When a baby tooth is lost prematurely, a space maintainer may be indicated to preserve the gap, which helps ensure proper alignment of the permanent tooth and prevent drifting of adjacent teeth. Here is an overview of different types of space maintainers: • Band and loop: Used to hold space for a single missing tooth, usually in the posterior area. It consists of a metal band wrapped around a neighboring tooth with a loop that spans the gap. • Distal shoe: Used when a primary second molar is lost early and the first permanent molar has not yet erupted. It consists of a metal band that fits around a neighboring tooth with a small metal blade extending into the gums to guide the eruption of the developing permanent molar. This requires careful monitoring because it extends slightly below the gumline. • Nance appliance: Used when more than one tooth is missing in the upper arch. It consists of two metal bands that fit around the upper molars, connected by a wire that extends to the middle of the roof of the mouth. It has an acrylic button that rests against the palate. • Lower lingual holding arch (LLHA): Used when more than one tooth is missing in the lower arch. It consists of two metal bands that fit around the lower molars, connected by a wire that runs along the inside (lingual) side of the teeth.
"We’re very pleased with Dr. Kwok’s care for our daughter. From the initial consult, Dr. Kwok explained the treatment plan clearly, answered our questions, and kept us informed about progress and milestones. The whole team is friendly, gentle, and efficient, and the results so far have been excellent. Highly recommended for thoughtful, child-friendly orthodontic care."
