Thursday, July 18, 2024
HomePediatric DentistryHow A Space Maintainer Will Look In Your Child's Mouth

How A Space Maintainer Will Look In Your Child’s Mouth

A few months ago, I wrote an article detailing why it would be necessary for a child to get a space maintainer.  A space maintainer is commonly referred to as simply a spacer.

A Child That Has Lost a Tooth PrematurelyIn the picture to the left, you can see how the lower teeth of a six year old child might appear with a missing baby tooth — the first molar.  Let’s say that this kid didn’t brush his teeth a lot and ended up needing his first molar extracted because of a large cavity that couldn’t be fixed.

If the dentist simply removed that tooth and sent the child home, that kid’s permanent tooth would probably never come in!

Under normal circumstances, all of the teeth in the mouth exert pressure on each other, which holds them in their proper position. When a tooth is lost, the teeth next to the lost tooth will move into the lost space since the lost tooth can no longer exert its pressure on the adjacent teeth. Also, the teeth above the lost tooth will erupt a little more to fill in the space below.

The picture below shows what happens if a space maintainer is not placed after a baby tooth gets extracted.

Tooth Loss - The Space Fills In
When a tooth is lost, the teeth around it are eager to fill in the empty space

Why Teeth Move

Many people wonder why teeth want to move to fill in the gap when a neighboring tooth is extracted.  Here’s an analogy to illustrate why teeth move.

Large CrowdLet’s say there’s a giant crowd of people waiting in line for the chance to read the latest article on Oral Answers.  Now suppose that one person decides he’s sick and tired of waiting and decides to leave.  When he leaves, there is a small opening in the crowd where he used to be excitedly waiting.  Does the crowd leave that space open?  No!  The people that were waiting right next to the space where that guy used to be waiting move to fill it in the empty space that he left behind.

That’s pretty much how it works in the mouth.  When there’s an empty space, teeth move to fill it in.

A Space Maintainer Maintains The Old Space

A space maintainer will conserve the space left by the extracted tooth.  That way, when the permanent tooth starts to grow into the mouth, there will be lots of room for it to fit in perfectly.

Here’s a space maintainer that I made during my pediatric dentistry lab earlier this year.

A Birds Eye View of a Space Maintainer - Spacer
Here is a top view of a band and loop space maintainer.

Here’s another view:

A Dental Space Maintainer - Spacer
A side view of a space maintainer. This is how the space maintainer would look if you were sitting on the inside of your child’s cheek.


If a space maintainer is not used, the jaw may never grow to its full potential and consequently it might not have room for all of the permanent teeth, necessitating the removal of some teeth along with orthodontic treatment (braces).

Do you have any questions or comments about space maintainers (spacers)?  Leave them in the comments below and I’ll get back with you!



  1. Great post. Especially the analogy about the crowd fillng in the open space. Gald to see you blogging about dentistry. I think your writing style will serve you well as it speaks much as I try to write, as if you are speaking to a patient. By the way you can make a Band and “L” by using only one solder joint–works quite well and is easy and fast to make while the patient is waiting in the chair. I solder one side, clip it about 2 inches long, bring it to the patient, try it on measure and bend it into an L shape, clipping off the excess. So it looks just like the band and loop but without one side missing. (usually the lingual part)

    When I was in dental school, I had no time (and no money) to blog or do pretty much anything else other than school. Of course, there was no such thing as the internet then. Good luck, and as was once said: “Blog on Wayne,– Blog on Garth.”

    • Hi Dr. Brandon – Thanks for the kind words! It’s a struggle to fit everything in, but I look forward to blogging – it’s relaxing and fun to be able to learn about different aspects of dentistry that real people have questions about.

      That sounds like a much more efficient method of making a band and loop spacer. I imagine that it would probably be a lot easier for the child to eat and keep the area clean with that design. I guess you don’t learn everything in dental school 🙂

        • Hi,
          I’m getting one of my teeth pulled out in a few days and I am going to get a space maintainer then I get braces on top of that. So my advice is space maintainers are really good to fix your teeth. And the cement that they use to make the space maintainer stay in your mouth has fluoride in it so your teeth stay clean!!!!!!!!

  2. my daughter just got removed 4 tooths 2 fronts and 2 in the back that had cavities
    the front were behind the old baby tooths so they had to remove them for the new ones to align properly
    the back ones had bad cavities so they had to remove them completely and the dentist said she will need a spacer on each side but the dentist visit was so bad almost traumatizing for her that i cant find a way to convence her to go back to the dentist and get this done and i am affraid the back tooths will shift…what do you recomend me to do…any help will be greatly appreciated it

    • Hi Damian – You won’t have to worry about the front teeth, but when we take out back teeth early due to cavities, you usually need some sort of space maintainer. The only time you wouldn’t need a space maintainer is if the permanent teeth are expected to come into the mouth within six months.

      When taking teeth out, it can be very traumatic for kids. All that they would need to do to get the space maintainers in would be to take an impression of her teeth and then make the space maintainer using that cast. After that, they would just need to put the space maintainer in. None of it should be painful at all.

