When a primary (baby) tooth is lost prematurely, we want to put a “reservation” sign on that space so the permanent tooth can move in when it’s ready. Baby teeth have a very important role in a child's dental development. They play a part in muscle and bone growth and they help guide the adult tooth into alignment and position. If a primary tooth is lost before the adult tooth is ready, the surrounding baby teeth can shift leaving the permanent tooth searching for its home. If a baby tooth is lost due to trauma or needs to be extracted for a dental concern, we would often recommend placing a space maintainer to keep the surrounding teeth from shifting so the adult tooth can take its proper place.
“As a pediatric dentist, one of my key goals is to keep the baby teeth healthy and in the right place so that the permanent teeth can come in properly. If a baby tooth comes out before the next tooth is ready to come in, we often use a space maintainer. This keeps the space open and ensures that when the time is right, your child’s permanent tooth will be able to grow up in the exact place it should be. A little planning and preparation can pave the way for lifelong dental health and great looking teeth.”
Space maintainers can be removable or permanently cemented in the mouth. The removable kind are similar to orthodontic retainers. They are made of the same acrylic material and sometimes have a false tooth attached to the mouthpiece to “live” in place of the missing tooth. A removable maintainer does make it easier to maintain good oral hygiene habits but a fixed appliance may be a better option to prevent the need for future orthodontic care.
There are several different options for a fixed space maintainer. Some hold the place open for the unerupted tooth using the opposing teeth as an anchor for the appliance. Some fixed space maintainers use a crown on a neighboring tooth as an anchor for the actual placeholder.
Sometimes children are missing teeth due to a congenital defect; there are options for permanent and removable partials with false teeth to fill in the empty space(s). Filling in the empty space from missing teeth is important to aid in proper development and possibly minimizing the need for orthodontic treatment. Making sure a child has a full smile positively affects the child’s developing self-esteem.
It is important to avoid sticky, chewy foods with a fixed space maintainer as they can cause the appliance to shift or even come out completely. Good home care habits are also important to keep surrounding teeth healthy and decay free.