Space Maintainers for Children

It depends, and plenty of early tooth losses need no appliance at all. The ones that do are cases where the tooth goes long before its replacement is ready, so neighboring teeth can shift across and block it. If the permanent tooth underneath is already close to coming through, your child may not need a space maintainer, and we will tell you so.

Age is part of the picture, and what the X-ray shows carries the most weight: which tooth was lost, how far along the permanent tooth beneath it is, and how much room is there now compared with how much will be needed. Losing a back molar early does not carry the same consequences as losing a front tooth, and the two are handled differently.

Catching that early saves far costlier and more complex orthodontic problems later, so Dr. Najjar will assess your child's situation and tell you plainly which way it falls. Finding out carries no obligation, and knowing where you stand is easier than wondering.

No, and no anesthesia is needed either. Fitting one involves nothing drilled and no numbing. With the fixed types, a band slips around the neighboring tooth and the appliance is cemented in place. A removable one simply goes in, much like a retainer. If a little space is needed between the back teeth first, small separators go in at a short earlier visit and can feel tight for a day or two.

Your child may notice slight pressure as it goes on, and the device usually takes a day or two to stop feeling new. Eating and talking can feel odd during that stretch, so it helps to say in advance that the space maintainer will feel strange before it feels normal. Soft foods for the first day make it easier. If your child tells you something genuinely hurts, call us and we will check the fit.

The permanent tooth sets the schedule, since the appliance stays put until that tooth starts erupting into the space. Depending on your child's age and dental development, that can mean anywhere from a few months to a few years. The tooth arrives when it is ready, and nothing speeds that up.

That is a long stretch in a growing mouth, so the follow-up visits are what keep it on track. Dr. Najjar checks progress at each one to confirm the space maintainer is still holding the gap, the band is still tight, and the permanent tooth is tracking the way the X-rays suggested it would. Regular cleanings and checkups carry on as normal alongside those appointments.

Taking it out is quick and easy once the permanent tooth breaks through, and usually no second procedure follows.

If your child is coughing, wheezing, gagging, or having any trouble breathing, seek emergency care right away. A small appliance that has gone missing can be breathed into the airway, and that is a medical emergency. Get your child seen first and call us afterwards.

If it is loose but still in your child's mouth, call our office right away and leave the device alone. A loose space maintainer can become a choking hazard, so don't reattach or adjust it at home, and ask your child not to wiggle it in the meantime. We'll book a quick visit to set it right.

If it has come out completely, keep every piece and bring them along, since an appliance that is still in one piece can often be recemented. If it was swallowed and your child is comfortable and breathing normally, call us and let your pediatrician know as well. When you ring, tell us what you are seeing, loose, out, bent, or broken, and we can tell you how quickly your child needs to be seen.

Loose, broken, or gone, call us the same day. The next scheduled visit is too long to wait. A space maintainer that is not seated properly is not holding the space, and the neighboring teeth get their opportunity to drift while it sits in a drawer.

Yes, apart from a short list. A space maintainer is built to live in a child's mouth through ordinary meals, and the foods to watch are the ones that can damage or dislodge the device:

• Sticky and chewy sweets: gum, taffy, and caramel, which cling to the appliance and tug at it on the way off.
• Hard candy and ice, which can bend a wire or break the cement holding the band.
• Whole nuts and popcorn, kernels included, which are best skipped while the space maintainer is in.
• Whole apples, carrots, and corn on the cob, which are fine once they are cut off the core or sliced into pieces.

Ordinary meals are otherwise unchanged, and your child can speak and play normally. The habit worth breaking early is fidgeting with the appliance, since fingers and tongue can work a space maintainer loose just as easily as food can. Brush and floss carefully around it every day as well, because the band traps plaque against the tooth it is cemented to.

Usually. For children, most dental plans cover a space maintainer as a preventive or orthodontic benefit, though how much they pay, whether a deductible applies, and how often the benefit can be used vary quite a bit from one policy to the next. Working that out is not something you should be left to do on your own.

Whoever your carrier is, we work with them. We accept most dental insurance, and the claim goes in from our office as a courtesy, so it is one less thing for you to think about. Your benefits are verified first, so you'll have your coverage confirmed and a clear written cost estimate in hand before treatment begins. If your plan pays less than you hoped, ask us about spreading the balance over time, which we arrange directly, and we take cash, check, Visa, MasterCard, American Express, and Discover.

It is worth keeping the bigger number in view too. The appliance costs far less than the orthodontic treatment it helps prevent, and the consultation where we tell you whether your child needs one is complimentary. Our flexible financing options page sets out how payment works if you want to look before you come in.

With nothing holding the gap open, the adjacent teeth may drift into it. A permanent tooth that loses its room can come in crooked, become impacted (stuck), or leave crowding behind that needs braces or other orthodontic treatment to correct. The drifting is gradual and easy to miss. Teeth shift a little at a time, so by the time a parent notices the gap looking narrower, a fair amount of the space is already gone.

Not every early tooth loss ends up there. When the permanent tooth is close behind, the space may hold on its own long enough to do without one. The only way to know which situation your child is in is to have the gap looked at and X-rayed while there is still space left to hold.

Holding a space open is a far simpler job than making room after it has closed. A space maintainer is a small appliance, fitted in a short appointment, and it can prevent a problem your child would otherwise carry into their teens.