Space Maintainers

Your child’s baby teeth aren’t there just so you can get a great smile for photo ops. They’re actually not just for chewing either. Each baby tooth clears a path and acts as a guide for the permanent tooth that grows to replace it. This is a natural process called eruption.

When your child loses a baby tooth too early, the eruption of the permanent tooth has no guide. It can erupt in the wrong position or drift to the wrong area of the gums. Teeth that neighbor it can also tilt or move into that space, disrupting their alignment. When this happens, it means there isn’t enough space for the permanent tooth, and hence the need for a space maintainer.

Losing Baby Teeth

Mila Cohen refers to the baby teeth as primary teeth. Primary teeth can be lost too early for a number of reasons, including:

  • An infection that causes tooth decay may prompt an extraction.

  • Injuries or accidents can knock them out.

  • Diseases and other health conditions may lead to early loss.

  • Primary teeth may be missing from birth.

Orthodontic care only requires space maintainers if the primary tooth is lost and the permanent tooth is ready to erupt. The space maintainer serves to hold that space open until the permanent tooth erupts.

Kinds of Space Maintainers

Most space maintainers are made from stainless steel, but others are made out of plastic. Other different types include:

  • Removable space maintainers

  • Fixed Space maintainers, which are cemented onto your child’s teeth

  • Distal shoe appliances

  • Partial dentures

Removable Space Maintainers

Removable space maintainers resemble retainers. They have artificial teeth built in to occupy the space that’s needed for the permanent teeth to grow into. This kind of space maintainer is only used when the space is obvious. They typically work better with older kids who are more able to follow directions from dentist when caring for the maintainer.

Fixed Space Maintainers

There are many types of fixed space maintainers, one of which is the band-and-loop type that’s made from stainless steel wire. A crown on the tooth beside the space holds it in place.

Another type, called a lingual arch, is used when the back baby teeth are missing on both sides of the bottom jaw. “Lingual” refers to the inside of the tongue next to the teeth. The lingual arch space maintainer stays in place by bands that are wrapped around the teeth on either side of the space they are filling. A wire is then connected to this band to maintain the space on both sides.

Distal Shoe Appliance

A distal shoe appliance is inserted under your child’s gums. A distal shoe is typically used when kids lose the baby tooth next to the 6-year molar before it erupts. The 6-year molar is the first molar that’s permanent. A distal shoe space maintainer has a wire that runs slightly beneath the gum. This prevents the space from closing.

The downside of distal shoe space maintainers is that they have to be checked regularly because it may actually block the new permanent tooth from erupting. Your dentist can adjust the appliance to allow the new tooth to align properly.

Partial Denture

If your child is missing more than one tooth, a partial denture is fitted instead of a space maintainer. So, if your child suffers and injury that knocks out many front teeth, or if he has a disease from birth called ectodermal dysplasia — which can result in missing teeth, your child can wear removable dentures until the permanent teeth grow in.

Space Maintainers Aren’t Always Needed

If children lose baby teeth early, don’t worry. It‘s entirely possible a space maintainer still won’t be required. For example, when one of the four front teeth on the upper jaw is lost, the space naturally stays open until the permanent tooth erupts. If the permanent tooth is about to erupt, your dentist may decide not to use a space maintainer unless your child needs braces and space is a critical issue.

Younger children might not cooperate with the procedure of making and installing a space maintainer. Other kids with swallowing or breathing issues may be at risk if the space maintainer breaks or comes loose. A child’s ability to cooperate with the kids dentist is vital in receiving a space maintainer.

Space Maintainer Risks and Care

If your kids don’t visit the dentist at least every six months, space maintainers can cause issues. These common problems are compounded if they don’t brush their teeth well. With improper brushing, the tissue of the gums can grow over the maintainer’s wire arm, increasing the potential for infection. If the gum tissue becomes infected, your child may need surgery to remove that tissue.

Your children may experience some discomfort with a space maintainer at first, but kids usually get used to it after a few days. Removable space maintainers can also affect children’s speech until they get accustomed to it.

Make sure your children brush their teeth regularly and properly. Also, have your kids visit Dr. Mila Cohen at least once every six months to make sure their gums and teeth are healthy. Kids with fixed space maintainers should avoid hard candy, sticky foods, gum and chewy candy. These things can loosen the metal band or get caught in the wire support arm. If that wire comes loose, there is a risk of swallowing it or inhaling it. Also, children shouldn’t push the space maintainer with their fingers or tongue. This can bend, damage or loosen it.

Following Up with Your Dentist

After your child receives a space maintainer, your dentist may take X-rays to track the progress of the permanent tooth as it gets closer to eruption. The dentist can then tell when your permanent tooth is ready to come in, and he can go ahead and remove the space maintainer.