Teething is the process where teeth begin to emerge with the young children from the age of three years. These are just primary teeth that will enable the baby to eat the first solid foods before the emergence of the second permanent set of teeth. Sometimes, the baby teeth can be either lost prematurely through accidents or even due to decay caused by poor oral hygiene. Here, there is a need for space maintainers to support the child’s mouth before the emergence of the permanent teeth.
Why the need for maintainers
Children will in rare cases develop trauma of the mouth due to accidents especially during the period they are learning to walk. Cavities can also grow if the mother or caretaker is not keen on the baby’s oral hygiene. If the baby feeding bottle is left to stay for prolonged periods in the mouth, the sugar content in the milk or any other food could wear out the enamel and therefore causing decay.
With missing teeth, it is imperative to consider tooth space maintainers; these ensure that the teeth only grow in the correct positions. Again, with an extended missing tooth, there is a risk of others becoming loose and grow in the unintended locations.
Types of space maintainers
- The removable are made of acrylic, and here, artificial teeth or blocks are used. These ensure that the spaces in between are maintained until the new permanent teeth emerge. They can be removed for cleaning and therefore appropriate for the older children who can be responsible enough to observe the maintenance procedure. When there are several missing teeth, partial dentures are the most suitable removable maintainers.
- Fixed maintainers are used in case of permanent tooth loss due to accident or in rare circumstances when the tooth does not grow hence leaving a permanent gap. We have unilateral spacers, which are fitted to one side of the jaw and bilateral maintainers, which are fixed on both sides. These can be mounted on the upper and lower jaw, as well as front and back teeth. The spaces and the location of the missing teeth will determine the kind of spacer that the dentist will recommend.
There are several types of fixed maintainers; brand -loop device is made up of stainless steel and adequately fitted with orthodontic bands, which allow permanent tooth to emerge freely without blocking it. Lingual holding arc maintains space for the lower back teeth while the transpalatal arch is fixed on the upper jaw to keep the appropriate space between the teeth.
All the baby’s dental appliances are custom made, therefore the dentist gets an impression of the child’s mouth, and then the device is manufactured in the dental laboratory.
There are incidences when the first permanent molar is lost. A distal shoe is an appliance that is fitted over the first molar and maintains the space in between. When this is not done or delayed, a new tooth could emerge which is often causes an overlap. Double teeth are however treatable.
Dental appliances require strict maintenance to ensure that the child is comfortable and does not develop other dental complications. Therefore, the dentist must keep a close eye to ensure that the baby rightly fits with the appliance and in case of complications arising; he/she can deal early enough.