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/teeth. The space left from losing this tooth needs to be held open for the permanent tooth to erupt in its correct position.
When there is premature loss of the milk tooth e.g. the lower second molar which should ideally be lost at nine to ten years of age , but beause of decay the child loose it at the age of five years , then that child needs the space maintainer to maintain the space till the permanent tooth is ready to come in that space.
Maximum space closure occurs within the first 6 months after extraction. therefore it is best to insert an appliance as soon as possible after extraction
When there is no alveolar bone overlying the crown of erupting tooth and there is sufficient space for its eruption.
When space left is excess of the mesiodistal dimensions required for the eruption and space loss is not expected.
When there is gross space discrepancy requiring future extractions and orthodontic treatment
When permanent succeeding tooth is congenitally absent and space closure is desired.
There are generally two types of space maintainers: Removable and Fixed.
Removable Space Maintainers: They are space maintainers that can be removed and reinserted into the oral cavity by the patient.
Fixed Space Maintainers: They are designed to be cemented on to the tooth and thus cannot be removed by the patient.
Space maintainers are used until the permanent teeth begin to break through the gums. While wearing a space maintainer, it is important to avoid chewing gum, sticky candies, and hard foods like Corn, nuts or ice. Teeth should be brushed after each meal and clean the teeth with bands especially well. Once a day, a fluoride mouthwash should be used to help prevent decalcification of the teeth around the band and wire. Do not try to bend the wire for any reason with finger or tongue. Notify dental office immediately if the bands come loose or the space maintainer is damaged in any way. If a tooth erupts under the wire this also needs to be checked.
Your child's dentist will take X-rays regularly to follow the progress of the incoming permanent. When the tooth is ready to erupt, the space maintainer is removed.
If a permanent tooth is missing, the space maintainer will be used until your child's growth is completed (age 16 to 18). Then a dentist will place a bridge, implant or removable partial denture in the space.
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