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Caring for your child’s oral health is equally important as their general health. It will establish confidence in them and also plays a major role in nutrition and their overall well being. Early loss of teeth can cause difficulty in speech and their chewing abilities.

Deciduous teeth are often neglected in society because of their shorter time of existence in oral cavity. However, they are equally important as they guide the permanent tooth to erupt in their place and hence aiding a proper alignment.

When a deciduous or commonly called as milk tooth is lost at an early age(i.e. before an year of eruption of permanent tooth) , we usually prevent the drifting of other tooth into the space allotted for permanent teeth to erupt. This procedure is called as space maintenance.

Some Common Causes of Early Falling of Primary Tooth :

  1. Early childhood caries due to prolonged bottle feeding.
  2. Extractions of grossly decayed primary teeth.

Types of Space Maintainers :

Depending on various factors space maintainers are broadly of two types.

  1. Removable space maintainers.
  2. Fixed space maintainers.

However, sometimes the child may have missing teeth due to congenital diseases which may need a partial denture instead of space maintainers. It is important to take a pediatric dentist’s opinion regarding this option.

Functions of a Space Maintainer :

  1. To maintain the arch length ,width and circumferential area.
  2. To prevent supra eruption of opposing tooth.
  3. To improve speech abilities if the anterior tooth is lost.
  4. Improved esthetics if the tooth involved is anterior.
  5. Also aid in management of oral habits like thumb sucking etc…

How to wear a Space Maintainer :

If it is a removable space maintainer , it requires some patience from the guardian’s side as it will take some time for the child to get accustomed to the appliance. Maintenance of the appliance plays a major role in preventing further infections. The child is advised to maintain his oral hygiene by regular brushing and flossing if required.

If it is a fixed space maintainer, the child is advised not to eat sticky foods, especially toffees and chewing gums as it may get stuck in between the appliance or the appliance may come off with the eatable And in general , the patient is advised not to put finger or tongue and try to tug the appliance as it leads to loosening of the appliance.

Constant monitoring is required from every 3 months to 6 months till the permanent tooth gets erupted.

When to place a Space Maintainer :

Ideally, the space maintainer should be placed as soon as possible followed by an extraction. But, if the extraction is already done, it is preferable to fix a space maintainer within six months of extraction.

Removal of a Space Maintainer :

It can be removed when the permanent successor starts penetrating the gum tissues or if the patient has any postoperative symptoms.

Eruption of Permanent Tooth :

According to studies ,It usually depends on root formation of the permanent tooth after the space maintenance .
If the root is formed less than 50% of its original length, the eruption will be delayed.

If the root is formed more than 50% , then the eruption process gets accelerated.

Advantages of Space Maintenance :

  1. It will prevent the misalignment problem. In the future which may hampers the physical and emotional well being of the child.
  2. It is more economical than other orthodontic procedures.

Do’s and Dont’s :

  1. Oral hygiene maintenance :- The child is advised to brush twice a day regularly and especially,floss the tooth which plays an abutment role at least once a day.
  2. Regular visits :- The child has to be monitored regularly by the consultant dentist i.e. once on every 3 months.
  3. Avoid sticky and crunchy foods :- Sticky and crunchy foods are to be avoided in order to prevent food accumulation and loosening of appliance.

What happens if a Space Maintainer is not used :

  1. Drifting and tipping of the teeth.
  2. Midline shift of the smile.
  3. Altered arch length causing narrow jaws.
  4. Crowding of opposing teeth.
  5. Impacted permanent tooth.
  6. Complex orthodontic procedures which may include extraction of some permanent teeth.
  7. Would prevent the cumbersome procedure to regain the lost space.

Authored by : 
Dr. Jahnavi Sridhar,
Dental Surgeon,

Ankura Dental – Best Dental Clinic in Hyderabad

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