Space Maintainers: Pediatric Partial

Space Maintainers If a baby tooth is lost prematurely, you may need a space maintainer to "save" the space.
What does that mean? Baby teeth are there for a reason. One key reason is that they save space for the permanent tooth, which will erupt into its position when the baby tooth is lost normally. If a primary tooth (baby or milk tooth), has to be removed early due to say, an abscess, or is knocked out in some kind of trauma, a space maintainer may be recommended to save the space. If the space is not preserved, the other teeth may drift causing difficult to treat crowding and orthodontic problems. If it is a front tooth then you don't need a space maintainer. However, you can place a Pediatric Partial to replace the teeth for cosmetic reasons. Now "Spacers" may be in there for a while, but they are not permanent. They are removed when the new tooth (usually a bicuspid) erupts or the abutment teeth get loose. Kinds of Space Maintainers: 1. Fixed Space Maintainers:
a. Unilateral: Just on one side, usually "replacing" one tooth. Can be a band and loop as you see here, or a crown and loop type (in photo below). This can also be a Distal Shoe type. The distal shoe being one used when the permanent first molar has not yet erupted. Hey, you are usually going to get "silver" in there no matter what kind of spacer it is.
Distal Shoe Type for unerupted 1st molar:
b. Bilateral: These are very useful. They are usually cemented with bands on back teeth on both sides connected by a wire just behind the lower incisors. Usually called a Lingual Arch. This can eliminate the need for two unilateral spacers. They are most useful if there is more than one tooth missing or you are trying to keep the lower incisors from tipping. An altered form can incorporate a looped lingual arch to actually move the lower incisors forward (straighten them a little too) before maintaining them in a better position. A maxillary bilateral spacer may incorporate an acrylic button and is called a Nance space maintainer.
2. Removable: I don't use these too often on children, although sometimes they can be fabricated
and used in specific cases. There are like orthodontic retainers, with part of the plastic placed in the empty space to keep things from drifting
Tooth brushing is a vital element of health for all children. Children need to be taught both good brushing habits and proper tooth brushing techniques. Failure to instill this discipline during a childs formative years can instill negligence in the mind that will follow that person into adolescence and adulthood. Proactive parents are encouraged to supervise their children as they are brushing their teeth to ensure they are doing it for long enough periods of time and in following the proper techniques. There are four things that constitute proper tooth brushing for children. Children should brush their teeth at least two times a day, but it is better to have them brush three times a day after breakfast, lunch, and dinner. The type of toothbrush matters. Children should always use a soft bristle brush. Medium and hard bristle brushes should never be used. Believe it or not, a soft toothbrush does a much better job of removing plaque below the gum line. This is of vital importance to a childs heath, because plaque below the gum line is one of the major contributors to rampant cavity formation in young children. Medium bristle and hard bristle toothbrushes lack the flexibility necessary to reach under the gum to clean plaque off teeth. They also have a tendency to cut the gums. Children should brush with fluoride toothpaste. Fluoride hardens tooth enamel and makes it more resistant to tooth decay. It has also been known to stop a cavity that is in the process of forming, thus making it easier to repair the tooth with cosmetic dental bonding (we do not recommend silver amalgam fillings for children.) However, fluoride toothpaste should never be swallowed, so teach this to your children and store the toothpaste out of reach until they are self-disciplined and old enough to understand the dangers of fluoride toxicity. The angle at which children brush their teeth is also very important. The toothbrush should be tilted so that the tip brushes the backs of the front teeth. This is because the insides of the teeth get less attention. It is best for children to begin by brushing the insides of the upper teeth, then move to the insides of the lower teeth. It is important for children to brush their teeth in a specific pattern. Whatever teeth the child begins with, it is important that he or she follow the same pattern each day to make sure all tooth surfaces are cleaned. After the insides of the teeth are cleaned, children should move next to the outsides of the upper teeth, then to the lower teeth. Children also should be reminded to gently brush their tongues and the roofs of their mouths. As odd as this may seem, it is actually very hygienic because it removes the same germs that cause plaque buildup and bad breath. Our experience in the pediatric dentistry field has also taught us that children consider it even more fun sometimes to brush their tongues as they do to brush their teeth!

Space Maintainers: Pediatric Partial

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Space Maintainers If a baby tooth is lost prematurely, you may need a space maintainer to "save" the space.

Distal Shoe Type for unerupted 1st molar:

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