The Role of Dental Space Maintainers in Early Orthodontics!

by | Sep 5, 2023 | General Orthodontics, Orthodontic Treatments | 0 comments

Your child loses their first baby tooth, and you’re both eagerly waiting for the adult one to make its grand entrance. But what if it’s taking its sweet time?

Space maintainers are here to save the day! These orthodontic devices swoop in, holding the fort in early orthodontics until the adult tooth is ready to take center stage.

Let’s dive into the world of space maintainers and see how they’re game-changers in keeping your children’s smiles on track!


What is a Dental Space Maintainer?

When a child prematurely loses a primary tooth, there is a risk that the surrounding teeth might shift into the vacant space, potentially leading to alignment problems when the permanent tooth starts to emerge.

The role of the dental space maintainer is to hold this space open by preventing such movement. This custom-made device ensures enough room inside your child’s mouth for the permanent tooth to grow in its correct position, preventing more complex orthodontic treatment later on.

Some children lose their first baby teeth as early as 4 years old!

Source: Cleveland Clinic


The 4 Types of Fixed Space Maintainers

Types of space maintainers

Unilateral Space Maintainers

Unilateral space maintainers are applied when there is a premature loss of a tooth on one side of the mouth. This appliance consists of a band attached to a permanent tooth, with a wire loop that extends across the space to prevent the neighboring tooth from shifting into the gap.


Crown and Loop Space Maintainers

Orthodontists typically utilize crown and loop space maintainers in cases where a primary molar has been lost prematurely. The process involves fitting a crown over the tooth adjacent to the space, with a stainless steel loop attached that extends into the missing tooth space, thus preserving it for the unerupted permanent tooth.


Lingual Space Maintainers

The term “lingual” in lingual space maintainers refers to the side of the tooth closest to the tongue. This appliance has a metal bar connected to the molars on both sides. Orthodontists employ lingual space maintainers in cases of multiple missing teeth.


Distal Shoe Space Maintainers

Distal shoe space maintainers are considered a more intensive orthodontic solution. Orthodontists use them when a primary molar with no permanent successor has been lost. These devices are inserted under the gum line to keep the space open for the future permanent tooth.


Removable Space Maintainers

Removable space maintainers are similar in many respects to retainers. They’re usually made of acrylic, often including artificial teeth to fill in the vacant space. This makes them particularly beneficial in areas of the mouth that are highly visible, as they maintain your smile’s aesthetic while serving their practical purpose.

These maintainers are best suited for older children or adults capable of reliably handling and caring for orthodontic devices. Since they are removable, removable space maintainers require careful management to ensure they are not lost or damaged.


How an Orthodontist Uses a Space Maintainer in Pediatric Dentistry

Why Your Child’s Teeth May Need a Space Maintainer

Imagine your child’s baby teeth as the opening act for the main event — the adult teeth. They’re setting the stage, ensuring everything is ready for the adult teeth to debut.

But what happens when the opening act finishes too early and the main event isn’t ready to start?

That’s precisely the issue with a baby tooth falling out too soon — the adult tooth isn’t ready to come in yet! You’ve got this gap that other teeth might start shifting into, causing problems when the adult tooth finally shows up and finds its spot taken.

That’s where a space maintainer comes in, acting as a placeholder until the adult tooth is ready to come in.

Then, it’s showtime!


The Space Maintainer Placement Process

The first step is visiting your child’s pediatric dentist. They’ll inspect your child’s teeth and decide whether a space maintainer is needed.

If so, they’ll take an impression of your child’s mouth. Think of it like a 3D snapshot of where all the teeth are and how they fit together.

Then, the impression gets sent to a dental lab, where we turn it into a custom-fit space maintainer for your child.

Once the space maintainer is ready, you’ll return to the dentist. They’ll place it in your child’s mouth to keep that space open.


Removing Your Child’s Space Maintainer

When that adult tooth is finally ready to debut, it’s time for the space maintainer to take a bow and exit the stage.

Your dentist will use special tools to remove the space maintainer. Depending on the type of space maintainer, this process involves unfastening a band or clipping a wire.

The entire process is straightforward and not at all painful. It’s akin to taking off a piece of jewelry. You might feel a weird sensation in your mouth, but it shouldn’t hurt.


Space Maintainer FAQ

How Long Will My Child Wear Their Space Maintainer?

The length of time your child will need to rock their space maintained depends on when their adult tooth decides to make an appearance.

Space maintainers are usually worn until permanent teeth start to erupt, or in other words, poke through the gum. 

Now, teeth don’t follow a set schedule. For some kids, this could be a matter of months — for others, it could be a couple of years.


