What happens if your child’s primary tooth falls off? In order to ensure that their adult teeth still come in place, your dentist will use a space maintainer.

This orthodontic appliance only comes into use in pediatric dentistry.

Its main purpose is to prevent the damage that premature milk tooth loss can cause.

However, your dentist may also fit your child with it to prevent overcrowding and teeth misalignment.

This article discusses why your child may need this orthodontic appliance and how this ensures their permanent teeth grow properly.

Keep reading below to know more!

girl pointing towards tooth loss in baby teeth

Reasons to Get Space Maintainers for Child

Baby teeth start falling when your child is 6 years old and above.

Every type of tooth follows a certain pattern while they fall and their permanent counterpart appears.

For instance, the lower front incisors are the first ones to fall and erupt, though the canines may fall later.

Either way, they only fall after their roots weaken when your child is over 6 years old.

However, in some instances, your child can lose a tooth before time.

A premature baby tooth loss can leave a space in your child’s mouth where the permanent tooth may not grow properly.

Baby teeth essentially hold up space for adult teeth.

By the time they fall, adult teeth grow in that place without any hindrance.

However, if they fall off early, then they no longer hold up space and the adult tooth will not come exactly under that place but will dislocate.

Therefore, when the dentist applies the space maintainer, it helps to prevent movement of the first molars so that the permanent tooth grows in proper alignment.

It is more commonly used for primary molars or if several baby teeth fall off.

If you do not use it then the first molars will move forward not leaving enough space for permanent bicuspids.

As a result, the first bicuspid also move forward preventing the permanent canines to erupt in their place.

Hence, this causes misalignment and overcrowding.

But why does your child lose teeth before time?

There are two main reasons behind that.

Let’s find out that below!

child with cavities

Cavities and Injury

Space maintenance treatment is due to over-retained primary teeth.

The baby tooth enamel is more fragile than a permanent teeth enamel.

Therefore, it is more prone to cavities and decay.

The commonplace for a child to get cavity is their molars.

Hence, your child can develop tooth decay which can lead to cavities and ultimately extraction.

If you do not treat cavities on time then the bacteria from one tooth can easily infect nearby teeth too.

Moreover, if the cavity is severe then tooth fillings may not help and your dentist may have to perform a tooth extraction instead.

When your child eats lots of sugars, starch and acidic foods then they should also maintain good oral hygiene.

Children usually have a sweet tooth.

They like to eat chocolates, candies, crisps, sodas and everything that is essentially unhealthy.

Though, you can limit their daily sugar intake and allow them to only eat sweets with meals rather than separately as snacks.

Furthermore, you need to maintain good oral hygiene.

Take care of their baby teeth by brushing them sparing a fluoride toothpaste.

Also, floss their teeth as the young ones can’t possibly do it themselves properly.

You cannot recognize decay and cavity unless sit pains them or shows up as a black spot.

Therefore, you should already prepare to prevent decay as it can lead to early tooth loss, malocclusion and overcrowding.

Cavities and decay are one of the main reasons for your child getting an extraction and premature loss of a tooth.

However, injury and over-retained teeth may also require space maintainers.


When children are growing up, they will keep falling and hurting themselves.

Well, this is also how they grow.

With their weak motor skills, they are likely to face injuries especially in the front upper and lower teeth.

Hence, they can lose their incisors or canines by falling or tripping on hard surfaces.

This will cause premature baby tooth loss.

Therefore, they will need space maintainers to prevent overcrowding as the adult teeth grow in their place.

Over-retained Teeth 

When it is time for your child’s primary teeth to fall, they become lose as the roots die.

However, in certain cases, as the teeth tighten back into the gums when it is time for permanent teeth to erupt from that site.

Hence, these over-retained teeth hinder the eruption of a new adult tooth when it is time for them to fall off.

Therefore, if the baby teeth do not fall off then the permanent teeth will still erupt over the over-retained baby teeth.

Moreover, it results in dental crowding where there is a lack of space for permanent teeth to erupt.

