Space Maintainers - Braces R Us

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Space Maintainers

Space Maintainers

Date: October 27, 2023

Space maintainers are an important preventive appliance that can have a lasting benefit when used appropriately. There are several varieties of space maintainers. Generally, they fall into two categories; fixed and removable. These categories are subdivided into unilateral and bilateral. Unilateral space maintainers usually hold the space of a single missing tooth. Bilateral space maintainers are capable of holding multiple spaces anywhere in the dental arch.

Fixed space maintainers are banded, bonded, or fixed to the teeth and are meant to stay in place until they are removed by the doctor. The patient cleans the space maintainer when they brush their teeth. The fixed space maintainer needs to be checked on a consistent basis by the doctor. These checks usually occur twice a year; more frequently if the patient is actively loosing baby teeth, less frequently if little growth or dental changes are occurring.

The most common bilateral fixed space maintainer is the lingual arch. It is a very good space maintainer as well as a retainer if Phase I orthodontic treatment has been done. A lingual arch is often placed so that “E-Space” can be preserved. The baby 2nd molar is larger than the permanent 2nd premolar that replaces it. The baby 2nd molar is frequently labeled as tooth #E, hence the space gained in the exchange of the baby tooth for the permanent tooth is called Espace. If left unmanaged, the E-space lost as the permanent first molar erupts into the mouth. If a space maintainer is used to hold the E-space, this space can be used to reduce crowding, correct the molar bite, or help adjust the overbite.

Removable space maintainers usually look like an orthodontic retainer and can be effective at preserving a single space, or spaces on both sides of the mouth. They are most often bilateral space maintainers. Removable space maintainers can also have a temporary tooth replacement so the opposing tooth has something to bite against. This can be important to give the opposing tooth something to bite against so that it does not grow into the space of the missing tooth. If this happens, the over-eruption of the opposing tooth can prevent the permanent replacement tooth from growing in all the way.

It is critical to determine the best time to place a space maintainer to acquire the maximum benefit. Generally, if a baby tooth is lost prematurely, a space maintainer should be placed immediately after tooth loss. If the space maintainer is being used to hold space while the patient transitions from the baby teeth to the permanent teeth, the space maintainer should be placed early enough to preserve all the space available.

Regardless of what type of space maintainer is used, they are a very beneficial tool that can be used to help teeth grow into a better position than they would otherwise. Whether a baby tooth is extracted because of decay, is knocked out by some trauma, or just lost early, saving the space that the tooth occupied is a good idea. Space maintainers can prevent several potential problems that result from premature tooth loss and are a good investment in health, tooth growth, bite function, and esthetics.

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