      As for getting her to go back here’s a few suggestions:

      1 – You can be honest with her and tell her that her permanent teeth might not come in if she doesn’t get the space maintainer. This works better with older kids – if she’s 3 or 4 years old, she may not care.
      2 – You can tell her how proud you are of her and how brave she was for going to the dentist and getting her teeth out. Let her know that at the next visit, it will be fun – they will put some gel in her mouth that will get hard, they will take it out and then make a model of her teeth. After that, they will put the space maintainer on her teeth and it shouldn’t hurt.
      3 – You can try rewarding her with something she wants for going to the dentist. We have stickers and silly bands in our pediatric dentistry department and we tell the kids that if they open their mouths for us they can have some stickers and silly bands. That usually works.

      If you (or others that may be reading this) have any other ideas, please reply so others can try them in the future. Thanks for your comment, Damian. I hope that helped.

      • I have a spacer and I am go to get It taken off tomorrow beacons my tooth is coming in can you give me some info when I getting my sparser taken out

  3. thank you for your quick response i am looking into dentist that use laughing gas so her nest visit wont be as painful as last one, they did promised me they used the laughing gas but rite after i signed the $800 dollar tab they said they dont even use it

    thanks for your help it is really nice to hear an honest opinion

    • I’m sorry to hear that, Damian. Luckily, since there shouldn’t be any pain with her next appointment, it may not be necessary.

      Another thing you could try is to ask your dentist for one of the plastic impression trays. You could take it home and practice putting it in your daughter’s mouth so she’ll know what will be happening at the next visit. A lot of kids simply fear the unknown. Good luck getting her to get that spacer!

    • We had the same issues with my son. They were going to put him to sleep to get dental work done. We just couldn’t afford that. I called my pediatrician and we now give him Benadryl 30 min. before his dental visits and make sure they give him gas a little longer before procedures. Some pediatricians will prescribe children’s valum. We tried the Benadryl first and it works for him.

  4. My son had his 2nd molars extracted due to cavaties he was 4 yrs old at the time. The dentist said that when his six yr molars come in that he will have to have space maintainers placed. I assumed that they would come in around 6 yrs old. Well he just turned 5 and is very independent when it comes to brushing his teeth. I just noticed that his 6 yr molars are completely in, and im scared that its to late. There is still an opening between the teeth, but it doesn’t look very big. Will a space maintainer still be helpful?

    • Hi Brittany – Based on what I’ve been taught in my three years of dental school, your son probably should have had what we call a “Distal Shoe” space maintainer put in right after his 2nd molars were extracted. You can read more about these at this page (it is the third image down – also take a look at the two x-rays below that which show how it works)

      Your son’s permanent tooth, a premolar isn’t extremely wide, so there may still be room for it to come in. Your best bet would probably be to take him to a pediatric dentist to find out if there is still room. They will be able to let you know if the tooth will still be able to come in or if a space maintainer would help at this point.

      I hope that helps, Brittany! Good luck with everything – Thanks for your comment.

      • thank you so much for the response. knowing that something should of been placed there even before his 6 yr molars came in does make me a little upset though. he just had his 2nd molars removed about six months ago. what will happen if there isn’t enough room for the permanant teeth to come in or if a space maintainer can’t be placed? i tend to drive myself crazy over everything when it involves my children. i am going to make him an appointment with a pediatric dentist in the morning hopefully they can get him in rather soon.

        • Hi Brittany – I’m just going by what I’ve learned in dental school. It could be that your son’s dentist had a good reason for not placing the space maintainer. If there isn’t enough room for the permanent teeth to come in, then orthodontics can most likely create the needed room to allow the teeth to come in normally. Hopefully the teeth haven’t moved too much and there’s still room for the permanent teeth to come in. Keep us updated on what happens at the appointment. Good luck with everything, Brittany!

        • Hello Tom…

          I have absolutley never posted a question on one of these sites but frankly… I’m freaking. I have terrible Mom guilt. My daughter had two baby teeth pulled for cavities and the dentist said he figures she would need space maintainers but would have to do X-rays to see for sure. Well.. following X-rays, and a second opinion from a co-worker, he concluded she did need spacers. After the consultation, extractions, the X-rays, the spacers and the extras… I was hit with a 3000+ bill. I just didn’t have that kind of money so I opted out of the spacers, thinking they weren’t necessary, and paid my already uncomfortable bill.

          Now, jumping a year later, her teeth have shifted and she just showed me the on tooth beside the one hole, is loose. Is it too late? Can I still get spacers?? What do i do? She has otherwise perfect teeth. Straight, white and beautiful.

          Thank you in advance for sharing your expertise 🙂


  5. Thanks for much for your post.

    I am 22 years old. My first lower molar was removed dued to some dental problem. I plan to wear brace in the next two years when I get back to my country ( because now I am abroad.) I want to know whether I should put a space maintainer for the hole or just leave it like that ( as I am going to wear the brace in the next 2 years anyway)?
    And if I put a space maintainer, will the tooth above the lost tooth still erupt a little more to fill in the space below?

