Space Maintainers

Your child’s baby teeth aren’t there just so you can get a great smile for photo ops. They’re actually not just for chewing either. Each baby tooth clears a path and acts as a guide for the permanent tooth that grows to replace it. This is a natural process called eruption.

When your child loses a baby tooth too early, the eruption of the permanent tooth has no guide. It can erupt in the wrong position or drift to the wrong area of the gums. Teeth that neighbor it can also tilt or move into that space, disrupting their alignment. When this happens, it means there isn’t enough space for the permanent tooth, and hence the need for a space maintainer.

Losing Baby Teeth

Mila Cohen refers to the baby teeth as primary teeth. Primary teeth can be lost too early for a number of reasons, including:

  • An infection that causes tooth decay may prompt an extraction.

  • Injuries or accidents can knock them out.

  • Diseases and other health conditions may lead to early loss.

  • Primary teeth may be missing from birth.

Orthodontic care only requires space maintainers if the primary tooth is lost and the permanent tooth is ready to erupt. The space maintainer serves to hold that space open until the permanent tooth erupts.

Kinds of Space Maintainers

Most space maintainers are made from stainless steel, but others are made out of plastic. Other different types include:

  • Removable space maintainers

  • Fixed Space maintainers, which are cemented onto your child’s teeth

  • Distal shoe appliances

  • Partial dentures

Removable Space Maintainers

Removable space maintainers resemble retainers. They have artificial teeth built in to occupy the space that’s needed for the permanent teeth to grow into. This kind of space maintainer is only used when the space is obvious. They typically work better with older kids who are more able to follow directions from dentist when caring for the maintainer.

Fixed Space Maintainers

There are many types of fixed space maintainers, one of which is the band-and-loop type that’s made from stainless steel wire. A crown on the tooth beside the space holds it in place.

Another type, called a lingual arch, is used when the back baby teeth are missing on both sides of the bottom jaw. “Lingual” refers to the inside of the tongue next to the teeth. The lingual arch space maintainer stays in place by bands that are wrapped around the teeth on either side of the space they are filling. A wire is then connected to this band to maintain the space on both sides.

Distal Shoe Appliance

A distal shoe appliance is inserted under your child’s gums. A distal shoe is typically used when kids lose the baby tooth next to the 6-year molar before it erupts. The 6-year molar is the first molar that’s permanent. A distal shoe space maintainer has a wire that runs slightly beneath the gum. This prevents the space from closing.

The downside of distal shoe space maintainers is that they have to be checked regularly because it may actually block the new permanent tooth from erupting. Your dentist can adjust the appliance to allow the new tooth to align properly.

Partial Denture

If your child is missing more than one tooth, a partial denture is fitted instead of a space maintainer. So, if your child suffers and injury that knocks out many front teeth, or if he has a disease from birth called ectodermal dysplasia — which can result in missing teeth, your child can wear removable dentures until the permanent teeth grow in.

Space Maintainers Aren’t Always Needed

If children lose baby teeth early, don’t worry. It‘s entirely possible a space maintainer still won’t be required. For example, when one of the four front teeth on the upper jaw is lost, the space naturally stays open until the permanent tooth erupts. If the permanent tooth is about to erupt, your dentist may decide not to use a space maintainer unless your child needs braces and space is a critical issue.

Younger children might not cooperate with the procedure of making and installing a space maintainer. Other kids with swallowing or breathing issues may be at risk if the space maintainer breaks or comes loose. A child’s ability to cooperate with the kids dentist is vital in receiving a space maintainer.

Space Maintainer Risks and Care

If your kids don’t visit the dentist at least every six months, space maintainers can cause issues. These common problems are compounded if they don’t brush their teeth well. With improper brushing, the tissue of the gums can grow over the maintainer’s wire arm, increasing the potential for infection. If the gum tissue becomes infected, your child may need surgery to remove that tissue.

Your children may experience some discomfort with a space maintainer at first, but kids usually get used to it after a few days. Removable space maintainers can also affect children’s speech until they get accustomed to it.

Make sure your children brush their teeth regularly and properly. Also, have your kids visit Dr. Mila Cohen at least once every six months to make sure their gums and teeth are healthy. Kids with fixed space maintainers should avoid hard candy, sticky foods, gum and chewy candy. These things can loosen the metal band or get caught in the wire support arm. If that wire comes loose, there is a risk of swallowing it or inhaling it. Also, children shouldn’t push the space maintainer with their fingers or tongue. This can bend, damage or loosen it.

Following Up with Your Dentist

After your child receives a space maintainer, your dentist may take X-rays to track the progress of the permanent tooth as it gets closer to eruption. The dentist can then tell when your permanent tooth is ready to come in, and he can go ahead and remove the space maintainer.

Habit Therapy

There are many benefits that can come out of the continuing relationship your dentist develops with your children. One of the most important services your dentist provides as he gets to know your child over time is stopping bad oral habits that can cause serious complications down the road. And that’s in addition to promoting general good tooth health habits.

