Space maintainer for four year-old?

When my son was 3 years old (he is now 4), he lost a front tooth in an accident in an inflatable bouncer. We never found the tooth and took him to the dentist to see what we could do. The dentist just barely looked at him and said it would be better to do nothing at this point because it was just a baby tooth he lost. Now his teeth are even more crooked than they were before with the tooth next to the lost one being almost completely sideways. Shouldn't he have a space guard or something to keep his teeth in place? Our dentist didn't want to bother (he is an HMO type dentist). If nothing is done, will this affect his permanent teeth? We already know he will need braces, but are we making the problem worse by ignoring it?

He also has bad breath even after brushing (tongue too). Is he too young for Breath-Assure? His doctor has told me to just brush his teeth more and have him drink water and that should help, but it does not. Our dentist is no help either, as he just wants to get us out of his office as fast as possible. Please help-it is awful!

Thank you.


Dear Debbie,

Primary teeth have many functions, one of which is to hold the place for the permanent teeth. Premature loss of the primary teeth can cause spacing problems with the permanent teeth if no space maintainer is placed. Premature tooth loss in the anterior region generally does not cause as much concern as premature loss in the posterior region, although "drifting" of the teeth can occur with anterior tooth loss. Space maintainers for the anterior region can be made and can even include a false tooth to fill in the gap created by the tooth loss.

I recommend you either consult with your dentist for this treatment or ask for a referral to someone who will. Even if payment for the space maintainer must be paid by you, it might save on more extensive treatment in the future. You may even want to consult with an orthodontist. Most orthodontists would consider 4 years old to be too young for treatment; so, if no treatment is recommended by the orthodontist at this time, you may then at least have an idea for the future.

I also recommend you have your son's mouth thoroughly examined by a dentist. It is possible the source of his bad breath is due to cavities, a gum problem, or both. Continuing to completely brush and floss his teeth and brushing his tongue is also very important in fighting his bad breath. I would not recommend Breath-Assure because it is only be a temporary fix. Currently, there is quite a bit of research to discover causes and effective treatments for halitosis. An oral source accounts for about 85% of people who suffer from bad breath. So far, researchers have discovered some of the problem can lie with bacteria which reside on the tongue. There are also some systemic problems, such as nasal and sinus problems, respiratory problems, and gastrointestinal problems (to name a few), which can cause halitosis.

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