    I am waiting for your reply. Thank you so much.


    • Hi Natalie – We usually use space maintainers in children so that there is room for the permanent teeth to come in. Although your teeth will slowly “drift” into the empty space, if you are planning on having braces, then your orthodontist should be able to move everything back to the way it was before you lost the tooth.

      The best space maintainer in adults is to replace the empty space with a false tooth, by getting a bridge or an implant. Let me know if you have any other questions. Thanks for your comment, Natalie!

  6. Hi Tom, our son is 7 and we were told by his dentist that he needs a “baby root canal” in his bottom left molar. Our other option is pulling the tooth and placing a spacer. His father and I have concerns with either alternative and need advice on which is the better option. Our concern with the “baby root canal” is what if they don’t remove all of the bad stuff and it becomes abcessed (that happened to my husband). Second option leaves me worried about my son’s future dentist visits if this becomes traumatic for him. My husband had a molar pulled when he was a child and did not have a spacer and the rest of his teeth came in fine, could this be another option for us? Or, what would happen if we left the tooth in until it fell out on it’s own? Any advice you can share with us would be greatly appreciated!

    • Hi Candis – As far as I know, it’s almost always recommended to get a space maintainer when you get that tooth pulled out. However, as you stated, getting that tooth pulled out can be traumatic for your son. The replacement tooth (the mandibular premolar) usually comes in between the ages of 10 and 12, so your son will be looking at 3-5 more years until that tooth comes in. For this reason, it’s probably not a good idea to simply leave the tooth in his mouth without doing anything. You can read this article about why baby teeth are important to see that an abscess can damage the permanent tooth.

      As for the baby root canal, that could be the better option. I understand that you’re reluctant to go through with this since things didn’t go very well with your husband. Although they are usually successful, sometimes root canals end up not working out.

      You do have a few options. All I can say is that if it were my own son, I would probably go with the root canal over the extraction. I hope that helps, Candis. Thanks for your comment!

  7. My son is 7 yrs. old and his back tooth was extracted 2 yrs ago. Unfortunately, the Dentist suggested space maintainer after the space healed. After that Dentist kept rescheduling. Now i went to see someone else and it is too late. The Dentist/Orthodontist suggested to put retainer because there is not enough space. The cost is $600. Any other suggestions?

    • Hi Janete – I’m sorry to hear that. The only way I know of to create enough room is through orthodontics. This means that either braces or a retainer would be needed to move the adjacent teeth so that there is room for the permanent tooth to come in.

      I wish I could give you better news! Let me know if you have any other questions. Thanks for your comment, Janete!

  8. My son had two (baby) top molars removed a year ago — his six year molars came in too close, destroyed the roots of the baby teeth in front of them. He had a spacer placed, and it came loose — so they simply removed the spacer and said his new teeth would just come in. My understanding was that the permanent molars (replacing the pulled teeth) were 10-12 year molars. My son is 7 1/2… I questioned them (twice) and was assured that these permanent teeth would indeed come in correctly. But do they come in earlier just because the baby teeth were pulled? We spent $300 on this spacer, not to mention time and frustration on my son’s part because of the length of time it took him to get used to having the spacer in his mouth. I worry that now the spacer is out, his teeth will move around because it will be years until his permanent teeth come in! I would love some advice. Thanks!

    • Hi Julie – The permanent “premolar” or “bicuspid” teeth are what will replace those two baby teeth that were removed. You are correct – those 2nd premolar teeth come in anywhere from 10 to 12 years old according to the eruption chart from the American Dental Association.

      To be honest, everything that I’ve been taught in dental school would indicate that a space maintainer is necessary in this case, since I am guessing that the six year old molars are excited to keep moving forward as they have been doing.

      Generally, a good choice of space maintainer would be a transpalatal arch appliance, one that hooks onto both of the six year molars on top and goes across the roof of the mouth. I had previously looked into this in response to a comment.

      It might be a good idea to get a second opinion from a pediatric dentist, and then try to get your money back or have a new, well-fitting appliance made from this other dentist. I hope that helps, Julie. Let me know if you have any other questions. Thanks for your comment!

  9. my son is 7yrs9 mths old. he had developed a cavity in his first molar 7 mths back which the doctor extracted. he said there was no need of a space maintainer. but after reading your articles i think i have done a blunder to my child. what should i do now? can i still put a spacer for him or it is too late? please guide me.

    • Hi Rekha – The baby first molar usually falls out on its own around the age of 10 to 11. Three years without a space maintainer may cause some shifting problems. You may want to go to a pediatric dentist to get their opinion on whether a space maintainer will be beneficial at this point since it’s only been seventh months.

      I hope that helps – Let me know if you have any other questions. Thanks for your comment, Rekha!

