It is very important to save the children teeth at the end of its age. This is done by explaining to the child parents about the true way of teeth cleaning and performed the prevention against dental caries like fluoride compounds and use of fissure sealants on posterior teeth and lastly, remove the dental caries from teeth and make fillings of it by suitable materials for children teeth. This is because now, beautiful teeth white fillings similar to teeth color but it happens and parents do not care for teeth treatment of their child in a suitable time, and the dental caries is spread within all teeth till they reached to be a very badly carious teeth. So, it is impossible to put any fillings to these teeth or put any crown like stainless steel crown to protect it from more broken and then we do not have in this case only the last choice of treatment is extraction of tooth. So, in this case it is up to the parents to be interested to the following points;
(1) If the extracted tooth is anterior and the child age was at 5 or 6 years old. So, parents need not be worried about their children in this case because of the child in this age , the permanent teeth will erupt as soon as possible after removal of deciduous teeth between 6-7 years old.
(2) If the extraction of tooth was anterior tooth at early age of child between 3-4 years old or less. So, this may make psychological problem for the child from aesthetic but this can be solved by putting an artificial tooth as a temporary till the underlying successor began to erupt. Besides, parents must be careful about the eruption of permanent tooth may be delayed because of a thick granulation layer which is formed in gingiva at the place of extracted deciduous tooth that will retard the eruption of permanent tooth. So, when the child reached to 7 years old and permanent tooth not erupt , the parents must visit the dentist and consult to do the procedure that make the eruption of permanent teeth easily.
(3) If the extracted tooth was one from posterior teeth, and the child age was more than 10 years old, at this time, it is very important to make consultation with dentist and then took x ray to the area to know the place where the permanent tooth is reached to erupt and whether it is near or far from the time of eruption. Therefore, if the permanent tooth needs 6 months or less to be erupted, the space can be left empty and wait without fearing form any side effects. However, if the eruption of underlying permanent tooth needs more than 6 months , in this case, we must put a space maintainer appliance at the space of extracted tooth.
(4) If the posterior tooth is extracted at early age, between 7-9 years or less, we must put space maintainer.
There are questions arise;
Why we must put a space maintainer and what are benefits and from what, is it constructed?
When there is an extraction of any posterior tooth for a child, this lead to the movement of adjacent tooth towards the space of extraction and close the space. Then, the underlying permanent tooth could not find any space to be erupted, so this cause either no eruption of permanent tooth forever or it erupts but at malformed way towards cheeks or tongue that cause them malocclusions.
Therefore, it is important to put the space maintainer appliance to prevent the adjacent teeth from moving towards the space of extracted tooth and then make the eruption of underlying permanent tooth too much easily.
What is a space maintainer appliance and which does it consist of?
It is a simple appliance put on the tooth adjacent to the extracted space consisting of stainless steel band that is fixed on tooth by cement and extend from it loop that will put on space and then fix on the other tooth in front of the side as it appeared in the picture.
The Shape of the space maintainer
(1) Unilateral space maintainer:-
It is put on one side from the lower or upper jaw.
(2) Bilateral space maintainer:-
It is usually put on both sides of the jaw when there is both sides extraction and it has two shapes:-
1/ First Type
Consists of lingual arch with bilateral bands on both left and right sides of lower molars
2/ Second Type
It is called (Nancy Appliance) and consists of arch put on upper jaw with two bands on upper molar and covered by layer of acrylic to protect the appliance from erosion.
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