One of the many functions of baby teeth is to hold space for the adult teeth that will eventually push them through. When baby teeth are lost prematurely, the permanent teeth that are coming in on either side can actually drift into the space that was reserved for another tooth. This can cause teeth to erupt out of position or to be blocked entirely, and it may result in crowded or crooked teeth.

There are both fixed and removable space maintainers. A fixed space maintainer is cemented onto the adjacent teeth, and saves room for teeth that haven’t grown in yet.

There are four types of fixed space maintainers:

• Crown and Loop: A stainless steel loop is attached to an existing crown, pressing against the tooth on the other side of the gap to ensure that the space will stay open for the incoming tooth.
• Unilateral: A unilateral device uses a wire that is wrapped around the teeth and connected to a metal loop to maintain a space between two teeth.
• Distal Shoe: A distal shoe is used for molars, and is placed directly into the gum line. It guides the incoming tooth as it grows in. These maintainers might require more maintenance and check-ups to make sure it is working properly.
• Lingual: Lingual maintainers are typically used when a child is missing multiple teeth due, and are cemented to molars. Wires are connected to crowns to make space across several gaps. It’s also commonly used in congenital defects, like in cases where the adult teeth never develop. The space maintainer is then used to make room for a future bridge or dental implant.

Removable maintainers are used when the tooth is growing in or almost ready to grow in. They are sometimes made to look like an artificial tooth, and are placed between teeth to save room.

Both permanent and removable space maintainers are custom-made to fit into your child’s mouth. Space maintainers are worn until X-rays reveal that the tooth underneath is ready to erupt naturally. It is very important that anyone wearing a space maintainer keep up good oral hygiene at home and have regular professional dental cleanings.