Space Maintenance (Nance Appliance & Lower Holding Arch)

A guide to space maintainers: What they are, why children need them, and how they support healthy development

“Baby” or primary teeth are not meant to stick around. But just because these teeth are temporary does not mean they are no less important. For this reason, an entire category of appliances exists to avoid the complications associated with early tooth loss. These appliances are called “space maintainers” and come in various designs. As a specialty orthodontic practice in Mission Viejo, California, SHN Orthodontics has the onsite expertise and capabilities to recommend the best option for your child. 

The importance of baby teeth 

The baby teeth that first become visible in the mouth at around the 6-month mark naturally continue to erupt and make way for the permanent teeth until around the age of 12 (except “non-essential” wisdom teeth that erupt in the late teens and early 20s). In part, these teeth help to encourage good chewing habits and other vital functions early on. They also support a healthy self-image and confidence during those vital phases of early childhood. When these teeth are threatened by early decay and other conditions, damage or the loss of the tooth can interfere with healthy development and have a destructive effect on your child’s quality of life and well-being. These baby teeth furthermore support the health of the permanent ones. As they are shed, the baby teeth help to “hold the place” for the primary teeth. In doing so, issues with crowding and misalignment may be avoided. Furthermore, the need for more extensive orthodontic treatment (such as braces) can also be avoided. 

The role of space maintainers

If teeth are lost prematurely, never fear!  Our orthodontist, Dr. Shannon Hilgers Nissen, can hold the space with fixed (non-removable) appliances. These space-holders function as the baby teeth would have, to usher the primary ones into the right positions. Examples of space maintenance devices include: 

  • The lower lingual holding arch – These appliances are fixed securely in the lower dental arch. They help to maintain the space for the lower teeth. They also help to keep the lower back teeth (molars) from moving forward. This complication can arise as teeth shift. If the back-most teeth move forward, they can block the secondary teeth from erupting or breaking through the gums properly.
  • The Nance appliance – This device is similar in line to the lower holding arch, only with one noteworthy difference. Two stainless steel bands are attached to the upper first molars, which are then connected to a wire that runs across the palate.

Both appliances are designed to sit “passively” and are not associated with pressure or soreness. Most of our patients say they feel “just like a part of my mouth” – and that is just the way we like it! 

Treatments at SHN Orthodontics should not cause additional complications or concerns and should be associated with a quick and easy adjustment period if any adjustment is needed at all. We encourage you to bring your concerns to us. Call (949) 830-4101 to speak with a member of our team in Mission Viejo, CA, and to schedule your child’s evaluation.

Dr. Shannon Hilgers Nissen, DMD, MS near me

Dr. Shannon Hilgers Nissen, DMD, MS

Shannon Hilgers Nissen, DMD, MS, studied at St. Margaret’s in San Juan Capistrano and obtained her BS in Psychology from Santa Clara University. After completing her Doctorate of Dental Medicine at Tufts University in Boston, she returned to Southern California and Loma Linda University where she received her Master of Science degree in Orthodontics and Dentofacial Orthopedics.
Dr. Hilgers Nissen is a third-generation orthodontist, her father being Dr. James Hilgers. Her patients enjoy outstanding orthodontics, honest communication, and a friendly and professional atmosphere. She and her team enjoy treating their patients well and educating them about their oral health.