You know you live in a sugar-saturated environment when nearly half of all kids experience decay in their primary (baby) teeth by the age of 11.
Yet even if you strive to eat healthfully and help your kids practice good hygiene at home, problems can arise. This is one reason why regular dental checkups and cleanings are so important: We can keep an eye on their developing teeth and intervene early if we see problems emerging.
For when you catch tooth decay early, it can often be treated non-invasively. If the decay is still on the surface, things like dietary changes, micro air abrasion, or ozone may be enough – no drilling and filling necessary.
But once decay reaches into the dentin – the middle layer of tooth tissue, between the enamel and the living pulp – we need to consider ways of restoring the tooth. (Yes, it will eventually fall out as all primary teeth do, but leaving empty spaces in the mouth can allow the teeth to shift and create orthodontic headaches down the road.)
In mainstream dentistry, this often means cleaning out the infection and either filling the tooth with mercury amalgam or capping it with a pre-fab metal crown.
A recent review in the International Journal of Pediatric Dentistry found that among all restoration types, stainless steel crowns had the highest success rate (96.1%), though composite performed well, too. Most times, failure was due to recurrent caries – reinforcing the point that treatment alone isn’t enough; you’ve got to address the cause of caries, not just patch up the damage it does.
This comes on the heels of a Cochrane review, which concluded that, based on “moderate quality” evidence,
crowns placed on primary molar teeth with carious lesions, or following pulp treatment, are likely to reduce the risk of major failure or pain in the long term compared to fillings.
So are metal crowns really the way to go? After all, they’re cheaper and easier to place, too.
No. Just as we would never place toxic mercury amalgam in anyone’s teeth, neither would we place metal crowns.
For stainless steel crowns are made mostly of iron, chromium, and nickel. Some pre-fab crowns are over 76% nickel. Both nickel and chromium are toxic heavy metals. And just as with mercury, those metals don’t stay “locked” inside the restorations. According to an important 2011 study in the International Journal of Dentistry,
Stainless-steel crowns release nickel, chromium, and iron in oral environment, and the ions are absorbed by the primary molars roots. The additional burden of allergenic metals should be reduced if possible.
And the allergenic aspect barely scratches the surface. Nickel, for instance, is known to be highly carcinogenic (cancer-causing) and can damage DNA, preventing cells from repairing. It’s also known to cause oxidative damage and may have negative effects on the reproductive and nervous systems, as well. Chromium is dangerous in many of the same ways.
When a child’s tooth must be filled, we opt for biocompatible, BPA-free composite. And just as with adults, we test for compatibility in advance, to make sure that what we put into your child’s teeth isn’t apt to trigger a negative reaction.
Our aim is to support their good oral and systemic health. The first step in that is to, in the words of the Hippocratic Oath, first, do no harm.
Crowns image by Trikkelle, via Wikimedia Commons