  10. I had a crown AND post come out of my molar area but the dentist didnt have time to do anything but drill away at the cavity that had grown in there. He has stopped it up with a little cement(all ok with that for now) but my concern is my gums, my molar root is still in my gum so how long can for an appointment b4 the gum starts to grow around my tooth?? I have no crown to push down on gum line so im afraid now. 🙁
    thank you

  11. My daughter had spacer put in 3 years ago we have since moved and just started with a new dentist I was told they were going to remove her spacer (she is 9 ) and see how how she does and then she will have to have another one put in. My question is, is this necessary? Or are they just trying to make a few more bucks out of me.

  12. My son had a tooth pulled two weeks ago and the Dentist took a mold to make a spacer. Yesterday he had the spacer installed. It looks like he has braces on the back side of all of his bottom teeth. He has crowns around both back teeth and a wrinkled wire running between them. The tooth that was removed was the middle molar on the bottom left. The wire looks so uncomfortable and my son says it hurts to chew and his tongue is being scratched by the back crowns. The photo you provided with your article is what I expected to see when my son came out. Do you think my son should have the work redone?

  13. I have an 11 year old son who needs 6 teeth removed – one ortho says he needs a maintainer and the other says a retainer (he says it helps if my son grinds his teeth) what is the big difference – I do know the retainer does cost a bit more? Thanks.

  14. Hello,
    My son had his first molars removed in July. He never got the spacers and I can see his teeth shifted. Is there a lab that can make it for me or does a dentist have to make it?

  15. Hi, I have a 5 1/2 year old son that had two molars removed from the bottom less than a year ago. He had spacers put in and has had no problems before now. He can’t even eat lately because of the pain. I noticed some molars coming in in the back. Is it just the pressure of those teeth pushing against the teeth and spacer? The gums don’t look irritated, that I can tell. Thanks.

  16. Hi Tom
    My 7 year old son got his 2 molars extracted last year and just got his spacers put 2 days back. These are the ones that connect with a wire on both sides. The wire is not attached to the inner gum line and there is gap. Is this ok?
    Reading your post and comments makes me assured that I did not do anything wrong by getting them put which I was doubting after looking at how uncomfortable my son is. He has not been able to eat properly and is also complaining of pain. Is this normal? How long will the pain and discomfort last?
    Could ypu please share something on post care?

    – Ro

  17. Hi Tom,

    My daughter is 11 and has two loose teeth on the upper left side of her mouth. They are the c or #6 molars? They are falling out naturally with no cavities or abscesses. Our dentist wants to pull them and put spacers in for 4 – 6 months. The roots are fully resorbed and the big girl teeth appear to already be breaking through the gums per the dentist reading the x-ray. I think this spacer is mostly for cosmetic reasons? Our daughter will need braces whether we do these spacers or not. Do you recommend them for 4 – 6 months? Or pulling the teeth before they naturally fall out? I saw the x-ray, and the big girl teeth are slightly angled, but nothing extreme in my opinion or the dentist’s opinion. Our dentist is a cosmetic dentist, so I’m wondering if he’s being more aggressive on aesthetics for that reason.

    Thank you for your time,

  18. hello,
    we had a maintaner placed @ bottom molar , i expected the maintaner itself resting on the gumline but it’s NOT . it’s approx 2-3 mm above the gumline making it so much more uncomfortable . also it’s wider than all the other teeth constantly rubbing against the bottom fo the tongue .
    on all the pictures i’ve seen so far ( including the ones you posted from your practice ) i have’t seen any where they sort of ” rest in the air ” . should i take my child to another dentist and have another spacer made ?

  19. Hi Tom! I have an 8 year old daughter and the destist is telling me that her 6 year old molars are coming in crooked and hitting the baby molars and they are gonna make them fall out. He wants to pull out the baby molars and put spacers with some type of orthodontic pushing something that will push the 6 year molars back so they don’t keep moving forward. My concern is that he told me that she’ll need braces and that her mouth is too small and she will need teeth pulled. We were thinking why should we put her through all this if in the long run those 6 year molars might end up being pulled. Should we just pull the 6 year old molars now and avoid the whole spacer, since he said we are gonna run into the same problem with the 10 or 12 year old molars. We don’t know what to do, please give me your advice. I found your site and read all the wonderful advice you’ve given to so many others. Thank you in advance!

  20. Hi –
    My 8 year old has a space maintainer that goes all the way the around the inside of his lower teeth. Apparently because he doesn’t have enough teeth on the side that needs a spacer? Anyway. It impedes his speech and I asked the dentist if we could just take it out since his lower teeth are already so crooked that he will likely need braces anyway. He agreed that the orthodonist could deal with it later. But reading your post makes me have second thoughts. I also read another website where people were talking about teeth straightening on their own by the teen years, so maybe I am assuming incorrectly about the braces. I hate that space maintainer but don’t want to make a bad decision for him. Would love to hear your thoughts.

