Early Loss of Primary Teeth and Space Maintainers

Space maintainers are fixed or removable appliances that protect the space for permanent teeth that will come in place of prematurely lost milk teeth.

Early loss of baby teeth can cause various problems. The most important of these is the crowding that occurs as a result of not protecting the permanent tooth space under the baby tooth. This problem that may occur in the future can be prevented with space maintainers that will be used following tooth extraction.

Space maintainers are divided into two categories: fixed space maintainers and removable space maintainers. Fixed space maintainers are generally used in cases where a single tooth is missing, while removable space maintainers are used in cases where more than one tooth is missing. Fixed space maintainers 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 a dentist. Removable space maintainers are appliances that the child can attach and remove on their own, and consist of wire and acrylic parts. Space maintainers should be used under the supervision of a dentist until the teeth appear in the mouth.

What happens if placeholders are not used?

In addition to their functions of nutrition, speech and chewing, milk teeth also serve as natural placeholders for the permanent teeth beneath them. Children continue to change teeth until they are 11-12 years old, so not protecting the places of milk molars lost at an early age can cause the teeth in front and behind the gap to shift, tip over and close the gap.

As a result of the gap closing completely or partially, the permanent tooth coming from below cannot find space to settle and irregularities and crookedness may occur in the alignment of the teeth. This may cause malocclusion of the teeth, chewing disorders, the permanent tooth remaining impacted because it cannot find space, the teeth adjacent to the gap tipping over, making the area difficult to clean and as a result, problems in the periodontal tissues and orthodontic problems.

What should be considered when using placeholders?

• It is essential to go for check-ups at the frequency 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 placeholder is used).
• Removable appliances should be removed while eating, teeth should be brushed after eating, the appliance should be cleaned and put back on.
• Fixed space maintainers can only be placed and removed by a physician.
• If the appliance breaks, comes off or is lost, a physician should be consulted immediately.

The cooperation of the child is very important in removable space maintainers. If the appliance is not used as recommended by the dentist, its harmony with the jaw may be disrupted, the teeth in front of and behind the space may tip over, and space may be lost as a result.

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

Specialist Dt. Cansu Uzun Önalan