Pediatric Dentistry: Space Maintenance

As most of us know, we are born with baby (primary) teeth, which give way for our adult (permanent) teeth. This is how the tooth fairy stays in business when parents put their kids' baby teeth under the pillow!

However, what most parents need to know are that baby teeth are important placeholders for the adult teeth. Baby teeth shouldn't fall out (exfoliate) at ANY time, they need to fall out at SPECIFIC times to allow the adult teeth to grow and emerge (erupt) from the gums properly.

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As stated above, baby teeth maintain the space required to allow the adult teeth enough room to grow. This is why spacing between baby teeth is great, since adult teeth are bigger and need space to enter. However, sometimes baby teeth exfoliate earlier than expected. There is a genetic component, as well as hygiene and diet component.

This patient is a 6-year old who lost his 2nd primary molar unexpectedly, leaving a large gap. As the chart above shows, this tooth should not exfoliate until he is at least 10 years old!

​Because he is still growing, his bone and teeth are constantly changing and moving, which means the big permanent 1st molar in the back (his adult tooth) is going to tip forward and close the gap.

Why is this bad? It means the permanent 2nd premolar will be blocked underneath because there won't be enough room to grow. He will have orthodontic problems as he ages if the tooth remains blocked.

What should parents do when this happens? Timing is everything. The adult tooth will immediately start to close the gap, so children need to see the dentist ASAP.

In this case, we placed a device called a space maintainer - it maintains the gap to stop the tooth from tipping and allows space for the permanent tooth to grow.

We cemented this device with a blue orthodontic cement for ease of visibility. This device can be removed when the permanent tooth below erupts, or when the baby tooth itself exfoliates in the future.

TIP FOR PARENTS: Please keep an eye on your child's teeth! Early intervention in their dental health means a more beautiful, healthier smile as they grow!