Orthodontic spacers, sometimes called separators, are small rubber bands or metal springs temporarily placed between certain teeth as a preliminary step in preparation for braces or other appliances. These devices often precede a more involved appointment. It is common for a spacer to become dislodged and fall out before its scheduled removal date, tempting patients to try and replace it themselves. This article explains the proper protocol for handling a lost spacer and why attempting self-replacement is generally discouraged.
The Purpose and Mechanism of Orthodontic Spacers
The primary function of an orthodontic spacer is to create a small, temporary gap between two adjacent teeth, typically the molars. Teeth that are tightly aligned do not have enough room for a metal orthodontic band to be placed comfortably around them. The band serves as an anchor point for the main archwire or other fixed appliances.
The spacer works by applying constant, gentle pressure to the periodontal ligament. This sustained force slowly nudges the teeth apart over a period of about one to two weeks. Once sufficient space is created, the spacer may fall out on its own, signaling that it has completed its work. Without this initial separation, fitting the metal band would be difficult and could compromise the precise fit of the appliance.
Why Self-Replacement Is Not Recommended
While re-inserting a spacer may appear simple, doing it correctly requires specialized instruments and a clear, overhead view that a patient cannot achieve alone. The greatest risk of a do-it-yourself attempt is the improper seating of the spacer. The device must be positioned correctly below the contact point between the teeth to ensure it remains effective and does not cause harm.
If a spacer is not seated properly, it will fail to apply the necessary separating pressure, allowing the space to close rapidly. More dangerously, it can be pushed down onto the gum tissue. Pushing the spacer too far can result in it becoming embedded beneath the gumline, causing significant inflammation, pain, and potentially an infection. This complication requires an immediate appointment with the orthodontist for surgical removal.
Furthermore, any attempt at self-insertion introduces a hygiene risk, as non-sterile fingers or tools can introduce bacteria. If the spacer is not firmly seated below the contact point, the teeth will begin to drift back together. This rapid closure defeats the purpose of the initial treatment and will likely delay the next appointment, as the entire separation process may need to be repeated.
Immediate Steps When a Spacer Comes Out
The first action when a spacer falls out is to contact the orthodontic office immediately to report the loss, even if it is after hours. This is time-sensitive because the space created by the separator can begin to close very quickly, sometimes within hours. The orthodontist or a member of their team will advise if an emergency replacement visit is necessary.
While waiting for instructions, there are a few temporary actions that can be taken. If the area is sore, over-the-counter pain medication can be used for relief. It is also helpful to stick to a soft diet to avoid irritating the sensitive gum area or potentially closing the gap further with chewing forces. If the spacer itself is recovered, it should be saved and brought to the office, as the orthodontist may choose to use it for re-insertion.
The professional re-insertion process typically involves the use of specialized separating pliers or two strands of dental floss to stretch the elastic spacer. This technique allows the clinician to thread the device under the contact point and release it safely. This ensures it settles into the correct location below the tightest part of the tooth crowns. Professional placement guarantees the spacer is effective and minimizes the risk of gum tissue irritation or embedding.