Baby teeth are not just placeholders; they play a vital role in guiding permanent teeth into position, supporting jaw development, and enabling proper chewing and speech. Some baby teeth are meant to remain in place until a child is 12 to 14 years old, but sometimes children lose them early due to dental disease or trauma. When this happens, the early loss of baby teeth can disrupt the natural sequence of tooth eruption. Teeth adjacent to the gap may shift into the space, leading to crowding or misalignment of permanent teeth. This often necessitates complex orthodontic treatments in the future, making early intervention essential. This is where space maintainers come into play. 

 

Space maintainers are custom-made dental appliances, crafted from metal or acrylic, designed to hold the gap left by a missing baby tooth. They are small, unobtrusive, and tailored to fit each child’s mouth comfortably. These appliances come in two primary forms: removable and fixed. Removable maintainers resemble orthodontic retainers and may include artificial teeth to fill gaps, while fixed maintainers are cemented in place and include designs like band-and-loop, crown-and-loop, and distal shoe for specific dental needs. Fixed bilateral maintainers, such as lingual holding arches, are used when multiple teeth are missing. By preserving space for the unerupted permanent tooth, these devices prevent adjacent teeth from drifting, ensuring proper alignment and avoiding future complications.  

Proper care for space maintainers includes avoiding sticky foods, practicing good oral hygiene, and attending regular dental check-ups to monitor their effectiveness. The dentist will ensure the device remains secure and effective until the permanent tooth erupts.  

 

While not every child who loses a baby tooth prematurely needs a space maintainer, consultation with a pediatric dentist can determine the best course of action. Factors like the child’s age, dental development stage, and location of the missing tooth play a role in the decision. Early intervention with space maintainers can save parents and children from extensive orthodontic treatments later, ensuring that the child’s dental development remains on track. These devices are a proactive solution to maintaining a healthy, functional smile and preventing future alignment issues. 

  • Meet the Author

    Dr. Phoebe Tsang

    Dr. Phoebe Tsang is a Fellow of the Royal College of Dentists of Canada and a Diplomate of the American Board of Pediatric Dentistry. Her interest in microbiology inspired her to pursue a PhD in oral biology. She is a member of both the American College of Dentists and the International College of Dentists. In addition to her private practice, she teaches in the graduate pediatric dentistry programs at UBC as a Clinical Associate Professor. She is also honored to serve on the examination committees for the Royal College of Dentists of Canada and the American Board of Pediatric Dentistry.