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Diastema (Gap Between Teeth)

A diastema, more commonly known as a space or gap between two teeth, can be a simple cosmetic issue. The most recognizable diastema is between the front two teeth like those you see in celebrities such as Michael Strahan, Madonna, and Niecy Nash. However, gaps can occur between any two teeth, and for a variety of reasons. You may notice a space when brushing or flossing, or your dentist can see spaces during an examination. At that point, they can diagnose and come up with a treatment plan for you.

Diastemas or spaces develop for a few other reasons as well.

  • Children can experience a diastema as primary teeth fall out, though in most cases, these spaces close when the permanent teeth erupt. 
  • When teeth are missing or smaller than others, a diastema can develop.
  • An oversized labial frenum can cause a diastema. The labial frenum is the piece of tissue that attaches the inside of your upper lip to the gum just above your two top front teeth. In some situations, the labial frenum grows further down and interferes with closing the space between the two front teeth.
  • Habits can also lead to gaps between the teeth. Thumb sucking tends to push the front teeth forward, creating gaps.
  • Spaces can develop from an incorrect swallowing reflex. For most people, the tongue presses against the roof of the mouth (palate) during swallowing. Some people develop a different reflex known as a tongue thrust, which can cause spaces to develop: When they swallow, the tongue presses against the front teeth, over time pushing them forward.
  • Periodontal (gum) disease might result in the loss of the bone that supports the teeth and cause tooth loss or tooth movement. This results in gaps between teeth.

Symptoms

The primary indication of a diastema is a visible gap between teeth. They may show clearly as a cosmetic issue, or you may find them as you brush and floss your teeth. A dentist will see gaps during any regular exam and assess whether or not treatment is even needed.

Prevention

Not all spaces are preventable. For example, if the reason for a space is a missing tooth or if you have some teeth that are smaller when they come in and create a gap, then this is a physical, genetic issue that cannot be prevented but is treatable.

Maintaining your gum health is essential to good oral health. Regular flossing and brushing will help to prevent periodontal disease and its related bone loss. Good oral hygiene can't eliminate all potential causes of periodontal disease, but it is your first line of defense. 

People with a tongue thrust habit can re-learn to swallow by pushing their tongue up against their palate. Breaking this habit can prevent the widening of the spaces between teeth.

When To Call a Professional

If there is an issue with your teeth or your children's teeth involving a diastema, talk with your dental professional. He or she will determine the reason for the space and may refer you to an orthodontist, a specialist in treatment with braces. The American Association of Orthodontists recommends that an orthodontist evaluate children by age 7. Treatment (if needed) may not begin right away as it depends on what the issue is as to the timeline of how the treatment should occur. You and the orthodontist will discuss the overall treatment plan.

If your space results from periodontal disease, your dentist may refer you to a periodontist for an evaluation.

What Are My Diastema Treatment Options?

Once your dental professional has determined the reason for your diastema, you can discuss a treatment plan. Options may include:

  • Orthodontic treatment - If there is an issue with your teeth or your child's teeth involving a diastema, talk with your dental professional. He or she will determine the reason for the space and may refer you to a specialist, such as an orthodontist or periodontist. Orthodontists specialize in treating bites, gaps, and may at times use braces to improve your smile. If treatment is needed, you and your orthodontist will discuss the overall treatment plan. The American Association of Orthodontists generally recommends that an orthodontist evaluates children by the age of 7.
  • Your dentist might also refer you to a periodontist for further evaluation. Periodontists have received extensive training in the prevention, diagnosis, and treatment of periodontal disease.
  • Cosmetic dentistry - If your lateral incisors are too small, your dentist may suggest widening them using crowns, veneers, or bonding.
  • Dental surgery - If a large labial frenum is causing the gap, you can fix the frenum through a procedure called a frenectomy. A frenectomy, done on an older child or an adult, the space may require braces to close the gap.
  • Periodontal treatment - A gap caused by periodontal disease, may require treatment by a dentist or periodontist, a gum specialist. A periodontist can review and determine the best course of action for care. By restoring gum health, in many cases, braces can be used to move the teeth into place. You can use a splint or retainer to attach to the teeth and prevent them from moving again. In some cases, it may require a bridge, dental implants, or a partial denture to close the space.

Prognosis

There are many options for treatment, and most diastemas are not permanent. After closing the diastema (gap) through orthodontics or other treatment the, space will tend to stay closed. However, to help prevent the gap from coming back, it is essential that you follow the directions given by your dentist. If the gaps in your or your child's teeth are a cause for concern, even if the concern is only cosmetic, you can take the first step of a conversation with your dentist and be on your way to the smile you want in no time.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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