When and Why Your Child May Need a Space Maintainer

When and Why Your Child May Need a Space Maintainer

Dr. Karen Conn of Bryn Mawr Orthodontics provides a parent’s guide to space maintainers in orthodontics

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The Importance of Space Maintainers

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As an orthodontist, I often get asked about space maintainers.  Many parents wonder if these small, orthodontic appliances are truly necessary for their child's dental health.  The short answer is: for some patients, yes.

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What are Space Maintainers?

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Space maintainers are orthodontic appliances that are used to preserve space in the mouth for future permanent teeth.  They are typically used when a primary (baby) tooth is lost prematurely, either due to an accident, decay, or other factors.

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When and Why Are They Important?

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When a primary (“baby”) tooth is lost too early, the neighboring teeth may shift to fill in the gap.  This can lead to crowding out of the permanent tooth that is supposed to erupt in that specific area.  Space maintainers help by holding teeth in their appropriate place and preventing those teeth from tipping and moving into a space designated for a different permanent tooth.  The space maintainer is worn until the permanent tooth begins to erupt into position.

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When Are Space Maintainers Not Necessary?

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In many cases, space maintainers are not necessary.  If a primary tooth is lost close to the time when the permanent tooth is expected to erupt, the permanent tooth will generally naturally fill the space.

When Are Space Maintainers Necessary?

Whether or not a space maintainer is necessary depends on several factors, including:

• The age of the child: If a primary tooth is lost before the permanent tooth is ready to erupt, a space maintainer is more likely to be needed.
• Delayed development of a tooth: If a permanent tooth is delayed in developing and erupting after the baby tooth is lost, a space maintainer may be needed.
• Location: While early loss of a front primary tooth is less likely to require a space maintainer, the loss of a primary molar, especially in the back of the mouth, often warrants the use of an appliance.

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Types of Space Maintainers

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There are several different types of space maintainers, including:

• Fixed space maintainers: These are cemented to the teeth and cannot be removed by the child.  These are used to hold the permanent molars from moving forward and tipping into the adjacent space needed for a different permanent tooth to erupt.  some text
  • Nance: A fixed space maintainer used by orthodontists in the upper jaw.
  • Lower Lingual Holding Arch (LLHA): A fixed space maintainer used by orthodontists in the lower jaw.
  • Band and Loop: A metal band that is cemented onto a tooth, typically a molar, with an attached loop of wire to prevent the molar from moving forward and encroaching on the space for a missing primary tooth.
• Removable space maintainers: These can be taken out by the child for cleaning, eating, and other reasons. some text
  • Hawley retainer: A removable retainer composed primarily of acrylic with a metal wire that fits around permanent molars to hold the teeth in place.
  • Essix retainer: A clear plastic aligner that fits over the teeth to prevent the teeth from shifting.

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Conclusion

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Space maintainers are an important tool in orthodontics.  By preserving space for future permanent teeth, a space maintainer can help prevent crowding and reduce the need for future orthodontic treatment.  If you think a space maintainer may be an ideal appliance for your child, consult with an orthodontist who can evaluate your child's specific situation and determine if an appliance is necessary.  An orthodontist can also recommend the most appropriate type of space maintainer for your child’s specific dental issues.

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Karen Conn, DMD, MS is a Board-certified orthodontist and co-owner of Bryn Mawr Orthodontics (Bryn Mawr, PA), where she specializes in Invisalign and braces for children, teens and adults.  She has been recognized as a Philadelphia Magazine Top Dentist, Main Line Today Top Dentist, Suburban Family Top Orthodontist, and is among the nation’s top 1% of Invisalign providers.  Dr. Conn received her undergraduate and doctorate degrees from the University of Pennsylvania.  She completed her residency in Orthodontics and Dentofacial Orthopedics at Temple University, where she also earned a master's degree in Oral Biology.

Bryn Mawr Orthodontics is an award-winning practice that was voted the Best Orthodontist in The Philadelphia Inquirer’s 2024 Philly Favorites contest.  Bryn Mawr Orthodontics serves its neighbors in Bryn Mawr, Gladwyne, Villanova, Ardmore, Haverford, Wynnewood, Narberth, Radnor, Penn Valley, Bala Cynwyd, Merion, Wayne, and the entire Main Line.

To learn more about Bryn Mawr Orthodontics, visit https://www.brynmawrorthodontics.com/. Contact the office today (484-383-0055) or complete this form to schedule a free consultation.