Pediatric Dental Spacers
In cases where a child’s baby tooth Has fallen out prematurely, or if it has been removed due to injury or decay, a spacer may be required.
Dental spacers are placed in the mouth in order to maintain adequate spacing between adjacent teeth to allow adult teeth to erupt naturally without space limitations. In other words, spacers are used to hold the space between teeth when the natural tooth is not in place to do so. Spacers are used to control overcrowding in the mouth and to prevent migration of teeth into areas that can make it difficult for subsequent teeth to erupt. While it may seem that overcrowding of teeth are simply an aesthetic concern, the truth is that crooked and crowded teeth can have negative implications for the developing mouth.
Our teeth are intended to share bite force loads by distributing the load across the dental arches. When teeth are overcrowded, it can result in some teeth being utilized more than others and some not at all. This can result in uneven wear on the surfaces of the teeth.
Crowding can also result in a mouth that is more prone to the effects of decay and gum disease. The reason for this is that crowded teeth offer far more opportunity for debris from food to collect and wedge between the teeth. Plaque bacteria also finds lots of opportunities to stick to the teeth and the soft tissues that surround it. Since crooked teeth are harder to clean, bacteria is often not effectively swept away with brushing. Over time, plaque bacteria and food debris can contribute to cavity formation and gum disease.
The formation of bacteria around the bases of the teeth and between crooked teeth is exposed to minerals in the saliva and eventually becomes calcified as tartar. Tartar and plaque irritate the gum tissues responsible for holding the tooth in place and can result in sore bleeding gums (seen in gingivitis) as well as gum recessions and, in severe cases, periodontal disease develops. Since bacterial counts in the mouths of children with crowding may be higher, it is no surprise that bad breath can often accompany crowding.
Properly aligned teeth are important in the developing mouth in order to ensure that the tongue has sufficient freedom of movement in order to develop good speech articulation. This becomes more difficult with poorly aligned teeth.
Chronic headaches, and pain in the jaw and neck can often develop due to poor alignment. Facilitating proper alignment of the teeth assists in distributing the demands on the mouth equally across the arches, and therefore supports the muscles and bones involved in speaking and chewing.
Your first visit will see your child getting familiar with the environment at the dental office. They will be shown how the chair works and may like to watch their favorite show on tv while the dentist examines their teeth.
How Are They Installed?
When your dentist sees that a spacer could benefit your child, the process will begin by inserting a small rubber band between the teeth and extending the rubber band over and around the crown of the tooth. The result is a rubber band ‘spacer’ that will put pressure on adjacent teeth to accommodate it by moving them away slightly. Although there are pressure sensations, the installation of a spacer is painless.
Following the insertion of the elastic spacer, it is reasonable to expect some discomfort as teeth begin responding to the pressure placed upon them. Elastic spacers are typically placed in order to make space available for a more long-term appliance to be placed in the mouth and are therefore used for only 1 to 2 weeks.
Children who feel discomfort after a spacer has been placed can be offered cool, soft foods to eat (like puddings) and over-the-counter pain relievers can be taken.
Once the rubber spacers have created adequate space between the teeth, a more long-term appliance can be cemented in the mouth. Although these appliances can be removable, pediatrics generally avoid removable structures in order to minimize risk of loss or breakage.
The cemented appliance is customized to suit the particular needs of your child and can be made of acrylic or metal materials.
Your dentist will also examine the muscles of the jaw to evaluate the muscle structure and comfortable movement of the joint. Parents will be asked to discuss the family’s medical history including any genetic disorders that we should be aware of. Your dentist may ask about the child’s natal and neonatal history as well as information about your child’s delivery. Medical allergies will be discussed, as well as the child’s current nutritional profile. This is a good time to discuss concerns such as thumb sucking or frequent pacifier usage which your dentist may be able to counsel you about so that you can ensure that these habits do not impact the alignment of the baby teeth.
Caring For Your Spacer Appliance
In order to ensure that your child’s spacer remains set in the mouth, it is important not to push, pull or pick at the appliance. This includes not manipulating the spacer with the tongue, as prolonged movement of the spacer can result in dislodging the ring that holds the appliance in place.
Sticky foods such as toffees or caramels can pull the spacer out of place while chewing, so it is important to help your child choose other treats that will not stick to the teeth. A square of chocolate is a safer alternative to toffees.
Regular flossing between the teeth can resume once the final appliance is set in place, however, flossing between teeth that have elastic spacers is not recommended. Encourage your child to brush their teeth regularly, even when there is initial soreness in the mouth. Brushing gently will not increase the discomfort.
Ask your dentist about any special care tips they recommend for your child’s customized spacer and be sure to schedule regular follow ups.
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