Your JC kids dentist is trained to notice the habits and changes in your kids’ teeth early on. It’s important to stop the behavior either by:

  • Bringing it to your attention to help correct as needed

  • Applying a device that discourages the negative behavior

Habit-Forming Issues

The two biggest habits dentists correct are thumb or finger sucking and tongue thrusting. Tongue thrusting is when your child pushes forward on his teeth with his tongue. Most kids outgrow these habits around the age of four, but if they don’t, they can cause serious misalignment of the teeth. Misalignments can cause side effects so serious that they can affect the appearance of your child’s face. It’s up to you and your kids dentist to correct these habits because your child’s too young to understand the consequences.

While thumb sucking and tongue thrusting are the two most common habits Dr. Mila in Jersey City can address, there are other bad oral habits that everyone, including adults, should avoid to maintain good tooth health, such as:

  • Chewing hard foods, especially ice

  • Sipping sugary drinks over long periods of times

  • Using your teeth as a tool

  • Teeth grinding

  • Nail biting

  • Swallowing toothpaste

Thumb or Finger Sucking and Dental Problems

Thumb sucking is a habit that usually occurs in children before the age of four after their pacifiers have been taken away. It’s happens when children suck on their fingers as a way to cope or because of its pleasant association with nursing.

Thumb sucking can be a hard habit to break especially because it’s a subconscious habit that often goes on and on throughout the day, sometimes lasting for years. If you don’t help your child overcome this habit, he could suffer from serious dental problems down the road. Some of these complications include:

  • Swallowing habits that cause serious health problems

  • Speech issues

  • Teeth misalignment

  • Unwanted face appearance that can look sluggish, causing pursed cheeks or an inability to close the mouth completely

Ways to Discourage Thumb Sucking

There are a number of ways to help your child stop his thumb sucking habits. But first, it helps if you observe when he typically engages in thumb sucking. Have an answer when your JC kids dentist asks if he sucks his thumb when he’s anxious, when he’s watching TV or when he’s falling asleep.

After keeping track of when your child sucks his thumb, you’ll start to notice patterns that may explain why he still sucks his thumb, which can help you encourage him to stop. A couple of good ways to discourage him from sucking his thumb that your dentist may suggest include:

  • Always use positive reinforcement instead of punishing your child, because this encourages him to try and change the behavior positively.

  • Use reminders if he sucks his thumb when going to sleep by placing socks over the hands, but be sure he knows it’s not a punishment.

  • If you’ve noticed him sucking his thumb when he’s nervous, try to help him cope with the anxiety or distract him.

  • Use a reward chart with small prizes for extended periods of time he goes without sucking his thumb.

  • Explain carefully and with pictures of what can happen to his teeth if he continues to suck his thumb.

  • Schedule an appointment with your dentist to discuss thumb sucking with your child. Sometimes, hearing recommendations from someone other than parents can help get through to him even better.

Tongue Thrusting and Why You Need to Stop It

Similar to thumb sucking, children typically outgrow tongue thrusting. It usually isn’t until they’re older though — around eight to nine years old. Tongue thrusting occurs when your child pushes his tongue against his teeth while he is swallowing. This constant pressure pushes the teeth outward and can prevent them from coming together during a bite, which is known as an open bite.

Open bites and other mouth deformations caused by tongue thrusting can affect the proper develop of the teeth and other conditions such as:

  • Improper alignment

  • Malocclusion

  • Difficultly eating and swallowing

  • Trouble talking

  • Mouth breathing

Ways to Stop Tongue Thrusting

Tongue thrusting is more difficult to stop because it can be harder for you to see. Many of the same correcting behaviors that are recommended for discouraging thumb sucking can be used for tongue thrusting:

  • Always remain positive

  • Explain what could happen to your child’s teeth from tongue thrusting

  • Give rewards for periods of time without tongue thrusting

  • Allow your dentist to explain to your child the importance of breaking this habit

Your Jersey City kids dentist can help you spot this habit early and use preventative corrections to stop the need for serious interventions. There are two different kinds of bites caused by tongue thrusting:

  1. Simple, which is when the teeth can be held together during a swallow

  2. Complex, where the teeth are apart during a swallow. Complex is more serious as it can cause infection, breathing difficulties, and requires more orthodontic work.

Devices Your Dentist May Recommend

There are two main appliances that Dr. Mila uses to stop bad oral habits like thumb sucking and tooth thrusting from happening:

  1. Spiked Tongue Thrust Appliance. This spiked tongue thrust appliance is typically attached to the top of the mouth by the molars. It consists of a wire that runs along the teeth with a smooth spiked gate that sits behind the back of the teeth and prevents the tongue from pressing up against them.

  2. Palatal Rake for Thumb Sucking. Thumb sucking prevention devices may also be similar to the spiked tongue thrust appliance or may resemble a small gate that’s attached to the molars, runs along the teeth, with the gate portion resting up against the back of the teeth on the bottom of the mouth.

These devices are simple and relatively cheap, and they can save you and your child thousands of dollars down the road in corrective dental work caused by bad dental habits. Talk to your dentist for what may work best for your child.