Space Maintainers Help With a Perfect Smile

Even though your child’s primary (baby) teeth won’t stick around forever, they set the stage for the proper development of the permanent (adult) teeth that follow them. As they fall out, they’re quickly replaced by the adult teeth, which are guided into the space left behind. The new teeth grow into the correct position, and your child’s bite (how the top and bottom teeth fit together) remains properly aligned. 

Because this typically happens in a short space of time, the gap is ready and waiting to accommodate the new adult tooth. However, when one or more of their primary teeth fall out early from tooth decay, injury or other causes, natural forces in the mouth (like chewing or biting) can push the surrounding teeth into the gap. By the time the permanent tooth is ready to come through, there may not be enough space. This can cause the permanent teeth to be crowded and crooked, which can lead to misaligned teeth, the need for orthodontic treatment, and increased risk of dental disease. In some cases, the tooth may not be able to erupt at all; this is known as impaction.

Space maintainers can help to avoid these problems. As the name suggests, these helpful dental devices maintain the space where your child’s primary tooth was lost early. This ensures that the surrounding teeth are not affected and can keep proper distance and alignment, giving the erupting tooth the best chance to grow properly when it eventually comes through.

There are various types of space maintainers that your dental professional may recommend for your child based on the location of their missing tooth (or teeth) and their individual health history. They may be simple or consist of multiple bands and wires, and they may be placed on any number of teeth, from a single tooth to the full arch. Unilateral space maintainers are attached to one side of the mouth, while bilateral maintainers are attached to both. But perhaps the most significant difference is whether or not they can be removed. Keep reading to learn more about fixed and removable space maintainers.

Fixed space maintainers are typically applied by cementing them onto your child’s teeth, making them non-removable. This helps ensure your child doesn’t take them out and they can do their job.

Types of fixed space maintainers include:

• Band and loop – consisting of metal bands attached to surrounding teeth and connected via wire.
• Transpalatal arch – consisting of a stiff metal band attached to surrounding teeth on both sides of your child’s mouth.
• Distal shoe – consisting of a band placeds on the surrounding primary tooth and attached to your child’s nearby unerupted tooth to help guide its growth.
• Lingual holding arch – consisting of metal bands fitted around the permanent surrounding teeth on both sides of your child’s mouth and a wire bent into an arch.

Removable space maintainers are not fixed to your child’s teeth or mouth and can be removed easily for cleaning or other purposes without the help of a dental professional. It’s more common for dental professionals to recommend the fixed variety as children can easily lose or forget to wear the removable type.

While it may cause some slight discomfort for your child to have a space maintainer, this will outweigh the potential discomfort for permanent teeth that grow improperly and the resulting treatment.

Cost is, of course, a common concern of parents when it comes to treating their child’s dental problems. Rest assured that your dental professional is equipped to help you navigate these concerns and offer the best solutions for your budget. It’s also important to consider that a small cost upfront for a space maintainer can prevent larger future dental issues that may be far more costly to treat.

Costs for your child’s space maintainer will vary on your location, dental professional, their specific type, and the amount your insurance covers. According to the North Carolina Industrial Commission, coverage for these appliances can vary from $197 to $380, in addition to costs for your dental professional’s diagnosis and recommendation.

Getting a space maintainer is a great opportunity to talk to your child about the importance of oral health, starting with an excellent oral hygiene routine. This can help your child to get the best out of their space maintainers and set them up for good oral health down the road.

To care for your child’s space maintainer, it’s important to:

• Practice proper oral hygiene, which includes brushing twice a day with a fluoride toothpaste. 

• Consume a healthy, balanced diet that limits sugary and acidic items.

• Visit their dental professional regularly (at least twice a year) to stay ahead of potential problems.

Fixed space maintainers can make it difficult to clean around and between the affected teeth, so special attention should be given to these areas to ensure they’re adequately cared for. Removable space maintainers can be taken out of your child's mouth and gently rinsed and cleaned twice a day when they brush their teeth, following the instructions provided by your dental professional.

When your child’s baby tooth falls out early, you can choose to leave the space as it is. However, it’s important to know that they may need orthodontic treatment at a later date when their permanent teeth start to erupt. They will also be at increased risk of complications and dental problems from crooked or crowded teeth. 

When your child gets a space maintainer, this period can be a tremendous opportunity to establish healthy habits that could persist into young adulthood and for the rest of their life. This could save them discomfort from dental issues and save you from the pain of reaching for your wallet. As with all dental treatments, be sure to discuss your options with your dentist, who will be happy to answer all your questions and concerns about space maintainers and your child’s oral health.

At what age might my child need a space maintainer?

The loss of space usually begins at around six months after losing a baby tooth. So if your child loses a baby tooth any more than six months before it would naturally be expected to fall out, then your dentist might recommend a space maintainer. This varies by tooth and from child to child, so your dentist can advise you if it’s the right time for a space maintainer for your child. 

Is it painful for my child to have a space maintainer installed?

Space maintainers are not usually painful, but they can be uncomfortable. However, they can spare your child from painful problems later down the line, so a little discomfort may be worth it in the long term!

How long does my child need to wear a space maintainer?

Your child will need to wear the space maintainer until the permanent tooth starts to erupt. 

What happens if my child loses their space maintainer?

If your child loses their removable space maintainer, your dentist or orthodontist will arrange for another to be made. This can be costly, though, which is why many dental professionals recommend fixed space maintainers for children instead. 

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.