  21. My grandson recieved a spacer on a bottom molar a year ago after a large cavity was found near the gumline.
    It has fallen out now for the third time. Every time we go back to have it replaced they charge $60 . He is due for a 6 month check up in 2 1/2 months. Will his teeth shift if we wait until that checkup or should we make a special appointment as soon as possible to have it replaced?
    Thank you

  22. My son got spacers but they didn’t look anything like the pics u posted they pulled two back teeth one on top and bottom and the metal piece attach to the back teeth on top and bottom both sides not even where the other teeth are coming in and yes the other teeth are coming in as I asked the dentist why pull the teeth when the others are right behind them…..wish I could send a pic for they don’t look right and every visit seems like all children his age are getting spacers ?????

  23. Hi Tom,
    My daughter is 17 months old and has developed dental carries. Just last week she was put to sleep and had crowns placed on her first four front teeth on the top. I went to two different dentist and rhey both were hopeful about the outcome with crowns and said her teeth looked like she would not have any problems after. I was told that the carries developed probably as a result of me night nursing her which I no longer do and that I should be extra careful about making sure she doesnt eat any hard or sticky goods as that could cause the crown to come off which I jave done. Well today out of nowhere and for no apparent reason one of her front crowns just completely fell off with her tooth leaving no mote than a tiny stub in the area where her tooth was. She didnt hit it on anything and was not eating a thing. I’m so confused how this happened in the first place and am scared to death to take her back amd have this whole procedure repeated(if that’s even possible with such little tooth structure left) or have her tooth extracted at such an early age. Any avice you can give me on what to do here? Thanks in advance:)

  24. My son had an SSC on thooth # L ( he is now 7) but now the Dentist said has infection under the ssc on L and need to be extracted and put space maintainer , looking at the pictures I am just wondering how painfull it will be to eat and chew, after words and how long does he have to wear his space maintainer.

    Thank you

  25. Hi, My daughter is 7 years old, Dr. advised to extract tooth B & I, and she was telling us to put the space maintainer. Is the space maintainer is must? Is that really required? Need your suggestion. If I am not putting her Space maintainer what will happen?

  26. Hi,

    My son(3 1/2 year old) had his tooth (#s) extracted last Monday. How long we could wait to put a space maintainer? Is there any difference between now and in two months to add the space maintainer?



  27. My 6.5 year old son had his top molar extracted in late July. Due to the illness of the pediatric dentist,(which I was not made aware of until after our first time visit to the office in August -in August they had another dentist evaluate my son’s month. Found he needed 3 fillings and 2 stainless steel crowns besides the spacer) , my son was able to get an appointment in October for an impression of the tooth to get a spacer. The office then scheduled the placement of the spacer 4 weeks later which was yesterday. Yesterday they put one stainless steel crown and filled one cavity and then they offered me the option to wait till next visit to put in the spacer because it was getting late and my son had been there awhile. i insisted that they place his spacer since that is why we changed to a pediatric dentist in the first place. What happened next frustrated me, they tell me that the spacer doesn’t fit and they will have to take another mold. The doctor said that it happens sometimes that the teeth can move within 4 weeks. Anyways, I got them to take another impression before we left yesterday and my son has an appointment in two weeks to have the spacer put in and per their recommendation another stainless steel crown and the other regular filling on the same day. My question is would his teeth have moved in the last month or was it a bad impression ? If he teeth moved, then will he need braces because we were forced to wait on getting the spacer placed promptly? Should I left them do all this work on our next appointment or should I spread it out?

  28. We have a son age 9 now. He has a couple spacers but have moved from the area of the dentist/oral surgeon that put these in. we were not given real care instructions but he now has some of his baby teeth coming out. One of them were attached to the spacer. My question is do these come out on there own or do i need to take him to a dentist to have them removed? We were told that they just come out by a couple of dentists but i am not sure… Any comments or suggestions would be greatly appreciated



  29. Hello,
    Could you please tell me if it can cause problems if the spacer is pushing down on the gums where the extracted tooth had been? Or if it was installed incorrectly? I see from your picture above that the spacer is not touching the gums below it in the space where the tooth had been extracted (the view from inside your child’s cheek). I’m very concerned because my son just had a spacer put in, it hurts & is pushing right into the gums. I was wondering if I needed to go back to the dentist to have them fix this? Thank you so much!!

    • Hi Vesper – Ideally, the space maintainer should not touch the gums. If it is causing discomfort and pain, it would be a good idea to have it looked at by the dentist to ensure that everything is alright. I hope that helps – have a great day!

  30. Hi Tom,
    i was researching spacers as thats what my 8 year old dentist said she might need. maybe i heard him wrong as this is not why she needs them. she was born well when her teeth first came in instead of her top teeth overlapping the bottom, her bottom teeth overlap her top. shewas late getting teeth and late to start loosing them. she lost her 2 teeth to the right and left of her two front teeth on the bottom about 5 months ago maybe longer. they have only come in half way. not sticking out as far as her other hoping these will eventually come the rest of the way out. her dentisthas never said anything about this. im not sure if you know. is it maybe just going to take some time? also do spaxers help for her i believe its called under bite? thank you so much!!

