SPACE MAINTAINER. Multimedia Health Education. Disclaimer

Transcription

1 Disclaimer This movie is an educational resource only and should not be used to manage your health. All decisions about the management of premature loss of primary teeth and use of space maintainers must be made in conjunction with your dentist or a licensed health care provider.

2 MULTIMEDIA HEALTH EDUCATION MANUAL TABLE OF CONTENTS SECTION CONTENT 1. Normal Tooth Anatomy a. Introduction b. Normal Tooth Anatomy 2. Overview of Premature Loss of Primary Teeth a. What is Premature Loss of Primary Teeth? b. Causes c. Diagnosis 3. Surgical Procedure a. Surgical Treatment b. Post Operative Care

3 INTRODUCTION The purpose of baby teeth is not only for chewing foods, but also to function as a guide for the permanent tooth that will replace it. If the baby tooth is lost too early then the permanent tooth will drift out of place and erupt improperly. The teeth beside it can also move into the empty space. This will prevent the permanent tooth from coming into the mouth properly. Space maintainers are a great way to keep the space open until the permanent tooth comes in. Space maintainers are small appliances that are worn to maintain the space between teeth.

4 Introduction Unit 1: Normal Tooth Anatomy In order to learn more about space maintainers, it is necessary to understand normal tooth anatomy. (Refer fig. 1) (Fig. 1) Normal Tooth Anatomy The teeth consist of two main parts, the crown and the root. Crown: The visible part of the tooth projecting above the gums is the crown. The crown has three layers: (Fig. 2) (Refer fig. 2 to 4) Enamel Dentin Pulp (Fig. 3) (Fig. 4) (Continued in next page)

5 Enamel It is the hardest outermost part of teeth. It is white in color and is made of calcium hydroxyapatite. The enamel layer is thinner in deciduous teeth, about 1mm. (Refer fig. 5) Unit 1: Normal Tooth Anatomy (Fig. 5) Dentin It lies below both the enamel and cementum layer of tooth and is softer than enamel which makes it more susceptible to decay. It is yellowish in color. (Refer fig. 6) (Fig. 6) Pulp It is present at the center of the tooth and is commonly referred to as the nerve of the tooth. It is the softer, living inner structure of teeth and is made up of blood vessels and nerves. The pulp chamber is larger in deciduous teeth (baby teeth). (Refer fig. 7) (Fig. 7) Root: The deciduous teeth have longer and more flared roots. It is that part of the tooth that is embedded inside the jawbone. This portion is made up of dentin overlying which a mineralized layer is called cementum. (Continued in next page)

6 Unit 1: Normal Tooth Anatomy Cementum contains very small fibers called periodontal ligament fibers which help in anchoring the teeth to the bone. Inside the roots there are small canals through which the main blood vessels and nerves pass to the pulp chamber. These are referred to as root canals. (Fig. 8) (Refer fig. 8)

7 Unit 2: Overview of Premature Loss of Primary Teeth What is Premature Loss of Primary Teeth? Your child begins losing primary teeth normally around the age of six years. The first teeth to be lost are the central incisors. The last baby tooth is lost around the age of twelve. Some children, however, lose one or more of their baby teeth too early before it should naturally happen. This is called premature loss of primary teeth. Although baby teeth will eventually be lost by the age of twelve, they are very important for normal development of jaw bones and muscles. When premature loss occurs, problems can result if left untreated. (Refer fig. 9) (Fig. 9) Causes Causes of premature loss of primary teeth can include the following: (Fig. 10) Caries: If caries (cavities) are not treated timely they can spread deep down, weakening the tooth, requiring tooth Extraction. Gum disease: This is an infection of the gum tissue and can cause the tooth to lose its support. (Continued in next page)

8 Unit 2: Overview of Premature Loss of Primary Teeth (Fig. 10) Injury /Accidents: Injury, usually during play, can loosen the teeth and make them fall out. Knocked out tooth: Here the tooth is fractured or is knocked out of its socket. This usually occurs in kids involved in sporting activities. Poor Oral Hygiene: Improper oral hygiene can lead to tooth loss. Diagnosis Visual Examination History X-rays Genetics: Some children are born without primary teeth. Medical Conditions: Some diseases or medical conditions can lead to premature tooth loss. Visual Examination Examination of oral cavity is performed by your dentist.

