Space Maintainers


Even though your child will use baby teeth for chewing, they have another very important purpose. As you may be ware, primary teeth provide crucial guidance for permanent teeth. Therefore, when a baby tooth comes out too early, the adult tooth may drift, and eventually erupt in the wrong position. Aside from this, adjacent teeth may move into the gap and prevent the correct tooth from dropping into position.

Why Procedure Is Used

There are a number of reasons why primary teeth may come out too soon. This includes trauma as well as severe decay. In some cases, primary teeth may be missing may never have developed. In each of these situations, space maintainers can be used to ensure that enough room is available for adult teeth to erupt.

Patient Concerns to be Addressed

Depending on where the tooth is, you may not need to worry about using a space maintainer. For example, if the upper four front teeth come out too soon, the space will stay open on its own. If your child needs a space retainer, good oral hygiene is essential. In most cases, your dentist will also recommend avoiding gum and sweet candies. Your dentist will also need to monitor the space maintainer every six months. Unfortunately, without monitoring, gum tissue may grow over the maintainer, and lead to an increased risk of infection.

How Procedure is Performed

Space maintainers are usually made from plastic or stainless steel. Some can be removed, while others will be cemented into the mouth. Removable space maintainers will look much like a regular retainer. It may also have artificial teeth to fill in the spaces. Usually, this type of space maintainer is used for the sake of appearance as well as to allow permanent teeth to erupt. Unfortunately, your child may not be able to have a removable retainer if he/she does not follow instructions reliably.

If your child needs a fixed space maintainer, a metal band will be put around teeth adjacent to the space that needs to remain open. Your child’s dentist will them make an impression of the teeth in order to create the space maintainer. From there, the band and the models will be sent to a laboratory, where the retainer will be constructed. Once your dentist receives the space maintainer, he/she will cement it into your child’s mouth. Depending on the resources at the dentist office, a space maintainer can be created and applied all in one visit.

As you may be aware, there are several different kinds of space maintainers. This includes:

Band-and-Loop Designs – a stainless steel band is placed around the crown of an adjacent tooth. A loop, or band is then attached to the band, and then stretched across the space that will remain open. The attachment will just touch the other side of the open space. Eventually, a permanent tooth will fill this space.

Lingual Arch Designs – a lower wire may be used when back teeth on both sides of the jaw are affected. Bands are wrapped around teeth on both sides of the mouth, as well as behind them. The band that creates the space is typically placed on the inside, or tongue side of the mouth, or along the bottom of the crown.

Distal Shoe Design – These space maintainers are placed under the gum. If your child looses a baby tooth that is in front of a molar that has not erupted yet. For example, if your child’s six year molar has not erupted, it may be necessary to use this type of space maintainer. As may be expected, a distal shoe appliance will have to be monitored carefully. Unfortunately, erupting teeth can be blocked by this type of wire.

If several teeth are missing, your dentist my recommend using a partial denture. This includes situations where there is a genetic issue present. Among other things, children with ectodermal dysplasia may need to have a partial denture. Once a child with this condition reaches adulthood, he/she may also need implants or bridges to take the place of permanent teeth.

Post-Operative Concerns

As may be expected, some children are too young, or may not be suitable candidates for having a space maintainer. Fro example, children with breathing and swallowing problems may not be able to receive a space maintainer. In addition to having problems with the actual procedure, there is also a risk of injury if the space maintainer breaks or becomes loose.

When the space maintainer is first installed, it will feel strange. That said, most children forget about it within a few days. If your child receives a space maintainer with teeth, it can also affect speech until your child adapts to it. Unfortunately, if the space maintainer becomes loose, you child may swallow it. These devices may also get inhaled into the lungs. Therefore, it is very important to make sure your child does not push on the space maintainer, or do anything else that might loosen it.

Perils of Disease

Typically, a dentist will keep track of when teeth are about to erupt by making use of x-rays. Once he/she notices that a tooth is about to emerge, it will be time to remove the space maintainer. If there is no permanent tooth available to occupy the space, the maintainer will remain in place until your child reaches 16 to 18 years of age. At that time, the dentist will insert a bridge or implant in order to create a full set of teeth.