  31. My 5 year old grandson had one of his lower molars extracted, and a spacer was installed.
    the spacer came out one week later while he was talking [not eating].
    What is the possibility that the child swallows the spacer?
    could swallowing the spacer be dangerous?

  32. How soon after the tooth is extracted should the spacer be placed in . My sons spacers are being placed in 4 weeks after extraction is that standard ? Not sure if I should push for an earlier appointment I am concerned with shifting .

  33. My 6 year old son had crowns placed on”S” and “T”. The T fell out (along with the tooth)last night and now S is loose. How would they place a space maintainer to keep it open?

  34. Grandson (7 yrs) had 2 baby teeth pulled and 2 metal spacers put in. told by ndentist that they needed to remain in place until he was 12ish and could not eat any crunchy or sticky food while spacers in place. One of them has fallen out twice in 5 months…causing concern (choking on metal spacer ),restricted diet, expense and most of all…the child is now fearfiul of this whole experience and so are we all. I understand the need to keep this space open for permanent teeth BUT???

  35. Hello!

    My 3 year old daughter had trauma to her front tooth from a fall about a year and a half ago. Since then the tooth became infected and she recently had the tooth extracted. My question is; how long will her dentist wait until he has a spacer made for her? Thank you!

  36. Hi my 10 year old daughter has a spacer on the right upper side of her teeth and it has been there for a few years now. She has a tooth coming through the opening on the spacer. Is this ok or will the tooth be deformed because of the spacer. Should it be removed? She says it hurts every now and then. I have been watching it closely. I have left a message with the dentist waiting on reply, but haven’t got one yet. Think this might be faster.
    A worried mother

    • Hi Dawn – When the permanent tooth starts to come through, then it is time to have the spacer removed. It’s not an emergency, but I’m sure the dentist will try to see her relatively soon to have the spacer removed. I hope that helps. Have a great weekend!

  37. Hello,
    I recently took my 7 year old daughter to the dentist. She is needing seven baby root canals, caped and about 3-4 teeth removed. I don’t fully understand why she has so many cavities and needs so much work done because she brushes her teeth twice a day. Well we decided to do four individual appointments instead of one, which they do in the hospital and put her to sleep. Well we just got done with her first appointment. (They worked on her upper right hand side of her teeth. That side needed two baby root canals and one tooth pulled. Well they instead only did one root canal and pulled two of her teeth which were beside each other. My question is will she still need spacers if the two teeth that were pulled are beside each other leaving a pretty big gap. Will the teeth really grow together before the adult teeth come in?

  38. I have an Autistic son who just turned 7 a few weeks ago. He doesn’t speak well enough to say pin point a problem but we noticed he started running a fever a few days ago and his jaw started swelling. We took him to dentist and he has a big cavity. Because of the swelling, there is talk about removing the tooth and using a spacer.

    My concern is with him being autistic and non-verbal. I’m assuming they would use a permanent fixture but he hasn’t gotten his adult molars yet to adhere to. I’m hesitant to get something like this because he loves gummy bears and other hard candies like StarBursts, etc. I’m afraid that something like this could dislodge and end up somewhere we don’t want it.

    Another concern is if it is a permanent fixture and he is non-verbal, I take it that we would have to get regular checkups for X-Rays to make sure that it isn’t causing any issues with the adult tooth when it decides to pop up a few years from now. My hopes that he would be more verbal by then so it may not be as big of an issue like it would be today.

    Any thoughts?

    • Hi Brian – Good job on taking him to a dentist – many times autistic children do not get into the dentist as soon as they should due to a variety of reasons.

      Even if his permanent molars are not in yet, there are still options available to prevent the space from closing. Most children will not tolerate removable space maintainers so nearly all of them are fixed with a very strong cement that holds them in place. I just removed a space maintainer last week and it was stuck on there VERY well even after putting up with chewing forces for years.

      Obviously, I would discuss your concerns with your son’s dentist. One thing to keep in mind is that if the spacer does come out, it will most likely be loose for a while before it completely dislodges. You can reach into his mouth every so often to check and make sure the spacer is firmly in place.

      X-rays are a good idea to check to see when the permanent tooth is coming in and the spacer is no longer necessary. If he can’t tolerate an x-ray inside the mouth, most modern panoramic x-ray machines can take an x-ray of an isolated area of the mouth from outside of the mouth.

      I hope that helps. Good luck!

  39. Hi Tom,

    My daughter had four molars removed when she was 6 and 7 and they never put space maintainers in. She has braces now and they are trying to make space she is 9. They have shaved her front teeth , used a palate expander and now a head gear. The space looks the same. Do you suggest anything else. Will the molars be impacted and not come down? The ortho suggested extracting her wisdom teeth now. She is only nine. I don’t want to have to put her under and permanent teeth.


  40. Thank you for this article. My daughter has 2 lower spacers and 2 upper spacers. She hint the edge of a table when she was 5 or 6 (currently 8 years old) and caused the 4 teeth to hit each other and we had no idea she had 4 abscessed teeth. There was no pain to 3 of the teeth and the 4th only hurt 1 day and we took her to the dentist the following day.

