Tooth Care: Space Maintainers
What happens when a primary (baby) tooth is lost too early? An appliance called a space maintainer will be recommended by your pediatric dentist. The area of the mouth and the age of the child will determine the need for and type of space maintainer.
The primary teeth save the space for the permanent teeth. The 20 primary teeth are replaced by 20 permanent teeth. The six-year molars, twelve-year molars, and wisdom teeth will erupt (come in) in the back of the jaw. The bone will begin to grow around five years of age to make room for these teeth. If a primary tooth is lost before the permanent tooth is ready to erupt, other teeth will drift or tip into the empty space. This may block out the spot for the permanent tooth that replaces the primary tooth. The space maintainer will hold the teeth in their proper position.
Primary teeth may be lost early because of decay, crowding, injury, or improper eruption of the permanent teeth. Most space loss occurs during the first six weeks after the loss of the tooth. This may continue over the next six months. A space maintainer should be placed before this loss occurs. Sometimes, space loss cannot be avoided and your dentist can only attempt to preserve the remaining space.
There are many types of space maintainers, but two are most often used. The band and loop is used to hold the space for one tooth. The lingual arch is used to hold the space for two or more teeth that have been lost from both sides of the jaw.
If a primary molar is prematurely lost and the six-year molar has not yet erupted (come in), the parent must watch closely for the eruption of the six-year molar. This is very important because the six-year molar will rapidly tip or drift forward causing space loss. The teeth that replace the first and second primary molars ordinarily do not erupt until between nine and eleven years of age. The six-year molar must be partially erupted to make the space maintainer for early loss of a second primary molar.
Space maintainers are usually made with orthodontic bands and wires. Two appointments are necessary. During the first dental appointment, an orthodontic band is fitted on the tooth next to the space. An impression is taken. Next, the band is removed from the tooth and placed in the impression. A mold of the teeth is made with the band on the tooth. A laboratory will custom make an appliance to exactly fit the space. During the second appointment, the appliance is cemented in place.
The space maintainer is not removed until the permanent tooth begins to erupt. The parent must be sure to tell the dentist when the permanent tooth is erupting. If the space maintainer is not removed at the proper time, the permanent tooth may come in improperly. Your dentist will inform you of the age when your child's permanent tooth will likely appear. Early tooth loss may cause the permanent tooth to be delayed in its eruption or to erupt earlier than expected.
by Jane A. Soxman, DDS
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.
Dental Health: Tooth Brushing for Pre-Schoolers!
Teaching toddlers some brushing basics is important. Developing good brushing habits for sound dental health early sets a positive pattern.
How Early Should I Begin Letting My Child Brush Their Teeth by Themselves?
Children learn by example and often want to copy the behaviors they observe in adults. "Let me do it!" is often a favorite phrase during the preschool period, so this can work in your favor when they're ready to learn.
When children are about three years old, they're usually ready to learn how to brush with your supervision. Schedule a visit with the dentist. Let them advise you about your child's readiness for proper brushing. The pediatric dentist or dental hygienist will also show your child the right way to brush.
Between the ages of three and five, your child will likely need help brushing the inner surfaces and way in the back. By age seven, most kids are ready to brush alone.
What Are Some Ideas for Teaching Good Brushing Habits?
- Take your child toothbrush shopping. Let them choose among all the colors and designs for child-size toothbrushes. Giving kids a chance to select the one they want helps them feel part of the process. Just make sure it has soft bristles.
- Show your child how to brush properly. Place only a pea-sized amount (at most) of toothpaste on their toothbrush. Tell them this is all that's needed and no more should be used (too much toothpaste at a young age is not recommended). If your child objects to using toothpaste, just brushing alone is fine. Brushing with water works, too (but the fluoride in fluoride toothpaste acts as a cavity-fighter and provides extra protection).
- Provide positive reinforcement. Give them colorful stickers. Make up a chart and have them place a sticker on it every time they brush.
- Put a sticky note on the bathroom mirror with a smiley face reminding your child to brush. When your child is old enough to read, post the 10 Tips from the Tooth Fairy on the mirror or refrigerator for gentle dental reminders.
- Praise them for their brushing ability. Tell them how shiny their teeth look.
- Making brushing fun to learn sets the right tone! Make up a song using their name while they're brushing. Avoid any battles about brushing, since this will only discourage cooperation. Associating it with fun and enjoyment reinforces positive experiences.
- Model good oral care habits. If they see you brush and floss regularly, that sets a good example they will likely want to follow.
Good oral care habits last a lifetime. Starting them early with good baby teeth care strengthens the habit and will help them keep their permanent teeth healthy, too!
by Brian J. Gray, DDS, MAGD, FICO
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.