Space Maintainers

This section is dedicated to the latest information on oral health topics, culled from authoritative sources such as the American Dental Association.

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Heart Disease

Poor dental hygiene can cause a host of problems outside your mouth-including your heart. Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use. A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That's why it is critical to practice good oral hygiene to keep infections at bay-this includes a daily regimen of brushing, flossing and rinsing.


Antibiotic Prophylaxis

In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection. However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.


Dentistry Health Care That Works: Tobacco

The American Dental Association has long been a leader in the battle against tobacco-related disease, working to educate the public about the dangers inherent in tobacco use and encouraging dentists to help their patients break the cycle of addiction. The Association has continually strengthened and updated its tobacco policies as new scientific information has become available.

Smoking and Implants

Recent studies have shown that there is a direct link between oral tissue and bones loss and smoking. Tooth loss and edentulism are more common in smokers than in non-smokers. In addition, people who smoke are more likely to develop severe periodontal disease.

The formation of deep mucosal pockets with inflammation of the peri-implant mucosa around dental implants is called peri-implantitis. Smokers treated with dental implants have a greater risk of developing peri-implantitis. This condition can lead to increased resorption of peri-implant bone. If left untreated, peri-implantitis can lead to implant failure. In a recent international study, smokers showed a higher score in bleeding index with greater peri-implant pocket depth and radiographically discernible bone resorption around the implant, particularly in the maxilla.

Many studies have shown that smoking can lead to higher rates of dental implant failure. In general, smoking cessation usually leads to improved periodontal health and a patient’s chance for successful implant acceptance.


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Kid missing teeth.Your child's little baby teeth have some big responsibilities. Until the adolescent years, they will not only help your youngster bite and chew (i.e., get proper nutrition) and speak correctly but also help guide the permanent teeth underneath them into proper position. In fact, a major function of baby teeth is to hold space for the adult teeth that will eventually push them out.

At least that's how it's supposed to work; sometimes, however, injury or disease can cause a baby tooth to be lost prematurely. When that happens, the permanent teeth that are coming in on either side can actually drift into the space that was reserved for another tooth. This can cause teeth to erupt out of position or to be blocked entirely, and it may result in crowded or crooked teeth.

Fortunately, if your child loses a tooth prematurely, there's a dental appliance that can be used to hold the space open for the permanent tooth that is meant to fill it. The device is, not surprisingly, called a “space maintainer” or a “space maintenance appliance.” Made of metal and/or plastic, space maintainers can be fixed (cemented) or removable, but either way their purpose is the same: to help your child develop the best bite possible and hopefully avoid the need for braces later on.

Fixed appliances are cemented onto adjacent teeth. They are made in many different designs: One consists of a band that goes around a tooth and then a wire loop that extends out from the band to hold the space; another features a loop attached to a stainless steel crown, which goes over a nearby tooth. In either case, the loop extends just to the point where it touches the next tooth. Fixed space maintainers are often preferred with younger children, because they are less easy to fidget with, break, or misplace than appliances that can be removed.

Removable appliances look like the type of retainer that is worn at the end of orthodontic treatment. It can have a false tooth on it, which is particularly useful when the lost tooth was visible in the mouth. Older children can usually handle the responsibility of wearing this appliance and caring for it properly.

Whether fixed or removable, your child's space maintainer will be custom-made after we take impressions of his or her mouth. A child will wear a space maintainer until x-rays reveal that the tooth underneath is ready to erupt naturally. It is very important that anyone wearing a space maintainer keep up good oral hygiene at home and have regular professional dental cleanings.

Space maintainers are also useful when one or more permanent teeth are congenitally missing — in other words, they have never existed at all. In cases like this, which are not uncommon, permanent dental implant teeth are often recommended for adolescents or adults to replace a tooth they weren't born with. But timing is very important with dental implants — they can't be placed in a growing child. Therefore, it is very important to use a space maintainer with a false tooth on it until jaw growth is complete and an implant can be appropriately placed. It's a simple, non-invasive way we can avoid a malocclusion (bad bite) with some timely intervention.

Related Articles

Baby Teeth - Dear Doctor Magazine

Early Loss of Baby Teeth If baby teeth are lost prematurely, other teeth can shift into the new space so that there is not enough room left for the permanent teeth to come in correctly; crowding or crooked teeth can result. Fortunately, a special oral appliance called a “space maintainer” has been designed to solve this problem... Read Article