Removable Appliances

Removable Appliances & Space maintainers

Early intervention takes advantage of the fact that a child’s jaw is still growing. Early treatment is useful when the dental arches and jaws are not in the correct position. Functional appliances can fix or improve these problems. More treatment usually is needed later on, but it may be shorter.


Why Maintainers Are Needed

Children lose baby teeth earlier than expected for several reasons:
• Trauma
• Cavities
• Genetically missing primary teeth


When to Consider Space Maintainers

Regardless of why a child has missing primary teeth, it’s important to consider space maintainers to make sure the permanent teeth develop in their correct locations.
• If a primary tooth is missing for a long period of time. The neighboring teeth can move into the space of the missing tooth which was intended for a permanent tooth.
• If a primary tooth is naturally exfoliated, a space maintainer is not needed as the permanent tooth is ready to erupt in its space.

Types of Appliances

Space maintainers come in two types: removable and fixed.
The most commonly used removable appliance at our office is the twin block appliance. It corrects major overjet. An overjet is misalignment in the jaw, which causes your child’s top teeth to stick out in front of the lower teeth further than normal.
The twin blocks work to bring your child’s lower jaw forward into the correct position. These are usually followed by full orthodontic treatment to straighten the teeth once the patient’s jaw is aligned.

During this time the parents should expect that:

• It takes time for a child to adapt to wearing a device
• The maintainer needs adjustment and requires immediate attention if it gets damaged
• The child should avoid chewing gum, biting hard food, and playing with the device

Types of fixed appliances include:

Nance Palatal Arch: It is an acrylic button that covers a section of the roof of the mouth. It has two metal bands around the upper molars to hold them in position until the missing teeth erupt. It is fitted on the upper jaw to preserve space on both sides.

Lingual arch: It has two metal bands cemented to the two lower molars, which are joined by a U-shaped bar behind the lower teeth. This is used to maintain space for lower back teeth on both sides.

Band-and-loop: A band is fitted on the molar, and a loop is held in the space. It allows the permanent tooth to erupt without blocking it. It is used when one baby molar is lost in one side.