Missing Front Tooth

A space maintainer is a dental appliance made of metal or acrylic. Its function is self-explanatory—it simply maintains the space that is created by a lost tooth while a child is waiting for the permanent tooth to grow in.

Ideally, of course, the perfect space maintainer is a natural one—the original baby tooth. If a baby tooth is lost prematurely, due to severe decay, trauma, disease, or if it has been missing since the child was born, the muscles and bones in the jaw may not develop correctly in order to properly admit the new, permanent tooth. In such instances, the child’s orthodontist or dentist may recommend the use of a space maintainer.

Two types of space maintainers

There are two types of space maintainers for children, removable and fixed. Removable space maintainers are much like orthodontic retainers. They are generally constructed of acrylic, and may employ the use of an artificial tooth. There are four types of fixed space maintainers:

  • Distal shoe space maintainer – This is usually recommended when a permanent molar is slow coming in. It is made of metal, and requires insertion below the gum line in order to keep the space open. The dentist monitors the progress of the molar. It occupies one side of the mouth.
  • Unilateral space maintainer – This is placed in the mouth, on one side, to keep space for one tooth open. It is wrapped around the tooth, and a metal loop keeps the space open.
  • Crown and loop space maintainer – This is similar to the unilateral space maintainer, but consists of an actual crown that it connected to the loop, ensuring enough space for the tooth to come in.
  • Lingual space maintainer – This device connects on both sides of the mouth, on the lower teeth. It is attached to the molars, and holds space open for developing front teeth (usually more than one).

A space maintainer is not always required

Your child may not need a space maintainer. For example, if several top front teeth are lost around the same time, the space will not usually close up, so a space maintainer won’t be required.

If your child does need a space maintainer, it is important to take care of it. If it is the fix type, it should be brushed two to three time each day along with all the remaining teeth. If it is the removable type, it should be cleaned at least twice a day, using a different toothbrush then the one used to brush the teeth. You can also use denture cleaning tablets a couple of times per week.