Early Appliances Can Reduce Future Treatments

While many associate "dental appliances" with teenagers, their use in young children is quite common. Pediatric dentists may recommend these devices for both preventing dental problems and for treating existing ones.

It can be challenging to encourage young children to wear removable dental appliances consistently. However, the good news is that these appliances can prevent injuries to the teeth and may also lessen or even eliminate the need for more extensive dental work later in life.

Common Types of Dental Appliances Used for Children

There are various types of pediatric dental appliances, each designed to serve a specific dental purpose. The main categories of these appliances are described below:

Mouth Guards

The American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) recommend that children wear mouth guards during any activity that could potentially cause injury, including sports and recreational activities.
Pediatric dentists can create custom-fitted mouth guards for children, or parents can purchase thermoplastic "boil-and-bite" mouth guards from sporting goods stores. Similar mouth guards are also used for children who grind their teeth at night (bruxism).

Space Maintainers

Sometimes, primary (baby) teeth are lost prematurely due to injury or decay. The adjacent teeth tend to shift into the empty space, which can cause spacing and alignment problems for the permanent (adult) teeth when they erupt. Space maintainers, or "spacers," are used to hold the space open until the permanent teeth are ready to come in. There are two main types:

Fixed Space Maintainers: Depending on where the missing tooth is and the condition of the surrounding teeth, the pediatric dentist may attach a "band and loop," a "crown and loop," or a "distal shoe" type of spacer to fill the gap. All these spacers serve the same purpose; only the way they attach to the nearby teeth differs. Fixed spacers are usually made of metal and are very durable. If a front tooth that is visible is missing, an acrylic button can be added to improve the appearance.
Removable Space Maintainers: Removable spacers are not often used with young children. Similar to orthodontic retainers, they have special plastic parts that fit into the empty space to prevent the neighboring teeth from shifting.

Thumb Sucking Appliances

Most children naturally stop sucking their thumbs as they grow. However, children who continue this habit after the age of five or six (especially if they do it vigorously) risk developing oral problems. These problems include narrowed dental arches, impacted teeth, and misaligned teeth. The "palatal crib" appliance usually stops thumb sucking almost immediately.

The "crib" is custom-made and attached to the teeth by the pediatric dentist, somewhat like a barely noticeable set of braces. By preventing the thumb from reaching the roof of the mouth, it reduces the satisfaction and breaks the habit very quickly. Removable versions of the "crib" are also available and can be used depending on the child's age and how willing they are to cooperate.

Expansion Appliances

An overbite, where the upper front teeth stick out over the lower front teeth, and a crossbite can both be corrected with an expansion appliance. This appliance is used to gently widen the dental arch, creating enough space for the teeth to be properly aligned in a straight position. Expansion appliances are custom-made and can be attached to the inside or the outside of the teeth. Children born with a cleft lip and/or palate may need to wear an expansion appliance or a Nasal Alveolar Molding appliance to prepare their mouth and lip for surgical repair.