When does a baby tooth need a crown instead of a filling?
When too little healthy tooth is left for a filling to hold onto. A filling is glued into a hole; if the walls around that hole are thin or already fractured, the filling will fail and you will be back, usually at an inconvenient time.
A crown covers the whole tooth. It is more work up front and it lasts until the tooth falls out on schedule.
What is a pulpotomy?
A pulpotomy is the removal of infected pulp tissue from the top chamber of a tooth, leaving the healthy tissue in the roots intact. People call it a baby root canal, which is close enough, though it is a smaller procedure than an adult root canal.
It is done when decay has reached the nerve. A crown goes on afterward in the same visit.
Silver or white?
Both are available. Stainless steel crowns are stronger, cheaper, and nearly impossible to break, and they are what we recommend for back molars that no one sees. Tooth-colored zirconia crowns look far better and are what most families choose for front teeth. They cost more and are slightly more technique-sensitive to place.
We will show you both and tell you which we would pick for our own kids on that particular tooth.
Last reviewed October 2025 by Brightburrow clinical staff.