Tag Archives: space maintainer

Pediatric Dentistry

Discolored Baby Tooth?

My four year old son took quite a tumble. Now one of his front teeth is chipped and discolored. Should I whiten it or is there something else I should be doing? If he loses the tooth, do I need to get a space maintainer?

Elsie

Dear Elise,

Young boy smiling holding his toothbrush

I am glad you wrote. I can tell that you are a good mother and want to make sure you are doing the best for him. In this case, there is no need to do anything. Teeth whitening will not work on a tooth discolored from trauma. Even if it would, I wouldn’t recommend it for a child. They’re not likely to keep the trays in and that tooth will not last long anyway.

Unlike the rest of us, young children are not bothered by things like a discolored tooth. In fact, on the school yard, an injury is like a badge of honor, especially for boys. The grosser the better.

If the tooth falls out, you will not have to worry about a space maintainer. It is close to the time in which he would lose that tooth anyway, so you don’t need the added, unnecessary expense. The one time that your son would need a space maintainer would be if he lost a back molar. These have to stay in his mouth until he is around twelve years old. If that tooth was lost, you’d have to keep the space reserved. Otherwise, in the amount of time until his permanent molars come in, the other teeth will drift or tip into the opening causing overcrowding.

Unless the tooth develops an infection, I’d just leave it alone. If it does get infected, his pediatric dentist can just remove it.

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Pediatric Dentistry

Five Years Old’s Teeth Rotting

I need some advice, My five year old daughter has some problems with her molars. Two of them have small cavities and two of them have lost about 30% of their structure. I want some advice of what to do about this before I take her to a pediatric dentist. Will they have to be removed? She’s awful young to have to lose teeth. She is saying that it hurts when she chews so I know I need to bring her in.

Laurie

Dear Laurie,

young boy smiling with toothbrush

I love that you are trying to figure out the best thing for your daughter. At her age, all of her teeth are all baby teeth and she needs them for many years to come. It is important you get her to see a pediatric dentist as soon as possible. This is especially true for her back teeth. They need to stay in her mouth until she is about twelve years old.

The molars with the small cavities will definitely be able to be saved. The ones where you estimate there is 30% loss of structure, I hope can be saved with a dental crown.

If they cannot be saved, it will be imperative that your dentist place a space maintainer there. If the molars are just removed, the remainder of her teeth will drift into that open space. then, when her twelve year old molars try to come in, there will not be enough space. This will lead to crowding and expensive orthodontics.

The extent of her decay is a little unusual for her age. It may be time for a bit of tough love on your part. She can brush her teeth twice a day just like she is supposed to, but if she is a frequent snacker it will sabotage her oral health. This is because one of the biggest proponents of oral health is our saliva, which contains bacteria fighting minerals. If she is a frequent snacker or drinks a lot of juice, does not give her salvia enough time to do its job.

I would limit her to one or two snacks a day and make sure she is not drinking a lot of juice or sodas.

One other thing. I know you are trying to get all your ducks in a row before seeing the pediatric dentist, which is admirable, but don’t put it off. These cavities can easily turn into a tooth infection, which will be a dental emergency.

This blog is brought to you Phoenix Dentist Dr. Hillary Peck.
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Pediatric Dentistry

Dental Flipper for a Toddler

My son, who is 3 years old fell and lost his two front teeth as a result. I spoke with my pediatric dentist about getting him a dental flipper and he refused. I looked online for the do it yourself kind, but they only make those for adults. What would you recommend for me to get him a flipper? I am worried about his teeth shifting.

Morgan

Dear Morgan,

young boy smiling with toothbrush

I wish your pediatric dentist would have explained things rather than just refuse. Parents are always better off knowing the reasoning behind the recommendations and decisions their child’s caregiver is putting forth.

Reasons Children Can’t Have a Dental Flipper

You noticed that there were only DIY flippers for adults. That is because it is dangerous for children to use a Dental Flipper.

First, they are removable. Just as we are careful with the size of toys we let our children play with, we try to do the same thing with any type of removable device. Otherwise, it is a choking hazard.

Second, they are removable. No, I didn’t make a mistake typing that twice. It is a rare toddler or even older child who will keep in an orthotic device. It is much more likely it will be removed and lost in a short period of time.

Third, they stay in by clasping onto other teeth. Your son’s jaws and teeth are in a constant state of growth right now. This means he will outgrow the flipper quickly and often.

The Really Good News

I know you are worried about your son’s teeth shifting which can lead to overcrowding of his adult teeth. That shows you pay attention to your son’s dental health. The good news is, with his front teeth that won’t be an issue.

When we talk about the importance of tooth retention in children, it is with their baby molars. This is because the adult molars don’t come in until the child is around 12-years-old. In that amount of time and given the placement, the teeth will shift.

If it ever happens that a child of yours does need to have a molar removed, getting a space maintainer will be important.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry

What the Real Reason My Toddler Can’t Get a Dental Flipper?

My son lost a tooth prematurely. He’s only three and it’s a front tooth. I’ve been told children’s teeth shift if the spaces are left open. I asked my pediatric dentist to provide him with a dental flipper. Instead, the dentist started shouting. He said it was the most ridiculous thing he’d ever heard. No child can sit still for a flipper. I’m not only offended, I’m sure with sedation it could be done. Unless you give me a better reason, I’m going to a different dentist.

Marilyn H. – Michigan

Marilyn,

I’m sorry your dentist was rude. That’s not a great way to build trust with patients, especially when you’re talking about their child’s dental health. While I’m sure you could work with sedation, the pediatric dentist is right, a dental flipper is a bad idea. Here’s why.

1. A child’s mouth is constantly growing. The flipper won’t fit for long. You’d have to keep making a new one.
2. It’s a choking hazard. Flippers are removable appliances. Even if he didn’t pull at it, which is highly unlikely, it could just slip out and he’ll partially swallow it.

I have some great news for you, though. The only teeth where you have to worry about shifting are the back teeth. In those cases, we’d place a space maintainer to prevent the shifting. Also, your child’s age means he won’t be self-conscious about the tooth loss. In fact, he might be proud he’s the first among his friends to lose a baby teeth.

You didn’t mention how he lost his tooth. If it was due to trauma, it might be a good idea to have the adult tooth checked for damage. In the unlikely event the adult tooth is damaged, don’t panic. There are plenty of options for his adult tooth. Dentistry has developed tremendously. Even if he completely lost the adult tooth (and again, unlikely, so don’t panic), we now have dental implants that mimic having a natural tooth exactly, even down to the tooth root.

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Pediatric Dentistry

Does a child really need a filling?

My four year old has a cavity. The dentist wants to fill it. Why, when he’s just going to lose it anyway?

Becky K. – Texax

Becky,

Much of that will depend on the type of tooth. If the cavity is small and on a tooth that is already quite loose then, yes, let nature take it’s course. But, if it is a tooth that’s going to be there for a while, especially one like a molar, than your pediatric dentist is right and it does need to be filled.

The cavity will spread and then become an abscess. IT might seem scary to give your four year old a filling, but that will be much less traumatic and painful than waiting until infection is set in and then he needs a pulpotomy.

If it is a molar and he ends up losing it, make sure your dentist puts a space maintainer there so his teeth don’t shift.

This blog is brought to you by Phoenix Dentists Drs. Kevin and Hillary Peck.