Gaps between teeth, often called diastemas, are common and can lead to aesthetic concerns or questions about oral health. They can develop for various reasons, from inherited traits to changes in the oral environment over time. Understanding these factors can help address concerns and guide appropriate actions.
Common Causes of Gaps
A frequent reason for spaces between teeth is a natural anatomical variation, most commonly observed between the two upper front teeth. This gap, known as a diastema, can occur when the jawbone is larger than the combined width of the teeth, or due to genetic predisposition.
Gum disease, specifically periodontitis, is a common cause for teeth shifting and creating new or larger gaps. Chronic inflammation and infection of the gums can destroy the alveolar bone that supports the teeth. As this bone diminishes, teeth lose their stable foundation, becoming mobile and drifting apart or forward.
Tooth movement can also arise from several factors, even after orthodontic treatment. If retainers are not worn consistently after braces, teeth can revert to their original positions, a phenomenon known as orthodontic relapse, leading to gaps reappearing. Habits such as tongue thrusting, where the tongue pushes against the front teeth during swallowing, can exert continuous pressure, slowly moving teeth apart. Chronic teeth grinding (bruxism) or clenching can also place excessive forces on teeth, contributing to their migration and the formation of spaces.
The absence of teeth also plays a role. When a tooth is lost due to extraction or trauma, adjacent teeth no longer have a neighboring contact point. Over time, these teeth can drift or tilt into the empty space, causing new gaps to open elsewhere in the dental arch. This drifting can disrupt natural alignment and bite.
An anatomical structure called the labial frenum can also contribute to gaps, particularly between the upper front teeth. This band of tissue connects the inside of the upper lip to the gum line between the two central incisors. If this frenum is unusually large or attaches too low on the gum, it can pull the teeth apart. Discrepancies in tooth size, such as naturally smaller teeth like “peg laterals” or unusual shapes, can also result in spaces even with normal jaw alignment.
When to Seek Professional Advice
Consult a dental professional if you notice new or widening gaps, especially if accompanied by other symptoms. Signs like bleeding or swollen gums, persistent bad breath, or increased tooth sensitivity can indicate underlying gum disease. These symptoms suggest an inflammatory process that requires prompt evaluation to prevent further bone loss and tooth mobility.
Tooth pain, discomfort during chewing, or teeth feeling loose also warrant a dental visit. Rapidly appearing or widening gaps can signal progressive issues a dentist can diagnose through examination and X-rays. A professional assessment can pinpoint the cause of the gaps and determine the health of surrounding bone and gum tissues. Addressing concerns early can prevent more extensive problems and preserve oral health.
Treatment and Management Options
Addressing gaps depends on the underlying cause, as determined by a dental professional. Orthodontic treatment, using traditional braces or clear aligners, is a common approach to move teeth into alignment and close spaces. This method is effective for correcting misalignment, orthodontic relapse, or spaces caused by tooth size discrepancies.
For smaller gaps, especially in the front of the mouth, cosmetic options like dental bonding or porcelain veneers are effective. Dental bonding involves applying a tooth-colored composite resin to the tooth surface and shaping it to close the gap. Porcelain veneers are custom-made, thin shells bonded to the front of teeth, altering their size and shape to eliminate spaces.
If an overly large or low-attached labial frenum pulls teeth apart, a minor surgical procedure called a frenectomy can be performed. This procedure removes or repositions the frenum, allowing teeth to move closer, often with orthodontic treatment. When gum disease is the culprit, treating the periodontal condition through procedures like scaling and root planing (deep cleaning) is important. This treatment removes bacteria and tartar, reducing inflammation and stabilizing supporting bone, which prevents further tooth movement.
Replacing missing teeth also prevents adjacent teeth from drifting and creating new gaps. Dental implants, artificial tooth roots placed into the jawbone, or fixed dental bridges, which span the gap of a missing tooth, can restore the dental arch. These options help maintain the spacing and alignment of remaining teeth.