What Is a Space Maintainer?
A space maintainer is a small appliance that keeps open the space left by a primary tooth lost prematurely. Primary teeth help preserve space for the permanent teeth developing beneath them. If a primary tooth is lost before it is due to fall out because of decay or trauma, the neighboring teeth can shift into the space, leaving the permanent tooth without enough room to erupt.
The appliance is made to fit the child’s mouth. Fixed types are attached to a neighboring tooth with a band and cannot be removed by the child, while removable types can be taken in and out. The type used is determined by the location of the lost tooth, the child’s age, and oral hygiene.
Who Is It Suitable For?
A space maintainer may be considered for children who lose a primary tooth significantly earlier than expected. It may be recommended when a primary molar is extracted because of decay, a tooth is lost due to trauma, a primary tooth is congenitally missing, or the permanent tooth is still a long way from erupting.
An appliance may not be necessary if the permanent tooth is close to erupting or an X-ray shows that it will erupt soon. The decision is made by considering the child’s age together with the stage of development of the permanent tooth seen on the X-ray.
Treatment Process
1. Examination and X-ray: The condition of the space and the developmental stage of the permanent tooth beneath it are evaluated with an X-ray.
2. Taking an impression: An impression is taken of the child’s mouth, or a digital record is made with an intraoral scanner. This step is painless.
3. Fitting the appliance: The space maintainer is placed in the mouth. With fixed types, the procedure is usually completed in a single appointment and does not require anesthesia.
4. Adjustment period: The appliance may feel slightly unfamiliar during the first few days, but children usually get used to it quickly.
5. Follow-up: The appliance is checked at regular intervals until the permanent tooth begins to erupt and is removed when the time is right.