Diastema (gap between the teeth)

Recommended treatment methods

A diastema, or dental gap, is a space wider than 0.5 millimetres that appears between the teeth in both children and adults. A diastema is the space that forms between the upper front teeth, commonly known as a ‘gap’, whilst dental gaps are the spaces that appear between any other two teeth.

Although many people consider a gap between the front teeth to have a ‘certain charm’, a diastema is regarded as a dento-maxillary anomaly, as the teeth are not properly aligned on the dental arch or the gap arises due to the congenital absence of a tooth (anodontia).

According to specialists, a diastema wider than 2 millimetres in the mixed dentition is unlikely to close on its own, and will therefore persist even after the permanent teeth have come through.

A study conducted in 2003 reported that the prevalence of diastema varies between 1.6% and 25.4% in adults, depending on age group and geographical region.

Diastemas and dental gaps can be caused, amongst other things, by a mismatch between the size of the jaw and the size of the teeth, an oversized frenulum, and periodontal disease.

Here are the main causes of diastema:

The size of the teeth in relation to the jawbone

If a person’s teeth are too small in relation to the size of the jawbone, or if some are smaller than others, gaps between the teeth may appear. For example, if the upper lateral incisors are missing or relatively small, a gap may develop between the central incisors – a diastema.

Oversized labial frenulum

The labial frenulum is the membrane that normally extends from the inside of the upper lip to the gum above the central incisors. If this tissue is oversized, it can lead to the development of a diastema.

Gum infection

Tooth movement can be a sign of gum infection. Gingivitis or periodontal disease can result in bone recession or loss of the bone supporting the teeth, and this can lead to a gap between the teeth (dental diastema).

Bad habits

A diastema can also be caused by bad habits such as infantile swallowing, thumb-sucking or lip-sucking.

In infants, swallowing is performed with the tongue pushed between the widely spaced dental arches, whereas adult swallowing (which occurs after 1–1.5 years) is performed with the arches in contact. Swallowing becomes a bad habit that can lead to the development of dental gaps when infantile swallowing (the tongue pressing against the front teeth) persists beyond the period when the child should have transitioned to adult swallowing.

Loss of primary teeth

When milk teeth fall out, children may develop temporary gaps, but these will be closed once the permanent teeth come through.

Dentists consider this to be a normal part of a child’s development, so treatment is usually not necessary.

Effective treatment for diastema requires an accurate diagnosis and appropriate intervention, depending on the cause of the gap between the teeth. To meet patients’ needs, dentists may recommend a range of orthodontic treatments or prosthetic restorations following an examination at a dental clinic.

Treatment with braces

Thus, if the diastema is caused by a mismatch between the size of the teeth and that of the jaw, the gap cannot be corrected without the treatment recommended by the orthodontist.

The most recommended treatment for a diastema is braces.

Brackets apply pressure to the teeth, gradually reducing the gap between them over time. Because any movement of the teeth affects the dental arches as a whole, the orthodontist may recommend a full set of braces rather than just correcting the spaced teeth.

Diastemas can also be corrected using removable or invisible braces, such as Invisalign®, considered one of the most modern treatments for straightening teeth.

Treatment with prosthetic work

If the lateral incisors are too small, the dentist may suggest dental veneers. To cover a diastema where teeth are missing, a more complex dental procedure may be required, which may include dental implants or dental crowns.

Treatment via frenectomy

If the diastema is caused by an oversized frenulum, it can be reduced through a surgical procedure called a frenectomy. If the procedure is performed on a young child, the diastema may close on its own. If the procedure is performed on an older child or an adult, the orthodontist may recommend braces as an adjunctive treatment to correct the diastema.

Periodontal treatment

If the diastema is caused by periodontal disease, the patient must follow the treatment recommended by the periodontist to restore the health of the gums and teeth before consulting an orthodontist to correct the gap.

People with dental gaps or spaces between their teeth should be aware that it is essential to consult a dentist for expert advice on the most suitable treatment method.

Come to DENT ESTET and find out from our specialists in orthodontics and dentofacial orthopaedics, or our cosmetic dentistry specialists, which option is best for you.