The purpose of your child’s space maintainer is to keep open the space needed for a permanent tooth that has yet to erupt. It will be left in place up to the time when the new permanent tooth can be seen breaking through the gum tissues.
Types of Space Maintainers
There are several kinds of fixed space maintainers. A band-and-loop maintainer is made of stainless steel wire. It is held in place by a crown on the tooth next to the space or an orthodontic-type band around one of the teeth next to the open space. A wire loop is attached to the band or crown. It sticks out across the space where the tooth is missing and just touches the tooth on the other side of the open space. The wire loop holds the space open. This allows the permanent tooth enough space to come into the mouth without crowding.
A lower wire known as a “lingual arch” is used when back teeth are lost on one or both sides of the lower jaw. “Lingual” refers to the inside or tongue side of the teeth. This type of space maintainer uses bands wrapped around a tooth on either side of the mouth behind the missing teeth. A wire connected to the bands runs along the inside of the bottom teeth, just touching them. This will maintain the space on both sides. It is often used to help straighten minor crowding/crookedness of lower front teeth. It is worn until all lower baby teeth are replaced by permanent teeth, usually by age 12.
Another type of fixed space maintainer is called a distal shoe appliance. The back portion is inserted under the gums. It is used when a child loses the baby tooth in front of a 6-year molar that has not yet come into the mouth. The 6-year molar is also called the first permanent molar. Because it has not come in yet, there is no tooth to hold a band-and-loop space maintainer in place. A distal shoe appliance has a metal wire that is inserted slightly under the gum. This keeps the space from closing by guiding the permanent molar into place.
Distal shoe appliances must be checked often because the incoming tooth can easily become blocked by the wire. The appliance may require adjustment to allow the tooth to come in properly. As a result, we will try to avoid using a distal shoe appliance by trying to keep the primary tooth in the mouth until the permanent tooth underneath is ready to come in.
What to expect with a space maintainer:
IN THE FIRST 24 HRS?
Aching teeth, sore gums
Extra saliva (spit)
Possible problems speaking
Possible problems eating
WHAT SHOULD WE DO TO CONTROL THE DISCOMFORT?
Ibuprofen (Advil or Motrin) can be taken prior to appointment and every 6 hrs for 2 days or as needed.
ARE THERE ANY SPECIAL INSTRUCTIONS ON WHAT THE PATIENT SHOULDN’T EAT?
Sticky foods (like taffy, jolly ranchers, and gummi worms/bears/etc)
Stringy foods may get caught in the wire
Hard items like corn nuts and ice
WHAT ABOUT GUM?
Best to avoid it, but if you must try it… chew sugarfree. It may get caught in the wire if you aren’t careful.
WHAT SHOULD WE DO IF IT COMES LOOSE OR BREAKS?
WHAT DO WE NEED TO DO TO CARE FOR THE APPLIANCE?
Keep it clean. Brush near the gums and under the wire.
Your child shouldn’t push on the space maintainer with his or her tongue or fingers. That could bend or loosen it.
Have us check the space maintainer periodically to insure that it is still properly placed.