If a child has lost a baby tooth prematurely and the permanent tooth has not erupted yet, then a space maintainer can be used to maintain the space needed for the permanent 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 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 lose 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. In the event that the child is missing only one tooth, we recommend a unilateral space maintainer. If the child is missing teeth on both sides, space is best maintained using a bilateral space maintainer. For the top teeth, this is called a Nance appliance, and for the bottom teeth, it is known as a lower lingual holding arch.

The pediatric dentists at A+ Dental always custom make the space maintainer so that it is the perfect fit for your child’s mouth. If it is a unilateral space maintainer, it can be made the same day of the appointment. However, for bilateral space maintainers, an impression will need to be taken. This is then sent to a dental lab that will custom make the space maintainer to meet the individual needs of the child.

As soon as the permanent tooth begins erupting, it is a good idea to bring your child into 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 tissue gets use to the appliance. As with all orthodontic appliances, it is important to maintain good brushing habits in order to prevent further irritation.