Maximizing Comfort and Effectiveness: Practical Tips for Success with Space Maintainers

Space maintainers play a vital role in preserving the integrity of a child’s oral arch after premature loss of primary teeth or for adults awaiting dental implants. However, ensuring the comfortable and effective wear of these devices requires a combination of professional care, positive habits and a good level of patient understanding. Here are some practical tips for patients and caregivers to enhance their experience with space maintainers.

Establishing a routine for oral care

Maintaining good oral hygiene is paramount when wearing space maintainers. A routine that includes thorough cleaning helps prevent plaque buildup and supports the overall health of the teeth and gums. All dentists and orthodontists understand and promote the importance of establishing a regular oral routine. This should involve brushing after every meal using fluoride toothpaste and a soft-bristled toothbrush. Paying extra attention to areas around the space maintainer, including both the front and back surfaces of the teeth, contributes to effective plaque removal. Patients being fitted with a space maintainer should receive comprehensive education about how best to clean their teeth, whether they have a fixed or removable appliance.

Flossing techniques for space maintainers

lossing can be challenging with space maintainers, particularly with fixed appliances, but it is crucial to prevent debris and plaque buildup between teeth and around the appliance. Proper flossing helps to avoid any bacterial overgrowth that could result in infection. Using floss threaders or orthodontic floss designed to navigate the tight spaces around the space maintainer can be helpful. Patients can also opt to use a water jet flosser, although this should ideally be in addition to flossing with traditional floss or brushes. Patients should be encouraged to floss at least daily for best results.

Choosing the right diet

Dietary choices can impact the comfort and effectiveness of space maintainers. Certain foods may be more challenging to manage with these appliances, and an awareness of suitable dietary habits contributes to their longevity. 

Many professional bodies advise that patients can eat a normal diet while wearing a space maintainer, but they should avoid certain food and drink to minimize the risk of damage to the appliance. This includes sugary snacks and drinks between meals; sticky, chewy or hard sweets; carbonated drinks; large quantities of fruit juice; and hard or chewy foods like raw carrots, pizza crust and whole apples. (1) Damage to space maintainers from foods can be obvious as the appliance can crack, break or become loose, or it can be less obvious with gradual attrition.

Regular professional checkups

Scheduled checkups with dental professionals are essential for monitoring the condition of space maintainers. Regular assessments help identify any emerging issues, ensure proper fit, and contribute to the long-term success of orthodontic treatment.

During these visits, dental professionals can assess the condition of the space maintainer, identify any signs of wear or damage, and provide necessary adjustments. Regular professional checkups allow the clinician to address any potential issues promptly, ensuring the continued effectiveness of the space maintainer.

Emphasizing the importance of consistent wear

Consistently wearing the space maintainer is critical to achieving the desired results of the treatment program. Adhering to the prescribed wear schedule maximizes the effectiveness of the appliance and contributes to successful orthodontic outcomes. Encouraging parents and patients to follow the prescribed wear schedule, even if the appliance feels uncomfortable initially, should help to improve comfort levels over time. Consistency is essential for ensuring that the space maintainer achieves its intended purpose and facilitates optimal dental development. (2)

Addressing discomfort promptly

If patients do experience significant and ongoing discomfort or irritation from the appliance, addressing it promptly is important so the relationship between patient and professional is maintained and any future non-compliance is avoided. Patients should be advised to contact the orthodontic team immediately if they experience ongoing issues so the device can be checked and adjusted before any damage occurs to the patient or to the appliance.

Protecting the space maintainer during physical activity

Engaging in physical activities such as sports poses potential risks to a space maintainer. Ensuring that protective measures are in place, such as custom-fitted mouth guards, helps to prevent damage. It is very important that patients do not feel that their treatment program is adversely impacting their life, so proactively offering protective measures helps maintain trust between a clinician and patient.

Ensuring the comfortable and effective wear of space maintainers is a collaborative effort between dental professionals, patients and caregivers. Following these practical tips fosters a positive orthodontic experience and is more likely to lead to a successful outcome of the overall treatment plan.

2. American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2023:359-77.