Early Loss of Milk Teeth and Placeholders

Space maintainers are fixed or removable appliances that preserve the space for the permanent tooth to replace prematurely lost deciduous teeth.

Early loss of deciduous teeth can cause various problems. The most important of these is the crowding that occurs as a result of not protecting the space for the permanent tooth that will come from under the deciduous tooth. This problem, which may occur in the future, can be prevented with placeholders to be made following tooth extraction.

Placeholders are divided into two as fixed placeholders and removable placeholders. While fixed placeholders are generally used in single tooth deficiencies, removable placeholders are applied in multiple tooth deficiencies. Fixed retainers are usually metal appliances that are fixed to the tooth behind the extraction cavity with an adhesive and can only be attached and removed by the physician. Removable retainers, on the other hand, are appliances that the child can put on and take off by himself/herself and consist of wire and acrylic parts. Placeholders should be used under the supervision of a dentist until the teeth appear in the mouth.

What happens if a retainer is not used?

It is not necessary to use a space maintainer for every missing baby tooth. The dentist decides whether a placeholder is necessary after a clinical and radiographic examination of the child. The age of the child and the time of eruption are the most important factors.

In addition to their nutritional, speech and chewing functions, deciduous teeth also serve as a natural placeholder for the permanent teeth below them. In children, tooth replacement continues until the age of 11-12, so failure to protect the places of milk molars lost at an early age may cause the teeth in front of and behind the gap to shift, tip over and close the gap.

As a result of complete or partial closure of the gap, the permanent tooth coming from below cannot find a space to settle and irregularities and crowding may occur in the alignment of the teeth. This may cause malocclusion, chewing disorders, the permanent tooth to remain impacted because it cannot find a place, the teeth adjacent to the cavity may fall over, making it difficult to clean the area and as a result, problems in periodontal tissues and orthodontic problems.

What should be considered when using a space maintainer?

• Check-ups should be made at the intervals recommended by the physician.
• The appliance should be cleaned and brushed regularly.
• Sticky foods should not be consumed.
• Acidic drinks should not be consumed (especially if a fixed retainer is used).
• Removable retainers should be removed while eating, teeth should be brushed after eating and the retainer should be cleaned and reinserted.
• Fixed retainers can only be fitted and removed by the physician.
• If the appliance is broken, dislocated or lost, a physician should be consulted immediately.

The child’s cooperation is very important with removable retainers. When the appliance is not used as recommended by the dentist, its harmony with the jaw may be impaired, the teeth in front of and behind the space may tip over and as a result, space loss may occur.

As a result, space maintainers are fixed or removable appliances that protect the space for the permanent tooth that will come from below instead of prematurely lost deciduous teeth. By taking early preventive measures, orthodontic and periodontal problems that may occur in the future can be prevented and a healthy alignment of the teeth can be ensured.

Uzm. Dt. Cansu Uzun Önalan