Space Maintainer Indication — MFDS Part 1 MCQ
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Correct answer: D — A 7-year-old with good oral hygiene, premature loss of a second primary molar, an unerupted successor and no spacing in the arch
Explanation lettering: B = shown as A · E = shown as B · D = shown as C · A = shown as D · C = shown as E
A is correct. Premature loss of a second primary molar can permit mesial movement and tilting of the adjacent first permanent molar, reducing the space available for the unerupted premolar. Space maintenance is therefore most useful when the successor remains unerupted, the arch is not spaced and oral hygiene is satisfactory. Generalised spacing makes clinically important space loss less likely, so B does not usually require an appliance. Once the permanent successor has erupted, as in C, there is no longer a space to maintain. A space maintainer has no role in a complete permanent dentition (D). Poor oral hygiene and uncontrolled caries (E) increase plaque-related risks and are contraindications until disease control is achieved.
Reference: Faculty of Dental Surgery, Royal College of Surgeons of England. Extraction of Primary Teeth: Balance and Compensation, sections 2.4–2.5, 2002. https://www.rcseng.ac.uk/-/media/files/rcs/fds/publications/extractp.pdf