Orthodontic Care: 3 Types Of Space Maintainers For Premature Tooth Loss And Maintenance Tips

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Primary teeth play an important role in acting as a guide for the placement of adult teeth. If a primary tooth is lost prematurely, the underlying adult tooth essentially loses its guide and may end up drifting or erupting at the wrong position. The gap where the primary teeth once was may also end up closing or neighboring teeth may tilt into its place. To prevent these complications from happening, orthodontists rely on space maintainers to keep the exposed site, where the primary tooth was, open until the adult teeth erupts, which is a progressive process that begins to happen when a child reaches the age of 6 or 7

This article will explain some of the options available for space maintainers, and give tips on caring for them. 

The Fundamentals of Space Maintainers 

Space maintainers are typically custom made by orthodontists to fit perfectly into the position where the primary tooth once was. The maintainers are generally made from either stainless steel or plastic, and can either be removable or cemented into place. Fixed space maintainers are normally recommended for young children, as they require less maintenance and care. There are 3 different types of space maintainers: band-and-loop maintainer, a lingual arch maintainer and a distal shoe appliance.

The first type of space maintainers are band-and-loop maintainers, which are typically made from stainless steel wire and are held in place by crowns that are capped on top of the two teeth adjacent to the open space. The loop is responsible for preventing the adjacent teeth from tilting into the open space, and will offer ample space for the adult tooth to erupt later on without experiencing any crowding.

The second type if a lingual arch, which is generally recommended for those missing a back tooth on the lower jaw. A band wraps around the teeth adjacent to the open space, and wiring connects the two bands and forms an open space.

The third type is known as the distal shoe appliance. A distal shoe appliance is installed underneath the gums, and is often recommended for baby that do not have many erupted primary teeth.

Although they are all beneficial in their own unique ways, the distal shoe appliance requires more care, as they can actually block the adult tooth from erupting if they are not removed properly. The type of space maintainer that will be recommended will solely depend on each patient's dental condition.

Maintaining and Caring for the Space Maintainers

Since space maintainers are custom made by orthodontists to fit each patient's dental condition, they are rather expensive and need to be handled with care. Some tips for maintaining and caring for space maintainers include:

  • practicing excellent dental habits. In short, patients should brush and floss their teeth regularly in order to prevent food from getting stuck in the wiring of the maintainers.
  • avoiding sticky, chewy and hard foods, as they can damage the maintainers over time, especially if patients have opted for fixed maintainers.
  • trying not to push on the maintainers with the tongue. Many patients are tempted to play around with the maintainers and move them about in their mouths. This can actually compromise the structural integrity and the shape of the maintainers, so it is a habit that is highly advised against. 


Once a space maintainer is installed, it is important to make regular dental appointments for the orthodontist to monitor the patient's dental condition to determine when the adult tooth will erupt. Although the primary objective of the space maintainers is to keep the position open and free, it is also crucial that the space maintainers do not interfere nor interrupt with the eruption process, as this can cause the adult tooth to come out crooked.

For more information, talk to an experienced orthodontist in your area.