Let's talk about space maintainers
As you already know, in our dental clinic in Murcia we follow a minimally invasive philosophy based on prioritising prevention over intervention, and once we have to intervene, we do it in the least traumatic way possible. However, sometimes there is no choice but to resort to dental extraction, which, considering that it is the loss of a tooth, is the last option.
Sometimes we also sometimes have to do it with a baby tooth. But,
When is it necessary to extract a baby tooth?
Although the removal of a baby tooth often sounds strange to parents hearing about it for the first time, there are actually several reasons why a baby tooth should be removed early, most of which are identical to those for permanent teeth.
- When tooth decay is too great and too little tooth structure remains, making tooth reconstruction impossible.
- When the roots are fractured
- If the tooth has had or has had an infection for a long time and the roots have resorbed (we could say that this process is similar to a 'self-destruction' of the tooth, and the roots are eliminated before their time). This infection is located around the new tooth in formation, the permanent tooth, and as the roots of the milk tooth are not complete, a root canal treatment is not feasible, so we must remove the causal tooth so that the infection does not return.
- Because the child is in pain, but is very close to the tooth replacement and it is not worth filling because it could fall out at any moment.
- Due to dental ankylosis, i.e. the tooth has fused to the bone, and if it is not extracted, the permanent tooth cannot appear.
- In unsuccessful pulpectomies where infection recurs
- Ectopic eruption of a permanent molar. In other words, the tooth is erupting from a place that is not the correct one, which causes it to eliminate a baby tooth that does not belong to it and closes the space of the tooth that does belong to it.
What are the consequences of losing that temporary tooth?
If the extraction has been carried out too early, the permanent tooth that must replace the one that has been extracted will be poorly formed and very far from erupting, so that the back tooth will move forward and lean forward, thus closing and limiting the space necessary for the eruption of the tooth, which will be obstructed and unable to erupt when it is due or will end up erupting in the wrong place. As you can see in this video:
Now let's talk about space maintainers.
In these cases, we use a space maintainer. This is a metal band that surrounds the adjacent tooth like a ring and a small structure that, as its name suggests, will keep the space left by the extracted tooth intact until the final tooth erupts.
This system, used in dental clinics all over the world, has a number of advantages:
- Not bothersome at all
- Children get used to it easily
- It is easy to brush
- It is also easily removed as soon as the tooth appears in the relevant space.
- It does not come off easily, as long as we respect some guidelines such as not trying to take it off or not eating too much chewing gum or chewy sweets.
However, this appliance will not always be necessary. If the permanent tooth is very close to eruption, we will let it develop normally.
Types of space maintainers
Unilateralfor cases with a single extraction
Bilateralfor cases where multiple extractions have been necessary, a bilateral space maintainer with bands can be placed on both molars.
Spring-loadedThis device tries to recover the space lost when an extraction has taken place and the appropriate precautions were not taken in time. It can only be used in specific cases and is available uni and bilateral.
With toothare used in cases of avulsion or extraction of aesthetic front teeth.