Many patients visit our office looking for a way to fix the gaps between their teeth. Although the issue is often a cosmetic one, many patients suffer from low confidence and self-esteem because of the gaps between their teeth.
Fortunately, there are several ways to fill these gaps, known as diastema. Before you come into our office to discuss your options, it’s helpful to understand what diastema is and what causes it.
What is Diastema?
Diastema is the clinical term used to describe gaps between teeth. While diastema can occur anywhere in your mouth, it tends to be more common between the front teeth.
In most cases, diastema does not have a negative impact on your oral health. However, there are some instances where it may be a sign of gum disease.
Both children and adults can be affected by diastema, although the condition is more common in children. For many children, these gaps close when their adult teeth come in.
It’s important to note that diastema is considered normal and common. Aside from cosmetic issues, gaps between the teeth are often not viewed as a problem that needs treatment. That being said, many patients prefer to fill the gaps between their teeth to feel more confident when smiling.
What Causes Diastema?
One of the first questions patients have is: what causes diastema in the first place? Diastema has many causes that include but are not limited to:
Gum Disease
Gum disease is an infection of the gums that can damage the tissues and bones that support the teeth. The damage caused by gum disease can loosen the teeth and cause gaps to form.
Symptoms of gum disease, include:
- Tender, swollen gums
- Inflamed gums that bleed easily from poor brushing
- Bad breath
- Pain when eating
- Loose teeth
Obstructions in the Mouth
For some patients, diastema is caused by obstructions in the mouth. This can happen if there are supernumerary teeth or if a child’s baby teeth don’t fall out.
Other obstructions that can cause diastema include:
- Cysts
- A large frenum (the tissue between your upper front teeth and gum line)
An especially large frenum can cause a gap to form in between the teeth.
Teeth vs. Jawbone Size
If your teeth are too small compared to the size of your jawbone, gaps can form between your teeth. Unfortunately, jawbone size is a genetic issue, so this is one cause that isn’t easy to fix. However, it does explain why diastemas often run in families.
Undersized or Missing Teeth
If teeth are missing or undersized, gaps can also form. Gaps often form when the teeth on either side of the two front upper teeth are relatively small or missing entirely.
Generally, teeth that have unusual positioning, shapes and sizes are more prone to develop gaps. If your canine teeth, for example, do not develop in the normal position, your front teeth won’t get the pressure needed to keep them in place. Eventually, they start drifting apart, and this leads to a gap between the teeth.
Swallowing Reflex Issues
When you swallow, your tongue presses against the roof of your mouth. However, some people may push their tongue against their front teeth instead. Repetitive pressure against the front teeth can eventually push these them forward and cause the gap to form.
Lifestyle Habits
Some lifestyle habits can also cause diastema, including:
- Tongue thrusting
- Thumb sucking
- Lip sucking
These habits can all put pressure on the front teeth, which can push them forward.
Tongue Position
It’s more common to see gaps between the front teeth, but they can also develop in the lower front teeth. In most cases, the cause of this type of diastema is the tongue pressing too far forward in the mouth. This is also known as tongue thrusting.
Normal Growth
Diastema is considered a normal part of tooth development in children. An estimated half of children between the ages of 6 and 8 have gaps between their teeth. These gaps typically close by the time their adult upper canines come in.
Understanding the Different Types of Tooth Gaps
While diastema can develop between any teeth in your mouth, it’s more commonly seen in certain areas.
The most common types of tooth gaps include:
- Midline Diastema: Also known as median diastema. This type of gap affects the two upper or lower front teeth.
- Mandibular Diastema: This type of gap affects any of the lower teeth.
Although rare, some people have gaps between all of their teeth. Filling the gaps between your teeth is possible using a variety of different methods and treatment options. The most common recommendations to fill gaps are outlined below.
How to Fill Gaps Between Teeth
Tooth gaps may make you unconfident and stop smiling, but we have many options to help fill those gaps once and for all. The most common options to fill gaps between your teeth include:
Crowns and Veneers
Dental veneers are a beautiful way to fill the gap between your teeth or replace temporary fillings, and it’s a process that we can do right in our office. Veneers are thin shells that we can bond to the tooth to fill the gap, and this is one of the leading options for front teeth.
However, veneers will require us to remove a minimal amount of enamel from your existing tooth.
The enamel is removed so that we can properly bond the veneer to your tooth.
If we don’t think that veneers will work well or the tooth has decay or trauma, we may decide to use a crown. Crowns look nearly identical to your existing teeth, and we can even match the color and shape of your tooth.
However, crowns will require us to:
- Fix the tooth
- Fit the crown
- Place the crown over the tooth
Often, crowns are a good option when dental decay is severe, but there’s enough of the tooth that can be saved to make placing the crown a viable option.
Dental Bonding
Large gaps, often between the two front teeth, are more common than people realize. In fact, 25% of people have at least one tooth gap. However, when you’re dealing with a gap between your front teeth, it can impact your confidence more than any other tooth in your mouth.
