Space Maintainers

Any space created by the early loss of a primary tooth must be preserved until the permanent tooth erupts. To achieve this, we use space maintainers, which are custom-made appliances designed to fit the child’s dental and jaw structure. There are two types of space maintainers: fixed and removable. The fabrication of these appliances is carried out by dental technicians in a laboratory setting.

To ensure that space maintainers are effective, they should be applied shortly after the tooth loss. This helps prevent potential space loss and avoids future orthodontic problems. Space maintainers remain in the mouth until the corresponding permanent tooth emerges.

Types of Space Maintainers

There are two types of space maintainers: fixed and removable. Fixed space maintainers are made according to the child’s measurements and are cemented to the tooth. They are commonly used in cases of unilateral tooth loss, very young children, and situations where patient cooperation is not feasible. Since they are fixed, only a dentist can remove them.

Removable space maintainers can be taken out and put back in by the child. Like fixed space maintainers, they are custom-made based on the child’s measurements. They are preferred for multiple primary tooth losses, bilateral primary tooth losses, and for addressing aesthetic concerns in the anterior region. Removable space maintainers require the child’s cooperation and are therefore used in older children. They must be worn all day except during meals.

Important Considerations When Using Space Maintainers

Proper oral and dental care should be maintained while using space maintainers. Teeth and appliances should be cleaned regularly as recommended by the dentist. When using fixed space maintainers, sticky foods such as gum and taffy should be avoided, as they can dislodge the maintainer. If the space maintainer comes loose, it should be re-cemented promptly. Regular dental check-ups are necessary during the period of space maintainer use to ensure timely intervention when removal is needed.

For removable space maintainers, it is crucial for the child to adapt to the appliance. If not used consistently, the appliance may lose its fit and effectiveness. Initially, space maintainers may cause sores in the mouth, which should be monitored by a dentist.

If a space maintainer is broken or lost, it needs to be replaced.

How to Clean Space Maintainers

Fixed space maintainers are cleaned by brushing around them during regular tooth brushing. Removable space maintainers should be cleaned under lukewarm tap water using liquid hand soap and a toothbrush. Occasionally, they can be soaked in a solution of white vinegar and water or cleaned with denture cleaning tablets for extra hygiene.

Should Space Maintainers Be Made for Every Primary Tooth Loss?

Space maintainers are used when a primary tooth is lost prematurely. If a primary tooth is lost due to the eruption of the underlying permanent tooth, a space maintainer is not needed.

If the root development of the underlying permanent tooth is sufficiently advanced, a space maintainer is not necessary, regardless of the reason for the primary tooth loss. However, these decisions can vary based on the child’s specific needs, so consulting an orthodontist or pedodontist is beneficial.