by Dr. J. Slaven
When a young child loses a baby tooth prematurely due to decay, infection or accident it creates a situation that requires immediate attention. One of the purposes of the lost baby tooth was to keep space available for the permanent tooth developing in the jaw underneath the baby tooth to have enough room to properly erupt into the child’s developing jaw. When teeth are lost the teeth on either side of the now empty space will quickly begin to drift into the space and effectively block the permanent tooth from properly erupting. If this is allowed to progress without intervention the permanent tooth can become impacted which will then require a surgery to uncover it to allow orthodontic movement of the tooth into proper position.
The simple solution to this is to fabricate and place a space maintainer. A space maintainer is either a passive space holding appliance or an active space opening appliance that is cemented to the tooth or teeth next to the space to assure that the permanent tooth can erupt into its’ proper position. The space maintainer consists of one or more bands that encircle the tooth next to the space with a stiff wire loop that touches the tooth on the other side of the space and keeps it open. If front teeth are lost early the space maintainer can have artificial teeth attached to the wire to create a cosmetic result allowing the child to have their self esteem intact and avoid being teased by other children.
Once the space maintainer has been placed it is important that the child be checked regularly, so that the appliance can be removed at the appropriate time. The space maintainer itself could prevent the final eruption of the permanent tooth, so monitoring is essential.