Space Maintainers

Pulpectomy & Pulpotomy

The main function of milk teeth is not only to chew but also to maintain the space required for the permanent tooth erupting underneath it. Decay or trauma may require premature removal of a milk tooth which in turn may result in adjacent teeth to move in to the space left by the milk tooth. When the permanent tooth erupts there will lack of space in the jaw.

To prevent this from happening space maintainers have to be used

Types of Space Maintainer

Depending on whether they are Fixed or Removable:

• Fixed Space Maintainer: This type of Space Maintainer is cemented in and cannot be removed by the patient. This type is usually made of stainless steel
• Removable Space Maintainer: This type of Space Maintainer can be removed by the patient and is usually made of Acrylic. Since this type of space maintainer is removable it preferable to use it in more mature children.

• Band and Loop: An Orthodontic type of band is placed on one tooth lying adjacent to the space and a loop made of stainless steel is fabricated along with the band. THis loop touches the tooth on the other end of the space and prevents the gap from closing.
• Lingual Arch: This type of space maintainer is used when the deciduous molars of lower jaws are lost on both sides. Two bands are made on the tooth lying behind to both the spaces. A lingual wire made of stainless steel running around the insides of the lower teeth is attached to the two banded teeth. This prevents the space from closing.

Procedure

Since each space maintainer is individually made you will have to bring your child to the clinic to have impressions taken. As children are very anxious regarding dental procedures they will be put at ease by the dentist. The entire procedure will be explained to the child so that they know what to expect. A suitable tray is selected and impressions are taken using Alginate. Plaster casts are made from these impressions and sent to the dental lab for fabrication of the prosthesis. In the second sitting the maintainers are delivered to the child and if they are of the fixed type they will be cemented in. Instructions are given to both the parent and the child on how to take care of the space maintainer.

After Care

It is normal for the child to have some sort of discomfort during the first few days. He may experience some difficulty in chewing and speaking but this will resolve in a few days. Proper brushing of the teeth must be done twice daily. Sticky food like chewing gum should be avoided to prevent the maintainer from getting displaced. It is advised to visit the dentist every six months for a review of the space maintainer and also to check oral health of the child.