What are space maintainers?
The purpose of your baby teeth is not merely for chewing. They also act as a guide for the permanent tooth that will replace it. If a baby tooth is lost too early then the permanent tooth will lose its guide. It can drift or it could simply erupt into the mouth improperly. The teeth beside it can also move or tilt into the space. This will prevent the permanent tooth from coming into the mouth.
Dentists refer to baby teeth as primary or deciduous teeth. Primary teeth could be lost too early for a number of reasons
- they could be knocked out by a fall or by trauma
- they may have to be extracted because of tooth decay
- they may be missing when you were born
- the tooth loss may be caused by some disease or medical condition
Space maintainers are a great way to keep your mouth in order. They may be used
- when a primary tooth is lost and the permanent tooth is not yet ready to erupt into the mouth
- when permanent teeth or a permanent tooth is missing
The space maintainer will keep the space open until the right time for the permanent tooth to come in.
What are the types of space maintainers?
Space maintainers are made from stainless steel, plastic, or both. They can be removable or cemented into a child's mouth. These are referred to as space maintainers. A removable space maintainer seems more like a retainer. Artificial teeth or acrylic blocks are used to fill in the space or the spaces that have to stay open. This type of space maintainer is used when the space is evident. Removable space maintainers work well in older children. This is because they can follow the directions from the dentist on how to use the dental appliance.
There are a lot of types of fixed space maintainers. A band-and-loop maintainer is made out of stainless steel wires. They are held in place by a crown on a tooth next to the space. They can also be held in place by an orthodontic-type band around one of the teeth next to the open space. A wire loop is connected to the crown or the band. It will stick out across the space where the tooth is missing. It will touch the tooth on the other side of the open space. This wire loop will make sure that the space is open. It will allow the permanent tooth enough space to come into the mouth. It will also prevent crowding from happening.
A lower wire or a lingual arch is used when both of the back teeth from the lower jaw is lost. Lingual refers to the inside or to the tongue side of the teeth. It is a type of space maintainer that uses bands wrapped around a tooth. It is found on either side of the mouth behind the missing teeth. There is a wire connected to the bands that run along the inside of the bottom teeth.
Another type of fixed space maintainer is the distal shoe appliance and is inserted under the gums. It is used when a child loses a baby tooth in front of a six year molar that hasn't come into the mouth. The six year molar is also referred to as the first permanent molar. Since this tooth has not yet come in, there is no tooth to hold the band-and-loop space maintainer in place. Since the distal shoe appliance has a metal wire inserted under the gums, the space will be prevented from closing.
Distal shoe appliances must be checked very often because the incoming tooth can easily be blocked by the wire. The appliance may have to be adjusted so that the tooth will come in properly. As a result, most dentists avoid using distal shoe appliances as much as possible. They will try to keep the permanent tooth in the mouth as much as possible. They will wait until the permanent tooth underneath it is ready to come in.
Children who are missing several teeth use partial dentures instead of space maintainers. For instance, when a child has a congenital disease like ectodermal dysplasia, several primary teeth are missing. There are also no permanent teeth to replace them. Children with this condition may have to use a removable denture until they grow up. Afterwards, the child may have dental implants, a bridge, or continue to use a partial denture.
Do you have to use space maintainers all the time?
Every tooth that is lost too early does not necessarily need a space maintainer. For instance, if one of the four upper front teeth is lost too early then the space will stay open by itself until the permanent teeth come in.
If you do not bring your child to the dentist every six months then these space maintainers can cause problems. It can be aggravated if your child does not even brush their teeth properly. The gum tissue in the space can grow over the wire arm and can increase the risks of infection. If this happens, your child's dentist may have to remove the gum tissue through a surgical operation.
If the permanent tooth is about to come into the mouth then your dentist may not use a space maintainer. A space maintainer may be used if the child needs braces and space is very important.
There are children who are unable to cooperate while making the space maintainer. Other people are simply at risk when the space retainer becomes loose or if it breaks. These include children with diseases that affect how they breathe, children with diseases that affect how they swallow, and children that are simply too young. The ability to cooperate with the dentist is more important than the age of the child. If a young child is able to cooperate with the dentist at a young age then they will be able to get space maintainers.
How is a space maintainer made?
Every space maintainer is custom built by every dentist or orthodontist. For fixed space maintainers, metal bands are placed around one of the teeth next to the space and then impressions are made. These impressions are made with a soft material. It tastes like toothpaste. It sets into a gel around the teeth and it is easily removed from the mouth. This will allow the laboratory to make a copy of the teeth. The copy of the teeth will be used to make the space maintainer. The band is removed and sent to the dental laboratory as well. The lab people will create the space maintainer and send it back to your child's dentist. It will be cemented into place on the second visit. There may be instances where the space maintainer is made on a single visit. For removable space maintainers, the dentist will make impressions, send it to the lab, and have the appliance made. The process is similar to making the fixed space maintainers.
How do you take care of your space maintainers?
A space maintainer feels unusual at first but after a few days, you should get used to it and eventually forget about it. A removable space maintainer with replacement teeth may affect your speech as well.
It is important for children to brush their teeth regularly in order to keep gum tissues healthy. Children with fixed space maintainers need to avoid chewy candy and bubble gum. They may loosen the band and may even get caught in the wire arm. If the space maintainer becomes loose then there may even be a risk of swallowing or inhaling the object into the lungs.
Lastly, your child should not push the space maintainer with their tongues or with their fingers because they may bend or become loose.
What are the follow-up procedures after installing space maintainers?
Your dentist should follow the progress of incoming permanent teeth by taking regular x-rays. When the tooth is ready to come out, the space maintainer may be removed. If there are no permanent teeth then the space maintainer must still be used until the child reaches the age of sixteen or the age of eighteen. The dentist will place a bridge, implant, or removable partial denture on that space.