In Dentistry, what is a Space Maintainer?

Erika C.

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.

A child might be given a space maintainer when she loses a baby tooth prematurely.
A child might be given a space maintainer when she loses a baby tooth prematurely.

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.

Primary teeth serve as guides for permanent teeth.
Primary teeth serve as guides for permanent teeth.

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.

A space maintainer may be provided if other teeth are lost because of tooth decay.
A space maintainer may be provided if other teeth are lost because of tooth decay.

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 who are missing many teeth, a partial denture may be used.
For children who are missing many teeth, a partial denture may be used.

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.

When a primary tooth is loss early, the two adjacent teeth may drift together and block the eruption of an adult tooth.
When a primary tooth is loss early, the two adjacent teeth may drift together and block the eruption of an adult tooth.

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Discussion Comments

Telsyst
Premature baby tooth loss can be caused by trauma.

Although many people believe losing a baby tooth is not a big deal, any child who loses a primary tooth as a result of trauma should be examined to see if a maintainer is need to keep spacing between teeth and whether there are fractures in the area around the missing tooth.

Certlerant

How do you know if your child has lost a baby tooth "prematurely?" Does this mean losing the tooth any way besides it naturally falling out?

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