Space maintainers in orthodontics help to prevent these dental issues from occurring.

Thereby ensuring that the adult teeth erupt in their right place.

unilateral space maintainer

Space Maintainer Types

These are of widely three types, removable and fixed space maintainer – fixed unilateral and fixed bilateral.

They further have their own subtypes.

Removable Appliances

Removable space maintainer consists of removable partial dentures.

Like a normal denture, they contain teeth and are used when there is more than one missing tooth.

Moreover, their use is also for aesthetic purposes.

If your child does not have the front baby teeth then it may make them underconfident and conscious.

Later when they become adults, they can replace it with dental implants or a partial denture.

Fixed Unilateral

Fixed maintenance appliances are cemented on the tooth.

Hence, you cannot remove them and that keeps them effective for a longer period of time.

They only maintain space at one side, thus they are good for a single tooth.

The most common form of the fixed unilateral maintainer is the band and loop space maintainer.

As the name suggests, it has a band that is cemented to the second molar and loop that touches the canine’s distal surface.

These help to maintain space in the child’s mouth when they lose the primary second molar and their permanent first molar erupts.

It is essential for it the permanent first molar erupts for it to work properly.

Another fixed unilateral maintainer is the distal shoe.

As the name suggests, it also goes on one side. It also goes over one tooth.

The stainless steel wire goes over the space where the permanent first molar erupts.

This helps to guide it into its right place before it erupts.

Hence, doctors use them before the adult first molar erupts and after your child loses the baby second molars i.e. if your child loses the tooth when it’s too early to have the permanent molar.

Fixed Bilateral 

As the name suggests, they do not go on one but both sides.

Hence, if there is tooth loss on both sides then your dentist uses a bilateral maintainer that isn’t removable.

One of these is a  TransPalatal arch (TPA) that is a 36-mil wire.

It goes above the roof of the mouth and connects with both the primary molars on each side.

Hence, it reserves space when teeth on both sides of the upper jaw are missing.

By using it, the permanent molars in the upper jaw erupt rightly in space as it prevents forward movement of teeth.

Next, there is the lingual holding arch that holds space in the upper and lower jaw connecting two primary molars.

Hence, there is enough space in the lower and upper dental arch for the eruption of permanent molars.

It usually goes behind your child’s front teeth.

Also, there is the nance arch that maintains the dental arch length and prevents the misalignment of molars.

Though it has a unique feature: An acrylic button!

It rests on the roof of the mouth and that helps perform its function.

Due to this feature, it can only work on the upper arch.

Consult your dentist will decide which type of space maintainer is a better option for your child.

While they may have benefits, they also have risks.

Such as:

child with dentist showing fora space maintainer adjustment

Space Maintainer Risks

All space maintainers have benefits as well as risks and most of them are around oral hygiene.

If your child does not maintain proper oral hygiene then they risk decay and gingivitis.

If their gums are inflamed there is a small chance the inflammation also reaches around the space maintainers.

This will cause them huge discomfort.

Hence, it is best to maintain proper oral hygiene, brushing and flossing routine so that they do not risk decay or inflammation.

Space maintainers can also cause oral hygiene problems.

For instance, the nance arch uses a button on the roof of the mouth which can be hard to clean.

That place can accumulate bacteria and cause oral health problems.

Moreover, a TransPalatal arch is hygienic but it can cause crooked teeth while maintaining space.

Fitting and adjusting the space maintainers can be bothersome for your child.

Especially, crown and loop and distal shoe require adjustments routinely.

Alongside they need constant monitoring to guarantee that it does not hinder the normal eruption of the permanent teeth and they are erupting in place.

Hence, you will have to make frequent visits to your dentist.

child with dentist on dental visit

That said,

A space maintainer is important for your child to have aligned teeth.

If they do not use it then eventually they will have to get braces due to overcrowding and misalignment.

Therefore, it is better to use these so that their teeth erupt in place and you don’t have to perfect them later.

If your child has lost a primary tooth, do not leave it as is but consult your dentist for the right orthodontic treatment.