I can sympathize with you totally, we spend over $5000.00 on a 2 year old's teeth, but it was well worth it. Please get a second opinion or just tell them no.

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K.W.

answers from Indianapolis on

My uncle had a metal cap on one of his front teeth when he was little, too. Actually, he wasn't teased at all...everyone thought his silver tooth was cool! In fact, when he got older they told him they could replace it, but he just kept it!! I think boys are more fascinated with stuff like that, so it may not be as bad as you think. Remember, Jack Sparrow in Pirates of the Carribean had silver teeth!!

Eventually, my uncle did had to have the cap replaced because they were doing other work on his tooth, but he was well into adulthood before that happened.

Hope it goes well!!

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A.B.

answers from Nashville on

My daughter has been going to the dentist since she was 3 years old. I noticed as a toddler that she had stained teeth, and her dentist told me her enamel didnt come in and it was nothing to worry about because she would lose them anyway. Well now she is 6 at I took her to a pediatric dentist when we moved to Nashville. She has many cavities and also need caps. She already had a few fillings and did really well. My point to all this is even had you taken your son in soon, they probably wouldnt have done exrays because he was young and they wouldnt want to scare him. This was the case with my daughter. Either way his teeth are bad like my daughters and there is nothing as parents we can do to prevent this from happening. I feel the same as you, like people are blaming me. I feel like Im defending myself to the dentist and everyone else. Like your kids my daughter isnt aloud a lot of sugar, she rarely drinks sugary drinks and I brush her teeth myself at least twice a day. Dont worry about what others think. It seems like it is pretty normal for kids to have these problems. My daughter has a few kids in her class who have silver or gold caps. I am concernced about the silver caps though. I wonder if they are safe. I know silver filling are not safe for people.Good luck with everything.

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D.L.

answers from Cleveland on

Hey S.,

why are they putting caps and crowns on a 4 year old when his permanent teeth arent in yet?...Seems to me they are trying to get money out of you and your insurance company. I know that caps/crowns are very expensive even with insurance, there always seems to be something yet to pay out of pocket...
I would check into another dentist in the network, just in case. Unless 4 year olds have started losing their baby teeth, I don't see why they would need something so permanent unless it is on their permanent teeth. Check it out with other dentists first and let us know what happened.

God Bless
D.

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R.V.

answers from Toledo on

Hi S..
I feel your pain...I have a 6 yr old boy with horrible teeth as well. We took him to the dentist at 2 yrs old, and I am thankful she is the best pediatric dentist. He has had 4 metal caps, and 3 porcelain crowns. He has even had a partial root canal. She is intent on keeping his permanent teeth protected, just as it sounds like your dentist is. We had to cross the same bridge with Dominics front teeth. She did not put metal because it does look pretty corny. She used porcelain. But they didn't last too long (well, the one on the left didn't) He started having pain and we went in for the appt. She did xrays and said she could do a little root canal and replace the crown but it would only happen again in a few months. Her advice was to pull the front tooth. (I did have a hard time with this cuz his front teeth had been looking so nice)But, as she said, his permanent teeth would be coming in in about 3 yrs and that would be better than spending money to replace the crown every couple months. We decided to do it. He was absolutely FINE with it since he was close to 5, everyone thought he lost the tooth and kept calling him such a big boy. He looks adorable, and he is now soon to be 7 and the tooth is peeking through the gums. Sorry for the LONG response, but my advice is to request that she pull the front teeth (incidentally this same dentist pulled my friends daughters front teeth at age 2 because they were severly decayed and were going to damage her permanent teeth) that girl is 9 now and has BEAUTIFUL teeth! She was always the cutest kid, no one ever thought anything about it. Don't do the metal. Either take your chances with porcelain, and if it doesn't work have the teeth pulled.
Hope this helped.
From one mom of a dentalized kid to another....

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B.L.

answers from Youngstown on

Little girls get porcelain because they are calmer? Wish someone would have told my 3 daughters that, lol! The dentist I worked for years ago would use metal caps on kids, but only because they were less expensive (since the child was going to get adult teeth eventually, anyway). For the front teeth, though, I'd use porcelain on my kids.

Since you only have a couple of years since he starts losing his baby teeth, I agree with others that you should work with a dentist who is willing to take a hard look at what work absolutely needs done now and which areas can use the "wait and see" approach. Make sure you have a skilled dentist who can do the filling in the front the right way the first time, so you may not even have to worry about capping them.

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A.L.

answers from Indianapolis on

hi S.,

I just want to say before you have all of that done, get a second opinion. Be sure to ask ALL of your options.

** And personally, I would keep in mind that in a couple of years, many of his teeth will have already fallen out and new ones grown in. Ask them about minimal work and recomendations.**

I bet some of the work done is to achieve the perfect mouth, but all of that work and money - your child who is about to loose them, and the dentists are struggeling with the drop in business since the middle of 2008, so you are gonna get a HUGE amount of recomendations for your son from that dental office. They are desperate for business and money.

Of course, you want to protect your son from unecessary hardships (teasing and issues with his teeth). And find out why all of this happened so you can avoid it with his 2nd round of teeth.

Good luck.

A.

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V.O.

answers from Kokomo on

Well I don't want to sound crewl but I wouldn't spend money on teeth that are going to be coming out, in a year or two.
Especially with porcelian crowns that will be pulled off. They have to grind down the tooth for the caps to fit, I would think they could fill the teeth!!!And I would not put my child through the stress of all of this., because it is not fun. And my question is why did his teeth get this bad before you took him to the dentist???

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A.C.

answers from Cleveland on

i don't have advice regarding your question -- but would like to know what experiences, how was it determined and what special things are being done is school with your daughter who has the sensory processing disorder. I believe our son (7 years old) has that. feel to email me private at ____@____.com

A.

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P.R.

answers from Indianapolis on

The reason for the metal crowns is simply should they have to do additional work on those teeth the crowns/caps can easily be removed and put back on, the porcelain crowns/caps will break if they need to work around or under them and would have to be replaced.
I would consider the fact he will be losing the those two teeth in the next year or two anyway. It might be a consideration if the filling does not work to pull them and have a spacer put in to keep the other teeth from moving into that space and just have them out.
Personally I would want to go that route first, the choice, naturally is yours to make, but you might want to get a second opinion.

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R.B.

answers from Toledo on

I am just wondering how a 4 years old's teeth got in such bad shape in the 1st place?! It sounds like you need to work on avoiding sugar and high fructose corn syrup, and help him thoroughly brush his teeth twice a day. Some people are more cavity prone than others, but this seems so excessive in such a young child. Hopefully you can get into better habits before he gets his permanent teeth.

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