What A Space Maintainer (Spacer) Is And Why Your Child Might Need...

What A Space Maintainer (Spacer) Is And Why Your Child Might Need One

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Spacer Space Maintainer Teeth
©Tatyana Vyc/Shutterstock.com

Whenever a tooth is lost, the teeth on either side of it move towards the empty space to try to fill it in.

SA Red Headed Boy with Baby Teethometimes this can be a good thing, like if your orthodontist has to extract a tooth due to crowding.  After the tooth is extracted, the teeth adjacent to it move together and line up perfectly to create a beautiful smile.

Other times, this movement can be a bad thing.  Let’s say a little boy named Johnny with baby teeth and his six year molars lost his baby second molar (the second tooth from the back after the six year molars have come in) because he had too many cavities in it and it was too far decayed to try to put a filling in it.  The six year molar (the last tooth – at the very back of the mouth) would move forward to fill that space.

The problem is, Johnny has a permanent tooth right under that baby second molar that may not be able to come into his mouth if the six year molar has moved forward to fill that space.  This permanent tooth may give up trying to come up into Johnny’s mouth and may never come into his mouth, but just stay lodged deep within his jaw.  It could also try to force its way out sideways and cause big problems for Johnny (and his parents who are paying the bill!)

This is where space maintainers (spacers) come into play – they keep teeth from moving together and filling the empty space.

How Dental Space Maintainers (Spacers) Work

A space maintainer consists of one or two stainless steel crowns or bands that attach to the teeth and hold a bar or wire loop between them that prevents the teeth from moving toward each other into the empty space.  This provides a force that keeps the two teeth from coming together.  It’s kind of like an overprotective father following his daughter on her first date to the movies with a cute boy and sitting between them – he will block the natural forces that attract them to each other and prevent them from moving together and filling the empty space between them.

With a nice open space in the child’s mouth, the permanent tooth that is still deep within the jaw will happily erupt into the welcoming space waiting for it.

Do All Prematurely Lost Baby Teeth Need Space Maintainers?

Not all prematurely lost baby teeth will need space maintainers.  If the permanent tooth will be coming in shortly, then it is probably not necessary.  A dentist is able to take x-rays of your child’s mouth and determine about how long it will be before the permanent tooth will come in.

Also, spacers are usually not necessary when kids’ incisors (the front four teeth) are prematurely lost because there is rarely any space loss that occurs in this front area.

It is important to note that when kids naturally lose their teeth, there is no need for a space maintainer.  Space maintainers are only necessary when a baby tooth has been prematurely lost.  For example, if the tooth was knocked out in an accident or the tooth had to be pulled because it was too decayed to be saved.

What If the Teeth Have Started Moving Together Already

Fortunately, there is something called a space regainer, that has springs and can push the teeth away from each other to create a big enough space for the permanent tooth to erupt into the mouth.  Luckily, most dentists know that a space maintainer is necessary and will put one in when indicated.

If you have any questions about space maintainers, type them in the comments.  Thanks for reading!

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18 COMMENTS

  1. My 7 yo son had a tooth pulled – second from the back upper. The dentist had put a stainless cap on it which later became infected (blister at gum). The Molar behind that has just came in fully and we have an appt to discuss space maintainers. It seems the type of space maintainer you discuss in your example would be the solution. At our last appt it was mentioned that the space maintainer would probably need to go across the roof of the mouth and sounds much more complicated in putting it in and also upkeep (food/brushing)- and much more expensive. I am trying to inform myself as a parent and would like your advice.
    Thank you, Mary Werner

    • Hi Mary - That type of space maintainer (the band and loop) makes sense to maintain space so that the 2nd premolar can come in without any problems. My guess is that your dentist wants to also make the palate (the upper arch of teeth) a little bit wider to give some more room as well. Since your son is seven, it would be fairly easy to control the growth of the palate at this point, and it gets harder as they get older. For example, I’m in my 20’s and with my bones completely formed, my palate can’t be expanded anymore using orthodontics; I would need surgery.

      This is from what I remember, but when I get home this afternoon I’ll take a look in some of my textbooks and follow-up if I feel like I left something out.

      Talk to your son’s dentist and ask him why a band and loop space maintainer wouldn’t work, and see if there’s anything else that the dentist wants to accomplish to help your son’s teeth erupt into good alignment. Thanks for your question!

      (UPDATE – 11/12/2010 – I DID REMEMBER WRONG! SEE MY COMMENT BELOW AS THE ABOVE INFORMATION IS INCORRECT.)

    • Hi Mary – I was wrong!

      I ended up reading the book and then talked with one of the professors in our pediatric dentistry department. The band and loop space maintainer would not be a good choice because the tooth that the “loop” part would go up against would be lost before the permanent tooth that we are saving space for (in your daughter’s case, the 2nd premolar) even comes in. Then, you would have the space maintainer just sitting there not doing anything.

      The better choice for when you’re missing that tooth would be to have a transpalatal arch appliance put in. It would connect both of the 6-year-old molars on top. It is more expensive, but it would probably be the best choice in the long run to make sure that both of her premolars have space to come in.

      I hope that helps! Let me know if you have any more questions.

  2. My 7 year old son just had is 4 front teeth instruct, due to a severe decay. i would like to know, when are the front permanent will come out? when the dentist x-ray he’s teeth, i seen them on the top of he’s primary teeth.
    how many months or old is he when they start to be visible or grow?

