When children receive extractions of posterior primary teeth earlier than natural exfoliation, it may be appropriate for our dentists to create a space maintainer appliance. Such appliances help “maintain” the space that was previously held by the primary tooth so the permanent successor has ample room to grow into the mouth when ready. Without space maintainers, the permanent molars may drift forward, closing the space necessary for the future permanent tooth. Reversing the space closure down the road with orthodontics can be both costly and time consuming.