Anterior esthetic fixed appliances for the preschooler: considerations and a technique for placement

One of the pediatric dentist's greatest restorative challenges is the esthetic rehabilitation of a young toddler who has suffered multiple tooth loss subsequent to rampant early childhood caries or extensive dental trauma. An anterior esthetic appliance may be used to replace lost teeth. The most decisive factor for placing an anterior esthetic appliance is parental desire. Other considerations include: space maintenance, masticatory function, speech development, and tongue habits. However, there is no strong evidence that early loss of maxillary incisors will have any significant, long lasting effect on the growth and development of the child. This paper discusses in detail one type of fixed anterior esthetic appliance and the considerations to be made when deciding when and why to place them.