  3. My son bumped his front two teeth almost two years ago. The one turned gray and we have been watching it since January 2010. The dentist just informed us that he needed to have it pulled. He also mentioned maybe putting in a space maintainer. However, he said that was up to us. My husband and I don’t know what to do as far as the space maintainer. If its not necessary that he get it, I would rather not. But I don’t want to do the wrong thing. Does he have to have the space maintainer?

    • Hi Kerry – We have been taught that it is not necessary to put a space maintainer in when a front tooth is lost prematurely. The biggest reason to put something there would obviously be for looks.

      Pinkham’s Pediatric Dentistry textbook agrees that space maintainers don’t need to be placed after the loss of a front tooth. The author states, “Some dentists think that early removal of a primary incisor results in space loss because the adjacent teeth drift into the space formerly occupied by the lost incisor. However, this does not seem to be true in most clinical situations. There may be some rearrangement of space between the remaining incisors, but there is not a net loss of space. Intuitively, this makes sense because there is no apparent movement or drifting of teeth when developmental spacing is present in the primary dentition.”

      I hope that helps, Kerry. Thanks for your comment!

  4. My son 8 needs to have tooth #A extracted because it is anklyosed. The pediatric dentist said the space maintainer should be placed 1-2 days after but the oral surgeon said it should be done a week after so it will heal and that the teeth will not shift so quickly. Please advise. Thanks..

  5. my son needs to have his molar removed due to decay… the dentist said he needs a spacer put in.. do these hurt? are they bothersome for the kids? is it hard to clean the behind of the teeth due to the wire that go accrost them? im not sure if im going to have this put in

    • Tanya,

      My son who is 8 (almost 9) had one put in a little over 1 month ago. It was nance appliance which is semi permanent and will be removed once his permanent tooth comes in(told1-2 years). He had no discomfort but his speech was affected slightly for the first few days because the appliance was placed on the roof of his mouth and took a bit to get used to. I was warned of possible fungal infections but was told it is rare and was shown how to clean it properly. So far so good. I hope this helps you.

  6. Tom,

    My son is 9 years old and just had the space maintainer put in and he has the type that has the band on the roof of his mouth. He is having a difficult time eating and we are looking for any tips you can provide to help us with this. He is very frustrated and is just eating yogurt right now. Help!

    Thank you!

  7. My 8 year old had her 2 bottom first bicuspids pulled and had a spacer put in. It has fallen out 3 times in 8 days. I am very frustrated and wondering what can be done or if she would be able to go without it. She is already almost eight and a half. The dentist is wanting to make her a new one and charge me over $300 for it and I do not feel that I should have to pay. Twice it fell out within 24 hours of being put in. Will it hurt that much to just not have one? I feel that making another will only be the same problems.

  8. Hi Doc, I have question about space maintainer. My son who is 10 years old doc pull out his baby teeth and use maintainers from last 2years. Now once again he pull his teeth his dentist said because adult teeth has not enough space to come out so we have to pull out his baby teeth. so we did the proper treatment for my son. he still using space maintainers it cost me $1000.00. Now he suggest me the same thing for my daughter too Dentist said she does not have enough space for adult teeth to come out he already pull out her eight teeth. now he is insisting to use space maintainers I was wondering its a need or money making thing how I can find out that my daughter need these space maintainers. Please suggest me if you can I’ll be waiting for your answer.
    Regards
    Sonia

  9. Hey Tom,my daughter had her four front incisors extracted three years ago and we are now(shes 6)seeing the inflammation in the gums which is an indicator of eruption(as we also see some of the bone emerging in the gumline).I am unable to determine which tooth it is which is a little concerning.its on the left side and considering two teeth are supposed to erupt,it feels like one big tooth,which leaves very little room for the second tooth on that side.is this normal? Thank you!

  10. Dear Doctor,

    My daughter 5 yrs old, hv cavity and teeth to be removed and our dentist sugested to put spacer. Will space pain full? will she sollowe it while eating food by accedient.

    Thx to advice.

  11. My 9 year old son has a baby tooth that will not push through even though his permanent tooth is trying to push it through. The orthodontist wants to put a lingual arch on his lower molars to keep them back and have the K tooth pulled so the other will come in. The cost estimated to me was 1200.00 Does that seem inline with what this should cost or should I get a second opinion? Thank you for your time and consideration.

  12. my 7 year olds 2nd to back molar is loose….and the dentist wants to put a spacer in…..will he pull that tooth first? and is it really even nec. /??? thanks…

  13. Hi Dr. Tom, I have a 4 year old son who fell off his scooter and clanked his upper and lower jaw together. The end result, the upper left canine shaved off half of the bottom molar (the molar behind his bottom canine). Upon his dentists examination, it was discovered that he fractured the root of the tooth and she was very relaxed about treatment. She wanted to wait and see what happened. After a week, I had enough and called the office because the tooth was bothering him and I do not want a risk of infection. From there he was referred to an oral surgeon. The surgeon said it needs to be pulled and it will Friday. He also spoke voiced a concern to speak to the dentist about something to maintain the gap between the teeth and the adult tooth won’t erupt till he is 10 (6 yrs away). I have some concerns such as what are the options, how well do they work and are there any side effects?

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