Space Maintenance

Sometimes when a primary molar is nonrestorable (due to infection and/or large decay with insufficient tooth structure), we may recommend a space maintainer.  The purpose of a space maintainer is to preserve/hold the space for the developing permanent tooth under the primary tooth, which was removed and prevent adjacent teeth from drifting into this space.  

A space maintainer may be prefabricated and completed in one visit or may involve several appointments (setting orthodontic bands, impressions and seating the appliance).

Types of Space Maintainers

Since young children and/or adolescents tend to lose removable space maintainers or do not wear them often enough we recommend fixed space maintainers that are cemented onto the teeth.  These are more efficient at maintaining the space and require minimal care on the part of the child.  Depending on the tooth the child is missing, we may recommend a unilateral space maintainer-( called a band-and-loop or distal shoe) or a bilateral space maintainer ( for the upper arch(top) this is called a nance space maintainer and for the lower arch(bottom) it is known as a lower lingual holding arch.

How are Space Maintainers made? 

Our office does custom make your child's space maintainer to allow for the best fit possible.  We take an impression of your child's mouth and this is sent out to a lab to custom make the space maintainer to fit the individual needs of the child.  An exception to this is our patients having treatment completed in an outpatient setting, prefabricated space maintainers are used in this case to allow placement of the space maintainer on the same day as the rest of the treatment is completed while under sedation.

When will the Space Maintainer be Removed?

As soon as the permanent tooth begins to erupt.  We will monitor your child's eruption of their permanent teeth at his/her regular recall appointments and let you know when it is appropriate to remove.

Caring for Your Child’s Space Maintainer


There are four general rules for taking care of your child’s appliance.

  • Your child should avoid sticky foods.
  • Encourage your child not to push or tug on the space maintainer with the fingers or tongue.
  • Keep your child’s space maintainer clean through effective brushing and flossing.
  • Your child should continue to see the pediatric dentist for regular dental visits.