A diastema is the technical term for a gap or space between two teeth, most commonly seen between the two upper front teeth. While many people seek orthodontic treatment to close a diastema, some patients wish to correct misalignments while deliberately preserving this unique aesthetic feature. Maintaining a dental gap during braces treatment is possible, but it moves the process from standard alignment to a highly specialized and controlled procedure. This goal requires meticulous planning, customized hardware, and a commitment to lifelong retention to ensure the gap remains stable alongside the newly straightened teeth.
Orthodontic Planning to Maintain a Diastema
The journey to preserving a diastema begins with a thorough diagnostic phase to understand the underlying cause of the gap. Diastemas can result from natural spacing, a discrepancy between jaw size and tooth size, or an oversized labial frenum—the small band of tissue connecting the upper lip to the gum. If an enlarged frenum is the cause, minor surgery called a frenectomy may be necessary to remove the tissue that could cause the gap to close or relapse.
Establishing the gap as a non-negotiable treatment objective guides all subsequent decisions. The orthodontist uses specialized imaging, such as three-dimensional cone-beam computed tomography (CBCT) scans and digital intraoral scans, to precisely map out tooth movement. Treatment simulation software calculates the exact amount of space that must be maintained while all other teeth are moved into ideal alignment. This planning ensures the bite (occlusion) is functionally corrected and dictates the customized approach needed for active treatment.
Specific Techniques for Gap Preservation During Treatment
During the active phase of wearing braces, the orthodontist utilizes specific mechanical techniques to ensure the gap remains open. The placement of brackets on the teeth adjacent to the gap is often modified, sometimes by bonding them further away from the midline. This altered placement helps control the direction of the forces applied by the archwire.
The archwire may be customized with precise bends or loops designed to prevent the central incisors from migrating toward one another. Open-coil springs may also be employed on the archwire, placed between the bracket of the gapped tooth and its neighbor. This spring constantly exerts a gentle outward force, actively maintaining the space against the natural tendency of the teeth to drift together.
Another method involves using specialized power chains or elastics configured to pull surrounding teeth toward the back of the mouth or away from the central gap. In certain situations, the two teeth forming the diastema may not receive brackets at all, creating a bracket-less segment that isolates them from alignment forces, allowing surrounding teeth to be moved independently.
Long-Term Maintenance After Braces
Once the braces are removed and the intentional gap is achieved, the teeth face a strong tendency for relapse. This is due to tissue memory, particularly from the periodontal fibers surrounding the teeth, which constantly attempt to pull the teeth together and close the space. Therefore, retention is significantly more critical when a space has been intentionally left open.
To counteract this relapse, a permanent retention method is almost always required to stabilize the preserved diastema. The most effective solution is a bonded lingual retainer, a thin, discreet wire custom-fitted and permanently glued to the tongue-side surface of the two teeth that form the gap. This fixed wire acts as an invisible scaffold, continuously holding the teeth in their final, separated position. While removable retainers are also used, they are generally less reliable for an intentional diastema because their effectiveness relies entirely on patient compliance.