Dental space maintainers are common tools used in pediatric dentistry to help guide a child’s oral development. These appliances preserve necessary space in the mouth, managing situations where primary teeth are lost earlier than expected. Their goal is to ensure a healthy path for permanent teeth to emerge correctly.
What Are Dental Space Maintainers?
Dental space maintainers are custom-made devices that hold open the space created by the premature loss of a primary, or baby, tooth. They prevent adjacent teeth from shifting into the empty area, preserving sufficient room in the jaw. This ensures the permanent tooth, which will eventually replace the lost primary tooth, has adequate space to erupt into its proper position.
Space maintainers are typically made from metal or acrylic materials and are custom-fitted to a child’s mouth. These appliances are generally recommended when a baby tooth is lost due to decay, injury, or extraction, and the permanent tooth is not yet ready to emerge.
Why Are Space Maintainers Necessary?
Space maintainers are necessary to prevent dental problems that can arise from premature primary tooth loss. When a baby tooth is lost too early, the adjacent teeth can drift or tip into the vacant space. This shifting reduces the available room for the permanent tooth that is developing underneath the gums.
Without a space maintainer, the permanent tooth may become blocked, leading to issues such as crowding, misalignment, or impaction. Such complications can result in an improper bite and may necessitate more extensive and costly orthodontic treatment, like braces, in the future. Space maintainers help to guide the permanent tooth into its correct location, maintaining proper oral function.
Types of Dental Space Maintainers
Dental space maintainers are broadly categorized into two main types: fixed and removable.
Fixed Space Maintainers
Fixed space maintainers are cemented onto the teeth and cannot be removed by the child, making them a common choice for younger patients.
Band-and-loop maintainer: A widely used fixed type, consisting of a metal band fitted around a tooth next to the gap and a wire loop extending into the space.
Crown-and-loop maintainer: Similar to the band-and-loop, but uses a dental crown on the adjacent tooth with a loop extending to hold the space.
Distal shoe maintainer: A specialized fixed appliance used when a second primary molar is lost before the first permanent molar has erupted; it features a metal bar that extends slightly under the gum line to guide the unerupted permanent tooth.
Lingual arch: Used for multiple lost teeth in the lower jaw, this is a wire placed on the tongue side of the lower teeth, attached to molars on both sides to maintain space.
Removable Space Maintainers
Removable space maintainers resemble orthodontic retainers and can be taken out for cleaning. These are typically made of acrylic and may include artificial teeth to fill the gap. Removable options are generally more appropriate for older children who can consistently follow instructions for wearing and caring for the appliance.
Getting and Caring for Space Maintainers
The process of getting a space maintainer begins with an initial consultation where the dentist examines the child’s mouth and may take X-rays to assess the need. Impressions of the child’s teeth and the space are then taken, used by a dental lab to custom-fabricate the maintainer. Once ready, it is cemented onto the adjacent teeth during a follow-up appointment.
Caring for a space maintainer involves diligent oral hygiene and dietary adjustments. Children should avoid sticky foods like caramels and chewing gum, as well as hard foods that can dislodge or damage the appliance. Regular brushing and flossing around the maintainer are important to prevent plaque buildup and cavities. Routine dental check-ups allow the dentist to monitor the maintainer’s fit, assess the eruption of permanent teeth, and address any issues. The maintainer is usually removed once the permanent tooth begins to erupt into its proper place.