Braces are highly effective for closing gaps between teeth, a condition known as diastema. Diastema refers to any space between two teeth, most often noticeable between the two upper front teeth. Orthodontic treatment uses braces to physically move teeth, correcting the visible gap and any underlying bite or alignment issues contributing to the spacing.
Common Causes of Gaps Between Teeth
Gaps often form due to a mismatch between the size of the jawbone and the teeth. If teeth are naturally too small for the jaw (microdontia), excess space results in gaps between most or all teeth. Conversely, a large jaw combined with average-sized teeth can also lead to generalized spacing.
Missing teeth (hypodontia) can create gaps when adjacent teeth shift into the vacant space. Certain oral habits, such as chronic thumb-sucking or tongue thrusting during swallowing, exert consistent pressure on the front teeth, gradually pushing them apart.
A common cause, particularly for a gap between the two upper front teeth, is an oversized labial frenum. The frenum is a band of tissue connecting the upper lip to the gum line. If it is too thick or extends too far down, it physically blocks the teeth from moving together. A minor surgical procedure called a frenectomy may be necessary to remove or reposition the tissue before or during orthodontic treatment.
The Mechanics of Gap Closure with Braces
Traditional braces close gaps by applying a continuous, gentle force to guide teeth into new positions. The system consists of brackets bonded to the teeth and an archwire that runs through them, acting as a track. The orthodontist uses the archwire to initiate and guide the sliding movement of the teeth.
This controlled movement relies on a biological process where the bone surrounding the tooth roots is constantly reshaped. Pressure on one side stimulates the removal of bone tissue (resorption), while tension on the opposite side encourages new bone tissue to form (deposition). This cycle allows the tooth to safely move through the jawbone into the desired position.
To expedite space closure, orthodontists often use specialized tools such as power chains or closing springs. A power chain is a continuous strand of elastic rings that fits over multiple brackets, applying concentrated force to pull the teeth together. Depending on the gap’s size and location, power chains can close spaces in a relatively short period, often ranging from six weeks to several months.
Alternative Treatments for Diastema
While braces offer a comprehensive solution that corrects bite and alignment, they are not the only option for gap closure, especially for smaller spaces. Dental bonding is a quick, minimally invasive procedure where a tooth-colored composite resin is applied to the sides of the teeth and sculpted to fill the gap. This method is cost-effective and completed in a single appointment, but the material may be less wear-resistant and prone to staining.
Porcelain veneers represent a more durable and aesthetic alternative. They consist of thin, custom-made ceramic shells bonded to the front surface of the teeth. Veneers are fabricated to be slightly wider than the natural tooth, concealing the space and providing a long-lasting cosmetic correction. However, this option requires the removal of a small amount of tooth enamel and is considered a permanent, irreversible treatment compared to bonding.
If a prominent labial frenum causes the gap, a frenectomy is a necessary surgical step regardless of the ultimate closure method. The procedure removes the restrictive tissue, preventing the gap from reopening after closure. For cases involving a missing tooth, a dental implant or bridge may be used to replace the tooth and eliminate the resulting space.
Post-Treatment Retention and Stability
Achieving a closed gap is only the first part of the process, as newly moved teeth have a natural tendency to shift back toward their original positions, known as relapse. This movement is driven by the memory of the soft tissues, particularly the gingival fibers surrounding the teeth, which recoil and pull the teeth apart. Therefore, a retention phase is required immediately after braces are removed to stabilize the result.
Retention involves specialized appliances that hold the teeth in their corrected alignment. Long-term retention is often advocated following gap closure to ensure the stability of the final outcome.
Fixed Retainers
Fixed retainers are thin wires bonded directly to the back surfaces of the teeth. They offer continuous, non-removable support.
Removable Retainers
Removable retainers, such as clear plastic aligners or Hawley retainers, must be worn diligently. They are typically worn full-time at first and then nightly to counteract soft tissue pressure.