Braces are a highly effective and common solution for closing spaces between teeth, known as a diastema. A dental gap is any space between two or more teeth, most frequently occurring between the two upper front teeth. Orthodontic treatment physically moves the teeth along the jawbone into alignment, eliminating the space. The specific treatment plan depends entirely on the underlying reason for the gap’s existence.
Understanding the Causes of Dental Gaps
A diastema often results from a disproportionate relationship between the size of the teeth and the jawbone. If teeth are naturally too small (microdontia) or the jaw is too large, spaces occur. Gaps can also be caused by missing teeth (hypodontia) or by smaller-than-average teeth, which allows neighboring teeth to shift.
Certain oral habits exert pressure that pushes teeth apart over time. These include chronic thumb-sucking, tongue thrusting (where the tongue pushes against the front teeth during swallowing), or prolonged pacifier use. Another cause is an oversized labial frenum, the band of tissue connecting the upper lip to the gums above the front teeth. If this tissue is too thick or attaches too low, it can physically prevent the central incisors from coming together.
How Traditional Braces Close Gaps
Traditional braces close gaps by applying light, continuous mechanical pressure, initiating a biological response in the jawbone. Fixed brackets and archwires transmit controlled force to the teeth, triggering alveolar bone remodeling necessary for orthodontic movement.
On the side of the tooth root where pressure is applied, specialized cells called osteoclasts break down the surrounding bone tissue. This bone removal creates space for the tooth to move into the gap. Simultaneously, on the opposite side where tension is created, osteoblasts build new bone tissue.
This coordinated breakdown and rebuilding allows the tooth to safely travel through the jawbone. Orthodontists use tools like elastic power chains or specialized wire bends (closing loops) to generate the precise pulling force required. Treatment can take several months to over a year, depending on the gap size and the patient’s biological response.
Other Treatment Options Beyond Braces
Braces are not the only option for correcting a diastema; the best choice depends on the gap’s size and cause. Clear aligners, made of progressive plastic trays, can effectively close small to moderate gaps. Aligners move the teeth with less visibility than traditional braces, making them a popular aesthetic choice.
For very small gaps, cosmetic treatments that do not involve moving the entire tooth are often recommended.
Cosmetic Solutions
Dental bonding involves applying a tooth-colored composite resin directly to the sides of the teeth, which is then sculpted and hardened to fill the space. Porcelain veneers offer a durable solution, as thin shells are custom-made and bonded to the front surface of the teeth to effectively widen them and eliminate the space.
Frenectomy
If the gap is caused by an oversized labial frenum, a minor surgical procedure called a frenectomy may be necessary. This procedure removes or reduces the excess soft tissue pulling the teeth apart. A frenectomy is typically performed before or during orthodontic treatment to prevent the gap from reopening after closure.
Maintaining Gap Closure After Treatment
After a dental gap is closed, the surrounding bone and gum tissues require time to stabilize around the newly positioned teeth. This maturation period makes the retention phase necessary. Without retention, teeth have a high tendency to relapse, meaning the gap may reopen due to the memory of the periodontal fibers.
Patients receive a retainer, which can be either removable or fixed. Removable retainers, such as Hawley or vacuum-formed trays, require strict patient compliance to prevent relapse. Fixed retainers are often preferred for closed diastemas because they are permanently bonded to the back surface of the teeth. This thin wire provides continuous support across the closed space, offering superior long-term stability.