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Space Maintainers

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A space maintainer is a custom-made dental appliance fabricated from metal or acrylic. It may be removable or cemented in place. It is designed to keep open the correct amount of space to allow a permanent tooth to erupt properly and to come through without being overcrowded. Using a space maintainer helps prevent problems such as tooth misalignment and bite problems.

Why Would My Child Need a Space Maintainer?

Your child may need a space maintainer if they lose a baby tooth too soon or must have a baby or primary tooth removed because of tooth decay. Although baby teeth are not permanent, pediatric dentistry specialists agree that they do play an important role while they remain in place.

Baby teeth are vital for helping teeth and the jawbones and facial muscles to develop properly. They help to guide permanent teeth into the correct positions, staying in place until the time comes for them to loosen and fall out naturally, once the adult teeth are ready to erupt.

When a baby tooth is lost too soon, the adjacent teeth can soon drift into the open space, and there is a far greater chance that your child will need orthodontic treatment in the future. Not every child who loses a baby tooth will need a space maintainer. It all depends on how quickly the adult tooth is due to erupt.

If your child needs a baby tooth removed, Dr. Tracy will assess them to see if a space maintainer is necessary. She will also discuss which type of space maintainer is best for your child. Children who have congenitally missing teeth, where they never developed, might need a partial denture instead of a space maintainer.

Removable Space Maintainers

A removable space maintainer looks a little like a standard orthodontic appliance and is usually fabricated using acrylic. Sometimes we will use an artificial tooth to fill in the space that must be maintained for the adult tooth.

Fixed Space Maintainers

There are four different types of fixed space maintainers, which are called lingual, distal shoe, crown and loop, and unilateral.


A lingual space maintainer usually involves both sides of your child’s lower arch of teeth and is cemented onto the molar or back teeth. When something is lingual, it means it is near to the tongue. There is a wire running lingually or near to the tongue, along the inside of the lower front teeth. A lingual space maintainer may be used when more than one tooth is missing.

Distal Shoe

In dentistry, distal relates to the surface of a tooth that is furthest from the front or middle of the jaw, and in this case, a distal shoe space maintainer is used when the first permanent molar has yet to erupt.

The distal shoe space maintainer sits on one side of the mouth and is fitted after a child loses their primary or baby second molars and before their permanent first molar emerges, around age six or seven. Distal shoe space maintainers can only fit over a single unerupted tooth and have a stainless-steel wire that helps guide the permanent first molar into place.


A unilateral space maintainer is fitted on one side of the mouth, holding open space for a single tooth. It has a band that fits around the outside of the tooth adjacent to the gap. The band is connected to a metal loop, holding open the space.

Crown and Loop

A crown and loop space maintainer has a crown fitted over the adjacent tooth. The crown replaces the metal band and is connected to the loop holding open the space for the adult tooth.

Helping Your Child Become Accustomed to Their Space Maintainer

Once your child has their new space maintainer, it will most likely take them a few days to become accustomed to wearing this appliance regardless of whether it is fixed or removable. Also, we can talk to your child about how to cope with wearing the space maintainer because it’s essential not to push it with the tongue or fingers, which could bend more loosen the appliance.

Keeping the Space Maintainer Clean

After fitting the space maintainer, we will review cleaning instructions with you and your child. It’s crucial to clean the space maintainer thoroughly and the teeth and gum around it to keep the gum and nearby teeth free of dental plaque. At this stage, we can also review general tooth brushing and flossing instructions to help your child maintain excellent oral hygiene.

Children with fixed space maintainers will need to avoid particularly sugary or chewy foods like candy or gum as these can easily become trapped around the space maintainer or could loosen it.

While your child is wearing their space maintainer, we will need to see them regularly so we can monitor how well they are coping and the development of permanent teeth yet to erupt. During these appointments, we can also clean your child’s teeth professionally.

In our pediatric dentistry center we offer the latest custom-made dental appliance fabricated from either metal or acrylic. Come visit our kids center and meet Dr. Khabensky DDS and Dr. Kim DDS. Our doctors provide Space Maintainers for kids, teens and use natural treatments and organic measures whenever possible.

This page was published on Oct 7, 2020, modified on Nov 24, 2020 by Pediatric Dentistry Center

Pediatric Dentistry Center
2148 Ocean Ave, Ste 401A
Brooklyn, NY 11229

The information on this website is to provide a general pediatric dentistry information. In no way does any of the information provided reflect a definitive treatment advice. It is important to consult a best in class pediatric dentist in Brooklyn regarding ANY questions or issues. A thorough dental evaluation should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call your local kids dentist or pediatric dentist Dr. Igor Khabensky DDS or Dr. Tracy Kim, to schedule a consultation.
Pediatric Dentistry Center Material published on the website is for general purpose only. Symptoms and conditions my sound similar but different in nature. In case of dental emergency, pain, or discomfort, we advise booking an appointment with our pediatric dentists Dr. Khabensky DDS and Dr. Kim. Useful Information
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