Baby teeth do more than help children chew and smile. They also hold space in the jaw for the adult teeth developing underneath. When a baby tooth is lost too early because of decay or injury, neighbouring teeth can drift into the gap, blocking the path of the adult tooth. A space maintainer is a simple appliance that prevents this and can save more complex orthodontic treatment later.
Baby molars normally stay in place until around ages ten to twelve. If one is lost years earlier, the teeth on either side tend to tip or drift into the space, and the opposing tooth may grow toward it. When the adult tooth is ready to come through, there may not be enough room, leading to crowding, impacted teeth or a bite that does not meet properly. Holding the space open helps the adult tooth erupt where it should.
Your dentist will consider which tooth was lost, your child's age, how far the adult tooth has developed and how much space is available. X-rays show the position of the adult tooth. If the adult tooth is expected to come through soon, a space maintainer may not be needed. If it is still several years away, one is often recommended to protect the space.
Fixed maintainers are cemented to the teeth and cannot be removed by the child. A common design is a band and loop, where a metal band fits around a neighbouring tooth and a wire loop extends across the gap. For the lower jaw, a lingual arch may be used, a wire running behind the front teeth connected to bands on the back teeth. Fixed maintainers work continuously and do not rely on the child remembering to wear them.
Removable maintainers are similar to retainers, with an acrylic base and sometimes artificial teeth to fill the gap. They can also improve appearance when front teeth are lost. However, they only work if worn as instructed and can be lost or broken, so they are better suited to older, responsible children.
Children usually adapt to space maintainers within a few days. They may notice the appliance with their tongue at first. Some children produce more saliva or feel slight pressure. Encourage normal eating and talking to help them adjust. Contact the clinic if your child reports pain or if the appliance feels loose.
Brush around the appliance carefully twice a day, paying attention to the bands and wire. Avoid sticky and hard foods such as toffee, chewing gum and hard sweets, which can loosen or bend it. Do not let your child push or pull the wire with their tongue or fingers. Bring your child for regular check-ups so the dentist can check the fit and monitor the adult tooth.
The space maintainer is removed once the adult tooth starts to come through. Your dentist will monitor progress with check-ups and X-rays. Removal is quick and painless.
Not always. It depends on the tooth, your child's age and how soon the adult tooth will erupt.
They may feel strange at first, but they should not be painful.
Until the adult tooth begins to come through, which can range from months to a few years.
Ask whether your child needs a space maintainer.
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