    Anyhow, she has had to have the bottom spacer replaced about 4 times. Is this normal? I know once was because her gram let her have gum (not any longer) but the other times she says she hasn’t had any chewy/sticky foods. This time it’s loose again and again she says she hasn’t had any chewy/sticky foods. We homeschool so I know what’s in the house and her gram knows not to allow her those types of foods.

    Any other reasons the spacers on the bottom keep coming loose?


  41. Thank you for explaining the importance of having a space maintainer . My daughter who is almost 3 years old is going tomorrow to have a space maintainer, i expect that she will get bothered whenever we do not allow her to have some candy like any other normal kid. Would it be pulled off easily if she eats any sticky food? I know i can control what she eats in the house but i am concerned about her when she is at day care. Also i would like to know if there is any chance of having her permanent tooth appear a bit earlier? We were planning to put her braces at age seven because of her lower jaw (under bite) i believe that is what it is called, would that space cause any problem when placing braces in future?

  42. Hello
    my son is two and will be having his front four top teeth extracted…
    Will he need spacers? I am worried about his adult teeth not coming in straight.
    Many thanks

  43. My daughter is having a molar removed (actually the same one from your pictures) due to it being fused to her jaw. I’ve been told it will never fall out, and will disrupt her permanent teeth when they attempt to grow in. How common is this issue of teeth being fused with the jaw. How long from extraction to a spacer being required….our dentist said about 6 weeks. Is the metal band that is around the molar cemented in place? How painful is the extraction because it may be drilled out unlike regular extractions where the teeth aren’t actually attached to the jaw?

  44. My son is 9 years old and got his back tooth extracted because of a cavity. The dentist suggested a space maintainer where wire is on two back teeth and wire comes in front of the lower front teeth. This looks horrible and I can’t imagine my son enduring this in his mouth for 3 years until he is 12 years old, what other alternatives are there to maintain the space between his teeth? Is there a tooth or something more comfortable than this wire? My son is not as responsible brushing his teeth as he should be and there’s no way he will keep this clean and deal with this, I’m sure we will be back to the dentist to have this removed, there must be some other alternative. Thank you in advance for any help you can offer.

  45. My son has 2 spacers from having abcessed teeth pulled (same one on either side if the mouth). The other day one came out. Is there something I can use temporally to hold it in?

  46. My son just had two spacers put in yesterday. He had two molars pulled due to a bounce house incident. It was my understanding that yesterday’s appointment he was just to have the molars pulled. This is what I was told. I was not allowed to sit in the room during the procedure. An hour or so later he came out with two pulled molars and two new spacers over the open wounds. Is this standard, or should they have given the gums time to heal before putting in the spacers as they told me they would? Any dangers in putting them in over open wounds?

  47. Hi am 13 my ortho put space mainters on my top and bottom its two rings cemented to my molars and they kinda bother me to eat and how long do you think they are going to keep them there

  48. I have a six yr. old son who had 2 top molars out and spacer placed in
    on the one spacer the front of it the gum of the tooth has grown over the front tip of it.
    How much of a problem is this
    does he need a specialist? Our dentist is a general not child specialist.
    What should I do?

  49. Hi there,

    I have had a space maintainer in my mouth for around 9 or 10 years but I think I may have swallowed it while eating… 😐 it was originally put in when a baby tooth came out with no adult tooth to replace it.
    I’m 23 years old. Are my teeth still growing? Do I need another space maintainer?

  50. Came across this excellent article….i do however have a question Tom, you indicated that a spacer also prevents the upper (in case of spacer on the lower gum) tooth from erupting further. The picture of the space you have, certainly seems to show that it’ll keep the space between the bottom teeth but how will that prevent the eruption of the upper tooth any further?

    We’re being given the option to do a root canal which i’m hoping can be avoided on a 4 year old who is not good in dental chair; instead i’m asking about an extraction and a spacer. This is the context.


  51. I have a 3-year-old who I was told will need 2 teeth removed and two spacers….by one dentist, another said the teeth can be capped and saved. What do I do? I’m really quite afraid to put my baby through so much pain and I’m also afraid that the spacer will break or loosen. How many years does my son have to walk around with his smile altered?

  52. Hi Dr. Tom,
    My daughter is 9 yrs old and we are starting orthodontics now. My daughter doesn’t have any teeth extracted because of major cavities and the 2 teeth she has surface cavities were baby teeth. She currently just got spacers in to get ready for an extender (expander) because her upper teeth are crowded and her bite on the front teeth don’t over lap, meet on top of each other. The other problem she has is her mouth is more of an 11 yr old. She only has 2 baby teeth to lose. Because her tooth grow is so far ahead of her years, will her jaw pallet grow more as she grows to allow the teeth that haven’t extended out of the gums to come in? Her alignments are not very far off from the front and profile mappings. If she doesn’t get the space she needs for her teeth to come in, they may need to extract 1 or 2 adult teeth. I’m not very found of removing adult teeth and neither is the orthodontist. I’m still trying to understand what all of this means. Spacers just went in to get ready for the expander brackets. How much more will her mouth pallets grow?

