CHILDREN'S DENTISTRY
Space Maintainer
The appliance that preserves the space for the permanent tooth
Provided at our clinic in Altunizade, Üsküdar (Istanbul).
IN SHORT
A space maintainer is an appliance used to preserve the space of the permanent tooth coming beneath a milk tooth that has been lost early. By preventing the space from being closed by the neighbouring teeth, the appliance leaves room for the permanent tooth to erupt in the correct position. Not every early tooth loss requires a space maintainer; the need is assessed according to the tooth that has been lost, the age of the child and the time remaining until the permanent tooth erupts.
What is a space maintainer and why is it needed?
Milk teeth are natural space keepers for the permanent teeth that will come beneath them. If a milk tooth is lost before its time because of decay, infection or trauma, the teeth on either side of the gap can drift towards it.
When the neighbouring teeth drift into the gap, the room needed for the developing permanent tooth narrows; this can cause the permanent tooth to erupt crowded or to stay impacted. By preserving this gap, the space maintainer leaves room for the permanent tooth to erupt in the correct position.
The logic of the space maintainer is simple: a gap preserved today with a small appliance can prevent the need for more extensive orthodontic treatment later. The appliance holds the place of the permanent tooth until the permanent tooth itself erupts; it is not a treatment but a preventive approach aimed at avoiding a problem that could arise later.
However, the space maintainer does not take on all the functions of the lost milk tooth exactly; its main purpose is to preserve the space. For this reason the need should be assessed in time from the moment the tooth is lost; once the gap has begun to narrow, the benefit the space maintainer can provide decreases.
Types of space maintainer
Fixed space maintainer. Attached to the neighbouring tooth with a band; the child does not need to remove it. It can be one-sided or two-sided.
Removable space maintainer. Can be taken in and out; it may be preferred when more than one tooth is missing or for aesthetic needs, but it requires regular use by the child.
Which type is suitable is determined by the position of the lost tooth, the size of the gap and the child's ability to use the appliance regularly. While a fixed appliance is often enough for a single-tooth gap, different solutions are assessed for wider gaps.
Who is it applied to?
A space maintainer is assessed in children who lose a milk tooth early and for whom there is still time until the permanent tooth beneath it erupts. At our clinic, patients are accepted in the field of children's dentistry; the need and the type of appliance are determined by examination and, when necessary, an X-ray.
The role of the X-ray in the decision is important, because the state of the permanent tooth below and when it will erupt can only be seen this way. If the permanent tooth is close to erupting, the appliance may not be needed, whereas in a gap where eruption is a long way off, the space maintainer gains more importance. This assessment is made separately for each child.
In which situations is it not needed?
Not every early tooth loss requires a space maintainer; the situation is assessed in detail in order to avoid unnecessary application.
If the permanent tooth below is going to erupt soon, a space maintainer is most often not needed.
If the position of the lost tooth makes the risk of the gap narrowing low, the appliance may not be needed.
If oral hygiene or cooperation is insufficient, a fixed option is assessed rather than a removable appliance.
Since the purpose of the space maintainer is to prevent a problem, applying it in situations where it is not needed places an extra burden on the child. For this reason the decision is made not with a "let's fit one just in case" logic, but by looking at whether the risk of the gap narrowing really exists. Avoiding an unnecessary appliance is as important as applying one in time when it is needed.
The application process
Assessment
The development and position of the permanent tooth are examined by examination and, when necessary, an X-ray.
Impression
An impression is taken so that the appliance can be prepared.
Fitting
The prepared space maintainer is applied in the mouth and its fit is checked.
Follow-up
As the child grows and the permanent tooth approaches eruption, periodic check-ups are made.
Care and use
Because plaque can build up under and around the space maintainer, regular cleaning of the area with the appliance is important. Hard and sticky foods can damage the appliance; for this reason care should be taken. When the permanent tooth begins to erupt, the space maintainer is removed by the dentist.
With removable space maintainers, using the appliance regularly is necessary for the result to be achieved; when taken out, it should be kept clean and safe. With fixed appliances, the child does not need to do anything, but keeping the area around the band and wire clean by brushing is important. In both types, regular check-ups keep the process progressing healthily.
How long is the process followed?
The space maintainer stays in the mouth until the permanent tooth erupts; this period can be months or years depending on the tooth that has been lost and the child's development. For this reason the appliance is not a "fit and forget" device; it needs to be followed with regular check-ups.
At the check-ups both the soundness and fit of the appliance and the eruption state of the permanent tooth below are assessed. As the child grows, the jaw also develops, so the appliance may need to be reviewed or replaced. When the permanent tooth begins to appear, the appliance completes its task.
Risks and possible situations
The appliance can break or come loose; in this case the dentist should be consulted.
If cleaning is insufficient, plaque build-up and decay can develop around the appliance.
If check-ups are missed, the gap can narrow again and the purpose of the space maintainer may not be achieved.
Fixed and removable space maintainer
The two basic types of space maintainer differ in terms of use and cooperation. The table below compares the two.
Compare the options
| Fixed space maintainer | Removable space maintainer | |
|---|---|---|
| Use | Fixed in the mouth, not removed | Can be taken in and out |
| Compliance | Does not require use discipline from the child | Requires regular use |
| Suitability | Often preferred for a single-tooth gap | More than one tooth / aesthetic need |
| Care | Cleaning around it is important | Can be taken out and cleaned |
Which option is suitable is decided together after an intraoral examination.
Frequently Asked Questions
No. The need varies according to the tooth that has been lost, the age of the child and the time remaining until the permanent tooth erupts. If the permanent tooth is going to erupt soon, one is most often not needed. The decision is made by examination.
After a short period of getting used to it, most children adapt to the appliance. If the appliance breaks or causes discomfort, the dentist should be consulted.
When the permanent tooth below begins to erupt, the appliance completes its task and is removed by the dentist. This process is followed with periodic check-ups.
Regular cleaning of the area with the appliance and avoiding hard, sticky foods are important. If the appliance breaks, comes loose or causes discomfort, the dentist should be consulted without losing time.
Related treatments
The content on this site is for information only and does not replace a clinical examination. The suitability, duration and scope of treatment are determined after a clinical assessment.
This content was prepared by Dt. Mevlüt Yazıcı.
Request an appointment.
Fill in the form to request an appointment and we'll get back to you shortly. You can also call us directly or message us on WhatsApp.
Altes Diş Kliniği
Altunizade, Üsküdar, İstanbul
- PHONE+90 533 474 43 94
- EMAIL[email protected]
- ADDRESSAlperen İş Merkezi, Valide-i Atik Mahallesi, Altunizade, Nuhkuyusu Cd D:191/B, 34664 Üsküdar/İstanbul
- WORKING HOURSWeekdays 10:00–19:00 · Saturday 10:00–16:00 · Sunday closed