How to Care for Your Space Maintainer

How to care for your space maintainer

  • Clean it like a tooth: The space maintainer needs brushing, just like regular teeth. Ensure your child brushes around it while cleaning their teeth to keep it debris-free.
  • Protect it during sports: If your child is playing sports, consider a mouth guard to protect the space maintainer and your child’s other teeth from rogue balls or elbows!
  • Check it regularly: Have your child check the space maintainer regularly to ensure it’s not loose or broken. If it is, get in touch with your dentist immediately.
  • Regular dentist visits: Keep up with regular dentist visits to ensure the space maintainer does its job and catches any potential issues early on.


Foods to Avoid With Space Maintainers

Foods to avoid with space maintainers

The following foods and snacks are not best pals with your child’s space maintainer:

  • Sticky candy: Candies that glue themselves to your teeth, such as caramels, taffy, and gummies, can get stuck and pull on the appliance.
  • Hard foods: Chowing down on hard foods, such as hard candies, ice cubes, or even super crunchy veggies and fruits, could damage the space maintainer.
  • Chewy foods: Foods that require a lot of chewing, such as chewy bread, dried fruits, and some types of meat, can be tricky, as they might yank on the space maintainer.
  • Popcorn: This movie night favorite is a troublemaker. The kernels can get stuck and cause discomfort or even damage the space maintainer.
  • Sugary drinks: While not a food, sugary drinks promote tooth decay around the space maintainer.


How Much Do Space Maintainers Cost?

Factors influencing the price of a space maintainer

The cost of space maintainers varies depending on several factors:

  • Geographical location
  • The types of space maintainers
  • The location of the maintainer (for example, on the upper or lower jaw, or both)

To give you a ballpark figure, expect to pay anywhere from a few hundred to over a thousand dollars per space maintainer. Fortunately, dental insurance often covers at least part of the cost for space maintainers, especially for kids.


Do Space Maintainers Help Adult Teeth, Too?

Adults can use space maintainers!

Let’s say you lose a tooth but can’t get a dental implant immediately (maybe you’re waiting for the spot to heal). A space maintainer will hold down the fort and stop other teeth from shifting into the space.


Why is My Dental Space Maintainer Causing Pain?

There could be a few reasons why a space maintainer is causing pain.

Firstly, it is a matter of getting used to it. Just like a new pair of shoes, sometimes, it takes time to break in a space maintainer.

However, ongoing pain indicates that something else is going on. The space maintainer could rub against the gums or other mouth parts, causing irritation. It might need to fit properly or have been damaged or moved out of place.

Also, the gum tissue around the space maintainer may become inflamed, especially if food particles get stuck and are not cleaned properly.

If the space maintainer continues to cause discomfort, it’s time to book a visit to your dentist. They can check things out, ensure the fit is right, and address any issues.


What if My Space Maintainer Fell Out?

If your space maintainer falls out, it is crucial to respond swiftly and appropriately.

First, locate and safely store the space maintainer. Refrain from attempting to reinsert the appliance, as incorrect placement may cause further issues.

Next, promptly contact your dental healthcare provider. They will advise you on the necessary steps and schedule an appointment soon. Rapid response is paramount because the empty space closes if the appliance isn’t in place.

Before the appointment, maintain proper oral hygiene and exercise extra caution while eating to prevent further disturbances to the area.

During the appointment, the dentist will evaluate the cause of the dislodgement and the condition of the space maintainer. Depending on these factors, they may either reposition the original appliance or opt for a new one.


Unlock Your Child’s Perfect Smile With the Magic of Space Maintainers!

Contact Patuxent Orthodontics if orthodontic care is the solution to your dental woes. Whether you want to learn more about the benefits of orthodontic care or have questions about the process, use our live chat or call (240) 802-7217 or message us through our Contact Us page to connect with our friendly staff today and book a complimentary consultation! 

Our office, located at 44220 Airport View Dr., Hollywood, MD 20636, proudly serves Maryland’s Patuxent area, as well as the Greater Washington DC area. So, if you’re residing in Hollywood, Wildewood, or Leonardtown and are looking for one of the best orthodontists in Maryland, don’t hesitate to visit our office! 

We also invite you to keep up with our blog to get answers to many of the frequently asked questions about maintaining your perfect smile, and follow us on Facebook and Instagram to become a part of our smiling community!



  1. “Bracing for the Fallout: When Do Kids Lose Their Teeth?” Cleveland Clinic, Accessed 3 Aug. 2023.
  2. Lee, Dr. Richard. “Food and Braces Part 2: What Food for Braces You Should Avoid.” Loudoun Orthodontics, Accessed 3 Aug. 2023.
  3. Lee, Dr. Richard. “How Does the ITERO Scanner Work?” Loudoun Orthodontics, Accessed 3 Aug. 2023.

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