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Space Maintainers

Space Maintainers

Baby teeth serve as guides for where the permanent teeth will erupt. If a baby tooth is extracted or falls out prematurely, then adjacent teeth may drift into the gap created by the missing baby tooth. If this happens there will be no room for the permanent tooth to grow into. To prevent this, we recommended the use of space maintainers to preserve the space until the child’s permanent teeth are ready to replace the lost baby tooth.

A baby tooth can be lost early because the extent of decay requires for it to be pulled out or because it is infected. Some teeth also get loose due to internal resorption and fall out early on their own. Either way, the loss of the tooth creates a space and the only way to prevent other teeth from drifting into that space is through the use of space maintainers.

Since young children and adolescents tend to loose removable space maintainers, or do not wear them often enough, we recommend fixed space maintainers that are cemented onto the tooth. These are more efficient at maintaining the space and require minimal care on the part of the child. Also in the event that the child is missing only one tooth, we recommend a unilateral space maintainer. If the child is missing more than one tooth however, the space is best maintained using a bilateral space maintainer. For the top teeth, this is called a Nance appliance, while for the bottom teeth, this orthodontic device is known as a lower lingual holding arch. As soon as the permanent tooth begins erupting, it is a good idea to bring your child to see the pediatric dentist so they can determine if the timing is right to remove the space maintainer.

After the space maintainer is in place, it is common to have some gingival irritation around it, until the tissues get use to the appliance. As with all orthodontic appliances, it is important to maintain good brushing habits, which will prevent further irritation. Gargling with salt water or mouth wash can also help the tissues heal and kill the bacteria that may build up in the region.