Space Maintainers
Dental space maintainers are appliances used to “maintain space” after a primary (“baby”) tooth is lost prematurely. There are numerous reasons that could result in early loss of a primary tooth, some of which include tooth decay, trauma, and congenital defects. Our providers are specialized in recognizing the need for and prescribing proper space maintenance for each child’s unique situation.
Space Maintainers are necessary because they save space in the mouth for permanent teeth that have yet to erupt. If these spaces are not protected, permanent molars will shift, and block out other permanent teeth that intend to erupt into the same space. By simply placing a space maintainer, we can protect patients from having impacted teeth that could require surgery to correct.
Bilateral Space Maintainers
NANCE: A Bilateral Maxillary (upper) space maintainer that connects to the molars on either side of the mouth with a band that rests around the two back teeth. We often prescribe a NANCE if your child is missing primary teeth on both sides of the mouth or if two teeth are missing from the same side. 
Lower Lingual Holding Arch (LLHA): a Bilateral Mandibular (lower) space maintainer that connects to the molars on either side of the mouth with a band that rests around the two back teeth. Similarly to the NANCE, our doctors will prescribe a LLHA if your child is missing primary teeth on both sides of the mouth or if two teeth are missing from the same side.
Once all of your child’s permanent teeth are erupted, these appliances can be removed.
Unilateral Space Maintainers
A Unilateral Space Maintainer is an appliance intended to hold space for only a single tooth. They come in different forms because depending on the missing tooth, they have different structures to protect your child’s growing mouth.
Band and Loop: This space maintainer consists of a band that is cemented to an erupted tooth with “Loop” of wire that extends over the space of the missing tooth and rests against the tooth on the other side of the space.
Crown and Loop: This space maintainer works in the same manner as the Band and Loop, however, instead of a band around the tooth, there is a crown that connects to the loop. These are often used if your child had a large cavity that could not be restored with filling material and required a crown.
Crown and Distal Shoe: This space maintainer is used when a second molar needs extraction, but their six-year molars have yet to erupt. This appliance is cemented to the erupted first molar, then extends over the space of the missing second molar, and rests in the socket of the missing tooth and acts as the root of that missing tooth. This way, the six-year molar will erupt properly and leave space for the bicuspid to fit into the mouth.
Once your child’s missing tooth begins to erupt with any type of unilateral space maintainer, the appliance can be removed.