Dental bonding is an option we may consider, and it includes:
- Choosing a tooth-colored resign to apply to the tooth
- Hardening the resin using a special light
We'll shape the resin to match the existing tooth and the procedure will take just a few hours to complete.
Dentures
Tooth gaps caused by missing teeth are fixable using many methods, which we’ll discuss in much greater detail throughout this article, are also a reason for diastema. You can fill in these gaps with:
- Partial dentures
- Complete dentures
Dentures can act as removable implants and help fill in the gaps between your teeth. This option for filling in the gap between your teeth is an affordable one when implants or crowns aren’t in your price range.
Implants
Dental implants are one of the most advanced tooth replacement options, and we do recommend them if you have a gap in your front teeth that spans the width of an entire tooth. However, the procedure is more intense and will require:
- Placing a post in your jawbone
- Allowing the bone to heal
- Attaching the tooth to the post
Implants are a great, permanent option for anyone who is considering filling gaps between their teeth or replacing a missing tooth. We'll be more than happy to examine your mouth to determine if you’re a good candidate for dental implants or not.
Invisalign
Braces can help close gaps between teeth, and most teens and adults will choose Invisalign. Invisalign will slowly push your teeth back into place, correcting crooked teeth and leaving you with a picture-perfect smile.
You can even see amazing results closing large gaps in between your teeth.
Invisalign’s clear design allows you to fill gaps between teeth without anyone even noticing that you’re wearing them.
Orthodontic Options
In some cases, we may determine that the best option for you is orthodontic intervention. Modern techniques can be used to help anyone who has:
- Overcrowded teeth
- Crooked teeth
- Diastema
As dentists we have multiple options available, which may or may not work for your condition. Among the orthodontic options that are at our disposal include:
- Aligners, such as the Inman aligner, which will help guide the teeth back to their appropriate positions. Invisalign will fall into this category as a removable option that is quite popular.
- Conventional braces can provide similar results as aligners and are often considered one of the most cost-effective options. The braces of today do not stand out as much as the braces of the past and can be made to blend into your teeth very well.
- Lingual braces are placed on the inside of your teeth and will help restore your smile while being unseeable like regular braces.
We also recommend that you try orthodontic options to reduce gaps between your teeth before surgery. However, there are times when the only viable option that we can recommend to our patients is surgery.
Surgery
The one time when surgery may make sense is if your diastema is a result of you having an oversized labial frenum. During the surgery, the excess tissue will be removed. Once the surgery is complete, we may then rely on one of the following:
- Braces
- Other methods on this list
However, if we perform surgery on a child, they will often have the space close on its own after surgery is performed.
Treatment for Gum Disease
If gum disease is the cause of diastema, treatment will be focused on controlling the disease.
Treatment will depend on how advanced the disease has become. If it’s not too advanced, we may recommend less invasive treatment options, such as:
- Root planing: With this procedure, we smooth the surfaces of the roots of the teeth. Planing will remove bacteria and help prevent tartar and bacteria buildup.
- Scaling: This procedure removes bacteria from the gums and teeth.
- Antibiotics: Because gum disease is an infection, we may prescribe antibiotics. Antibiotic gels and rinses may be inserted into the gaps between the gums and teeth to kill the bacteria. We may also recommend oral antibiotics.
In more severe cases of gum disease, surgery may be required. Treatment options include:
- Soft tissue grafts
- Bone grafting
- Guided tissue regeneration
- Flap surgery
- Tissue-stimulating proteins
If gum disease is causing the gaps between your teeth, we will discuss your treatment options with you.
Steps to Take to Prevent Diastema
In some cases, you can take steps to prevent Diastema from occurring in the first place. However, if you have undersized teeth, missing teeth, swallowing reflex issues and a few other conditions that lead to gaps between your teeth, these steps will not prevent your condition.
With that said, these steps are the basis of a good dental hygiene routine and certainly will not hurt:
- Brush and Floss: We always advise all of our patients to brush their teeth two to three times per day. On top of brushing, you’ll also want to floss your teeth at least once per day to remove any food particles that may be stuck between your teeth. Studies show that 68% of Canadians brush at least twice per day, so be sure that you are a part of this group.
- Dental Exams: Coming in for your routine dental exam and cleaning can also help you prevent issues and identify any concerns before they become apparent to you. We can often help stave off gum disease and more with just a routine cleaning.
- Thumb Sucking: Children should be discouraged from sucking their thumbs and so should adults. This habit can lead to diastema and is one of the easiest to prevent.
If you have issues with swallow reflexes, you can seek help that will stop this from impacting your teeth.
When to See a Dentist About Diastema
Diastema can cause you to lack confidence and will often only get worse, schedule your appointment and take the first steps to say “goodbye” to the gaps between your teeth.
