A space maintainer is an intraoral (inside the mouth) appliance used to preserve arch length following the premature loss of milk tooth/teeth. This allows the permanent teeth to erupt unhindered into proper alignment and occlusion. Primary teeth or milk teeth can be lost prematurely due to decay or trauma.
When a milk tooth is removed, space closure occurs in first 6 months, thus it is best to insert the appliance at the earliest. this space loss occurs mainly due to tipping movement of adjacent teeth into the empty extraction site. In upper molar teeth, space loss is also due to rotations occurring in the teeth.
To decide if your child requires a space maintainer it is important to evaluate their age at the time of loss of tooth and the area in which tooth loss has occurred. In case of loss of the primary molars at an early age, the underlying permanent premolars require 4-5 months to move through 1 mm of bone, thus preserving this space is important. In case of loss of anterior teeth, replacement is done more so for reasons of aesthetics and to prevent speech impediment if speech development is not completed during the time tooth is lost.
Failure to maintain the space leads to drifting or tipping of adjacent teeth into the empty extraction site, loss of arch length, shift in the midline of teeth, crowding of permanent teeth, impaction of permanent teeth and the need to perform orthodontic treatment to correct these malocclusions.
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