A gap between teeth, technically known as a diastema, is a common finding, most often noticed between the two upper front teeth. While many people embrace this feature, others seek professional methods to close or conceal the space for aesthetic or functional reasons. The treatment approach depends entirely on the underlying cause, which necessitates a thorough examination by a dental professional.
Identifying the Cause of the Gap
Consulting a dental professional is the necessary first step because the appropriate treatment is dictated by the gap’s origin. Diastema can be traced to several biological and structural factors, such as a disproportionate relationship between the size of the teeth and the jawbone, where smaller teeth create natural spacing.
The gap may also result from an oversized labial frenum, the tissue extending from the upper lip down to the gum between the front teeth. If this tissue is too thick or low, it physically prevents the teeth from coming together. Missing or undersized teeth, particularly the lateral incisors, can also lead to spacing issues. Furthermore, habits like tongue thrusting or chronic thumb-sucking exert pressure that gradually pushes teeth apart. If an enlarged frenum is the cause, a minor surgical procedure called a frenectomy may be needed before or during the closure process.
Cosmetic Treatments Using Dental Materials
For patients with smaller gaps or those seeking a faster solution, cosmetic treatments offer a way to conceal or fill the space without changing the entire dental arch. Dental bonding is a popular, less invasive option often completed in a single visit. This procedure involves applying a tooth-colored composite resin material directly to the edges of the teeth, then shaping and polishing it to close the gap.
The composite material bonds to the tooth structure, offering an immediate cosmetic improvement. While bonding is generally more affordable and requires no removal of healthy tooth enamel, the material is less durable and more susceptible to staining compared to porcelain. Bonding typically lasts between three and seven years before needing repair or replacement.
Veneers, made from composite or porcelain, provide a more durable and long-lasting cosmetic solution. Porcelain veneers are custom-made, thin shells that cover the entire front surface of the tooth, widening its appearance to eliminate the space. Applying porcelain veneers usually requires two appointments and involves removing minimal enamel for a proper fit. Porcelain offers superior resistance to staining and possesses a natural translucency that closely mimics real enamel, with a lifespan often ranging from four to twelve years or more.
Orthodontic Methods for Closure
Orthodontic treatment focuses on physically moving the teeth into a new, stable position, which is necessary when the gap is large or involves a larger bite issue. Traditional braces utilize brackets and archwires to apply continuous, controlled forces, shifting the teeth through the bone. This method provides precise control over tooth movement and is used for larger diastemas or cases with underlying malocclusion.
Clear aligners offer a more discreet alternative, using a series of custom-made, clear plastic trays to gradually move the teeth. Aligners must be worn for approximately 20 to 22 hours per day to be effective. While popular for their near-invisibility and removability, they may be less suitable for complex movements. Treatment duration depends on the severity of the gap, but simple midline closures can sometimes be completed within six months to a year.
The final phase of orthodontic treatment is retention. Teeth have a natural tendency to shift back toward their original positions, known as relapse. To prevent the gap from reopening, patients must wear a retainer, which may be a removable clear appliance or a fixed wire bonded to the back surface of the teeth. A long-term commitment to retainer wear is required to maintain the result.
Dangers of Home Treatment Options
The desire for a quick fix has led to the proliferation of do-it-yourself (DIY) methods for gap closure, which carry significant risks and should be avoided. Attempts to close a diastema using household items, such as rubber bands, elastic hair ties, or fishing line, exert uncontrolled and damaging forces. The primary danger lies in the elastic slipping below the visible crown and migrating into the gum line.
Once lodged beneath the gum, the elastic can destroy the soft tissue and surrounding bone structure supporting the tooth. This leads to severe gum recession, infection, and irreversible damage to the tooth’s root, sometimes resulting in teeth becoming loose or falling out. Furthermore, using unmonitored mail-order aligner kits without professional oversight can interfere with the bite and cause unintended nerve damage or misalignment. The cost of repairing the severe damage caused by DIY methods far exceeds the expense of professional dental treatment.