  53. Thanks for posting the cute kid with the crowded teeth. My 8 year old son is on his way to get spacers put in before braces next week. He felt nervous, we googled and found your page. He smiled and laughed and said, “Hey that kid has teeth that look like mine!” Now the vibe is “no big deal.” Instead of nervous unknowns. Great pic and posts- very informative. Thank you! You should be on the Doctors. Not many people know about denstitry.

  54. I have a 16 year old and a 14 year old. They aren’t missing any teeth but is there anything the dentist can to make their pallat bigger? My pallat is extremely small so I had lots of teeth removed as an adult and I’m afraid they’ve inherited it.

  55. My daughter is six and lost her bottom tooth beside the permanent mollar the dentist said it was to soon and she needs a spacer so the mollar doesn’t move since it’s permanent it’s going to cost a lot and she isn’t covered what are the chances of this mollar moving.

  56. My daughter is almost six years old. We just visited a new dentist since she has been complaining the past few weeks of her front bottom molar hurting which clearly I see has a cavity. We went to get it checked out and she has 4 cavities one being that one which is the worst one. The dentist suggested to remove the tooth or have a baby root canal which she said removal would be best. I am very concerned and not quite convinced about this decision of removing her tooth. I think it will be very painful and traumatizing. Please give me some advice on what would work best.

  57. My 5 year old daughter had a tooth removed on her bottom right side. They did an amazing job on the removal and during the, “loosening process”, she even said, “Hey Mom, this doesn’t even hurt!” 🙂 It has been 3 months since then and she while she healed beautifully, I am concerned about the gum now. The spacer is holding up fine but the gum underneath seems to be shrinking or thinning. The adult tooth is not suppose to come until close to 10 years of age. I was wondering if it’s normal for the gum to behave like this since there is currently no tooth to hold it up? Thanks so much!

  58. My 6 year old daughter just had a crown and a spacer added to a back tooth she had removed. It’s been 2 days and I noticed something inside the spacer. I am not sure if it’s her skin or food. How can I tell the difference? Should I try to pick on it? Or is this her scab? I’ve been keeping her on soft foods but she gets hungry and will sneak behind my back. Any advice?

  59. My son tooth spacer just fell out what can i do especially when is a friday he has no braceses it was around his molar one of those spacers

  60. I had no idea that teeth moved in to fill empty spaces in the mouth. Using a maintainer is a great way to ensure the teeth don’t move out of their designated space. It may help to talk to a dentist about getting a maintainer as soon as a tooth is lost.

  61. The space maintainer that our pediatric dentist showed me had a metal bar next to his bottom front teeth… kind of like a retainer. Is this normal???????

  62. My son had a spacer put in exactly like this picture, about 6 months ago. The spacer fell out two days ago and we are going today to get it replaced. What would cause the spacer to fall out? I am concerned that this will happen again if I am not doing something I need to to prevent it from coming out again. He brushes his teeth twice a day, as well as rinses with mouth wash twice a day, and flosses once a day… What am I missing?!?

  63. My son who is 5 yrs old just got his very last tooth in the back on the bottom right pulled out. The tooth in front of that they did a kid root canal and put a crown on it and than a spacer on top of it. Part of the spacer is laying in the hole where the tooth was pulled out. There is no tooth for the one side of the spacer to sit up against. Is this normal

  64. When Should You Put A Space Maintainer After The Baby Molar Is removed? Is is done the same day or a week later?

  65. Need help! My daughter got her spacer put in because molar was extracted. They put some type of glue to put spacer in. Is that how it is done? Looks like the tooth behind missing tooth has a lot of glue in it, would that be a problem?

  66. Hello, my son got a spacer a year ago and this morning the wire moved and its hurting him, how can I take a spacer of myself? Today is sunday and tomorrow is memorial day and everything is closed. Any suggestions.

  67. My son just had a spacer put in two days ago. He is having alot of problems eating and now has a blister in his mouth from it. what can be done to help this an d fix it so it wont happen again.

    • Hi Joann, If he has a blister from the spacer, it would be good to see the dentist to ensure that it’s not putting unnecessary pressure on his gums. I hope that helps!

  68. My 6 year old grandson had his very back tooth pulled and needs a spacer. I thought spacers went between two teeth that still remain. He is due for a spacer is this correct?

  69. My Daughter had a molar extracted and a spacer put in. It’s been about 1 mth. The gum is still a lil red and irrated. Is this normal? Should I do something?

  70. How long approx. does a 9 year old have to keep the spacer in?
    (It was put in at age 5, several teeth were pulled due to decay).

  71. My daughter had one out in a week ago. It is causing her pain. The metal around the tooth is taller than then tooth and has a lip. The dentist said that lip of metal is normal and she need to deal with it. When she bites down the lip of metal hits her upper tooth and causes pain. Is this normal?


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