9 Unit 2: Overview of Premature Loss of Primary Teeth History Your dentist will ask you about any history of injury or accidents. X-rays Dental x-rays are used to visualize the permanent teeth that are beneath the gums. If a permanent tooth is about to erupt, a space maintainer may not be needed.

10 Unit 3: Surgical Procedure What is a Space Maintainer? A space maintainer is an appliance that is used for premature loss of primary teeth to prevent the space from closing before the permanent teeth can erupt. (Fig. 11) (Refer fig. 11) There are two types of space maintainers, fixed and removable: Fixed space maintainer: This type of space maintainer is cemented into the child s mouth. There are three types: Band and loop: These are placed on one side of the mouth to hold the space open for one tooth. It wraps around the outside of the tooth and is connected to a metal loop that holds the space intact. Lower lingual holding arch: It is usually bilateral, may be cemented to molar teeth, and is connected by a wire on the inside of the lower front teeth. It is used for more than one missing tooth. (Fig. 12) (Fig. 13) Distal shoe appliance Used for an unerupted first permanent molar, the end of the metal appliance is usually inserted into the gum line to keep the open space from closing. (Refer fig. 12 to 14) (Fig. 14) (Continued in next page)

11 Unit 3: Surgical Procedure Removable space maintainers This type uses artificial teeth to fill in the spaces that need to stay open. (Refer fig. 15) (Fig. 15) Band Selection and Placement: A preformed stainless steel band is selected to fit the abutment tooth, the tooth that supports and provides retention of the space. The correctly fitted band does not interfere with the bite. (Fig. 16) (Refer fig. 16) Impression Once the band is appropriately placed an impression is taken. A sectional impression tray is loaded with impression material and placed in the mouth. Once the impression material sets, the impression tray is removed from the mouth. (Refer fig. 16 to 30) (Fig. 17) (Continued in next page)

12 Unit 3: Surgical Procedure The band may be removed by pliers or a scaler type instrument. The band should be stabilized in the impression or mold. The working model is then prepared in the lab. (Fig. 18) (Refer fig. 16 to 30) (Fig. 19) (Fig. 20) (Fig. 21) (Continued in next page)

13 Unit 3: Surgical Procedure (Fig. 22) Loop Fabrication The loop is made of stainless steel wire that is contoured to fit the band and the adjacent space. The loop is soldered to the band and polished. (Fig. 23) Cementation First the band and loop should be tried in to ensure that it fits the tooth and space. It should not interfere with the patient s bite. Once the fit is achieved, the abutment tooth is pumiced, rinsed, dried and isolated. (Fig. 24) (Refer fig. 16 to 30) (Fig. 25) (Continued in next page)

14 Unit 3: Surgical Procedure The band is loaded with cement and inserted onto the abutment tooth. Excess cement is then removed from all unnecessary surfaces. (Refer fig. 16 to 30) (Fig. 26) (Fig. 27) (Fig. 28) (Fig. 29) (Continued in next page)

15 Unit 3: Surgical Procedure Appliance Removal Once the desired eruption of the permanent tooth is achieved, the band and loop space maintainer can be removed using band pliers. (Refer fig. 16 to 30) (Fig. 30) Post Operative Care (Fig. 31) Diet: Avoidance of any gum, sticky foods or anything else that might cause the appliance to become loose. Oral hygiene: Proper cleaning of appliance and surrounding teeth is necessary to keep the gum tissue healthy.

16 Unit 3: Disclaimer Disclaimer Although every effort is made to educate you on space maintainers there will be specific information that will not be discussed.talk to your dentist or pedodontist about any concerns you have about premature loss of primary teeth and space maintainers.

17 YOUR SURGERY DATE READ YOUR BOOK AND MATERIAL VIEW YOUR VIDEO/CD/DVD/ WEBSITE PRE - HABILITATION ARRANGE FOR BLOOD MEDICAL CHECK UP ADVANCE MEDICAL DIRECTIVE PRE - ADMISSION TESTING FAMILY SUPPORT REVIEW Physician's Name : Physician's Signature: Date : Patient s Name : Patient s Signature: Date :