A space maintainer is a dental device used to keep the space for a permanent tooth open when a child prematurely loses a primary, or baby, tooth. Primary teeth serve as guides for permanent teeth. If they are lost early, permanent teeth can drift into the wrong position and ultimately erupt through the gums in the wrong place or at a wrong angle. Sometimes, when a primary tooth is lost early, the two adjacent teeth may drift together and block the eruption of an adult tooth. A space maintainer keeps the space where the tooth was prematurely lost intact so the position of the permanent tooth is not affected.
Children don’t always need a dental space maintainer for a prematurely lost tooth. For instance, if one of the four front teeth in the upper part of the mouth is lost, no space maintainer is necessary. Space maintainers are usually needed if one of the other teeth is lost because of disease, an accident that knocks the tooth out or excessive tooth decay. However, if one of these things happens at a time when the permanent tooth is close to erupting, a dentist may decide that a space maintainer is not needed.
Space maintainers can be made of stainless steel or plastic and they can be removable or cemented in the mouth. Removable space maintainers require more care on the part of the child, but they can be made to look like real teeth so that the child’s smile still looks natural. Affixed space maintainers usually have stainless steel wire and are held in place by bands wrapped around adjacent teeth. For children missing many teeth, a partial denture may be required instead of regular space maintainers.
Semi-permanent space maintainers must be monitored closely so they can be removed when the permanent tooth is ready to erupt. Children with these types of space maintainers must be particularly careful to brush well and maintain their dental health. It’s important they visit the dentist regularly so the dentist knows when to remove the maintainer and can monitor for inflamed gum tissue growing over the wire arms and causing an infection risk. In extreme cases, inflamed gum tissue that grows over the space maintainer may have to be surgically removed.
For children missing permanent teeth that should grow into the space being held by an orthodontic space maintainer, the space maintainers are left in until the child nears adulthood. When the child reaches his or her late teens, space maintainers can be removed. They are usually replaced with adult dental devices such as bridges or dental implants.
