Dr Amanda with straight smile Solutions straight smilesolutions.com and today we're going to talk
more about space maintainers and kids and this is really actually more of a pediatric dentistry
video I don't place this type of space maintainer not interested don't do it it's something that's
placed by a dentist are usually most commonly a pediatric dentist when a tooth is pulled out
so in this situation this well I don't know if this actually makes sense to me but in
this situation it would have been a first molar that was pulled out okay that's very smaller are
your sixes those are the teeth that normally come in when you're six years old six seven
something like that first permanent molar came out they put a band and loop space maintainer in
to maintain the space so that this tube wouldn't tip forward um this patient since there's a second
molar this patient would have to be at least 12. this doesn't totally make sense to me but I mean
it's good they did it so most commonly I would say banded Loops are placed on baby teeth okay
um or on permanent teeth because there was an early extraction of a baby tooth okay and
my opinion might be different than what is taught in Pediatric Dentistry I tend to see an overuse of
space maintainers when I think it's really not necessary so first thing you're going to do if
you're pulling a baby tooth out for whatever reason whether it was decayed unrestorable
you know traumatized um it had to go before it's time that you're going to take an x-ray
right if that permanent tooth that's underneath it is like pretty much gonna
erupt the next month or so you don't need to place a space maintainer or even the next
two months you know if it's right there little place of space maintainer I see this all the time
and it gets more trouble than it's worth because then that it's either blocking the eruption of
the permanent teeth which can cause permanent damage or impactions unless the patient is coming
in regularly to get it checked or a lot of times these things can go into the gums and cause major
issues I've seen some crazy stuff happen with these suckers when they're not monitored you know
patients eat whatever they're eating candy and all kind of other stuff and it it can cause damage so
you know don't Place one if you don't need it I generally and granted the kids that I'm seeing in
our offices you know historically have been older you know six and up I only time I think you need a
space maintainer is when either a permanent tooth is missing you know and they're not ready for
orthodontic treatment because if it's orthodontic treatment we might be able to use up the space or
move it around or we'll do something you know take care of that issue or if a second baby
molar not first baby molar not baby canine second baby molar which is in the U.S it's your a your J
your K and your T got extracted early that means normally they and the other word for that is ease
we call those ease and Ortho they call them um goodness what is it in international term it's
five five six five seven five and eight five so those any of those the ones that come up when
you're two years old two-year-old baby Mueller second baby molars if those come up and the
E sorry if those come up and the five which is your second uh premolar which is your four your
thirteen you're twenty and you're 29. if those aren't just about to come up you do absolutely
need a Space maintainer Place same time one hour within a week one hundred percent that drives me
absolutely nuts when I see a patient that wouldn't have needed braces and wouldn't need a complicated
treatment at all maybe you didn't need it at all and now you just cost this family seven thousand
dollars because you were sloppy and then put in a space maintainer that makes me really really
really really really mad and I see it all the time I don't understand why why are doctors
pulling these teeth out without immediately pacing a space maintainer if the patient I
mean you should just do it all at one time don't if the patient's parents say no then I wouldn't be
pulling off the tooth so because you're condemning this patient to really difficult Ortho later most
of the time it makes it so much harder you know and sometimes a really bad outcome because you
were sloppy it in place of space maintainer and more more commonly than not I see space containers
overly used when they don't need to be used like 90 of the time like you didn't eat this you didn't
need this you know I feel like sometimes it's either Medicaid fraud or just an overly cautious
dentist that didn't realize they did not need a space maintainer there probably wasn't malicious
sometimes it probably is but um it's like really take these all off you know get rid of them
um but yeah so abandon Loops I don't put them on but I see them all the time
oh I take them off all the time definitely goodbye you don't need this let's get rid of it
um and I only use them for missing permanent teeth or for missing second
um baby molars the ease your a your J your k your t or your eight five sorry you're eight five
you're seven five you're six five and you're five five that's the times when you need to use them
okay otherwise you usually don't need them maybe I don't know maybe in like two three-year-olds
maybe you do I don't know that's a pediatric dental question I don't I've never seen an issue
let's put it away and all my 20 years of being an orthodontist I have never ever seen damage
that's been caused by a patient long term or a mess up an ortho plan because one wasn't placed
it was pulled out early what that's actually not true if you take out a baby canine just one
sometimes the mid lines were shift but it's not a huge Dam it's just like so easy to fix you know
maybe you'll get a slightly impacted canine but that's easy to fix on that does that's not bad
it's when these suckers drift or uh well not this but if this was missing and this drifted forward
that's an issue so all right hopefully that was helpful and you know if if there's two I would
much much prefer a lingual Arts than two bands of Loops it's much more comfortable for the patient
and it has a lot of great orthodontic benefits so I love me all legal Arch so or an ants those
are great too TPA those are great too we use them all the time so um and it's an incredible thing to
put in either a patient with a little overjet or a patient with a slant underbite to put those in for
preventative I have a lot of emails emails I have a lot of videos on YouTube about space maintainers
used for Anchorage control so you definitely should check those out all right thanks so much