Space Maintainers

Certain situations, like caries or trauma, may cause a child to loose a baby tooth earlier than desired. After the premature loss of a baby tooth, children are often apt to have issues with crowding and a lack of space for the adult teeth to erupt into the mouth. Also, when a baby tooth is lost early, the adjacent teeth tend to drift in unfavorable directions with the newfound space available. To maintain all available space and reduce the risk of teeth drifting, a space maintainer is often recommended. Space maintainers are custom-made and designed based on the particular situation for each individual.

Healthy baby teeth are extremely important for many reasons. They help your child speak properly and eat a nutritious meal. They also serve an important function of holding space for their future adult teeth replacements, helping to guide the adult teeth into place.

In certain situations though, like trauma or extensive decay, a baby tooth may be lost prematurely. In this scenario, the body’s natural space maintainer (the baby tooth) is lost and nothing is holding the space for the future adult tooth replacement. Also, to make matters a little more complicated, the body’s natural reaction is typically to slowly close any space in the mouth. As a result, when a baby tooth is lost prematurely, the teeth adjacent to the newfound space tend to drift towards each other, causing a loss in available room for the future adult tooth. This scenario often causes crowding and leads to adult teeth coming into the mouth in the incorrect position. In cases of severe crowding, an adult tooth may not have any room to erupt and can become impacted – meaning it gets stuck without the ability to make its way into the mouth.

In this situation of a baby tooth being lost prematurely, Space Maintainers are often recommended. As the name implies, a Space Maintainer is used to maintain space when there is potential future crowding issues. For example, if a baby molar is lost at 5 years old when the adult tooth is not supposed to come into that spot until 12 years old, a space maintainer is the best preventative option to minimize future space loss.

Space maintainers come in various forms and designs. Generally speaking, there are two main categories: cemented and removable.

Cemented Space Maintainers are cemented into place using a special tooth glue. The most common Cemented Space Maintainer is called a Band-and-Loop, which is a small custom-designed appliance with a band around one tooth and a loop attached that extends across the space and rests on the adjacent tooth. The loop prevents these teeth from drifting closer together over time.

On the other hand, Removable Space Maintainers are custom-designed removable appliances that look similar to a typical orthodontic retainer. It has a thin metal bar across the front of the teeth and a colored acrylic on the inside. The child would wear this retainer each night when sleeping. Some kids get excited about this option to select the color of the acrylic and show their retainer to friends.

For younger children, Cemented Space Maintainers are typically recommended, as a removable option would not be advisable. For older children, the removable type are often a good option.

If a baby tooth is lost prematurely for one of our patients at Bright Healthy Smiles, we will typically recommend an appointment with our Board Certified Orthodontist Dr. Jordan Lissauer to discuss space maintainer options. If a space maintainer is in fact indicated, Dr. Lissauer will show you all of the options, explain the pros and cons of each, review the simple process and answer any questions.