When a gap between teeth is normal
During the period of teeth change, almost every second child has a gap between the upper central incisors. This is called a physiological diastema: the rudiments of the lateral incisors and canines press on the roots of the central teeth and slightly spread their crowns. When the side teeth erupt, the gap closes on its own, usually by age 9–11. Therefore, for a child without other problems, there is no need to rush into treatment. You should be concerned if the gap is very wide, if a massive frenulum is visible next to it, or if the gap remains after the eruption of the fangs.
- Physiological diastema is a common finding at 6–9 years of age
- Usually closes after eruption of fangs
- Requires only observation by a dentist
- An orthodontic examination is useful at 6–7 years of age
- Reason to be wary - a very wide gap
Causes in adults
The most well-known cause is a low-lying, dense frenulum of the upper lip, which wedges between the incisors and prevents them from coming together. The second is a discrepancy in size: narrow teeth in a wide jaw inevitably leave gaps. The gap can hold a supernumerary tooth located between the roots of the incisors - it can only be found in the picture. In adults, gaps sometimes reappear due to periodontitis, when the ligamentous apparatus weakens and the teeth fan out, as well as due to the loss of chewing teeth and the displacement of the remaining ones.
- Massive low attached frenulum of the upper lip
- Discrepancy between teeth and jaw size
- Supernumerary tooth between incisors
- Edentia of lateral incisors
- Periodontitis with teeth discrepancy
- Loss of chewing teeth
- Habit of inserting tongue between teeth
- Hereditary structural features
What can interfere with
For most people, diastema is a matter of appearance, and many quietly live with it all their lives. However, with wide gaps, functional difficulties are possible: a whistling tone when pronouncing whistling sounds, food getting stuck, increased load on the gingival papilla between the incisors. If gaps appear in an adult due to periodontitis, what is more important is not aesthetics, but treatment of the cause - otherwise the teeth will continue to diverge and become mobile. The condition of the gums is assessed separately, because the open interdental space is more easily injured.
- Aesthetic discomfort when smiling
- Whistling sound when talking
- Food getting stuck between teeth
- Trauma to the gingival papilla
- Progression with periodontitis
- Displacement of adjacent teeth
Diagnostics
The dentist measures the width of the gap, evaluates the shape and size of the incisors, the position of the frenulum and the condition of the gums. A targeted image shows whether there is a supernumerary tooth between the roots and whether the bony septum is destroyed. A panoramic photograph is needed if orthodontic treatment is planned. The orthodontist takes impressions, makes diagnostic models and a photo protocol to calculate whether there is enough space and how the smile will change. If periodontitis is suspected, the depth of the pockets and tooth mobility are additionally measured.
- Gap Inspection and Measurement
- Evaluation of the frenulum of the upper lip
- Spot X-ray
- Panoramic shot when planning braces
- Diagnostic models and photo protocol
- Periodontal assessment
Ways to close the gap
A narrow gap is most often closed with a composite restoration in one visit or with ceramic veneers if a more durable and aesthetic result is desired. It is more correct to close a wide diastema orthodontically - with braces or aligners: this way the teeth maintain their natural proportions. If the frenulum is in the way, frenuloplasty is performed before or during orthodontic treatment; The supernumerary tooth is removed. After any movement of the teeth, a retainer is required, otherwise the gap returns. In case of periodontitis, the gums are treated first, and only then aesthetic problems are solved.
- Composite restoration of incisors
- Ceramic veneers
- Braces or aligners
- Upper lip frenuloplasty
- Removal of a supernumerary tooth
- Treatment of periodontitis before aesthetics
- Fixed retainer after treatment