A gap or space between teeth is known by the technical term, diastema. While this condition can occur between any two teeth, it is most frequently observed between the two upper front teeth (midline diastema). Diastema affects both children and adults and can be attributed to inherited physical traits, acquired habits, or underlying health issues. Understanding the specific cause is the necessary first step, as the underlying reason dictates the most appropriate and effective treatment plan.
Developmental and Size Factors
The structure and proportion of the teeth and jawbone are often the primary determinants of spacing. When teeth are naturally too small for the size of the jawbone, a condition known as a tooth-to-jaw size discrepancy occurs. This proportional mismatch means there is simply more dental arch space available than the teeth can occupy, resulting in gaps. Genetic factors play a significant role in this size relationship, meaning a family history of spaced teeth can increase the likelihood of developing a diastema.
Another structural cause involves the number and size of individual teeth. The absence of a tooth (hypodontia) or the presence of abnormally small teeth (microdontia) can create or widen spaces. This is often seen when the upper lateral incisors, the teeth next to the two front teeth, are undersized or missing entirely, causing the central incisors to drift apart.
In young children, temporary gaps are a regular part of oral development as baby teeth are replaced by permanent ones. This spacing, sometimes called the “ugly duckling stage,” usually closes naturally as the larger permanent teeth erupt and the jaw continues its growth and maturation. If a gap persists into adulthood, however, it is likely due to permanent structural or size factors.
Impact of Soft Tissues and Oral Habits
Dynamic forces generated by soft tissues and repeated behaviors can exert enough pressure to push teeth apart over time. The labial frenum is a band of tissue connecting the upper lip to the gum between the two upper front teeth. If this tissue is unusually thick or extends too far down, it physically blocks the teeth from coming together, creating a midline diastema.
A reflexive habit called tongue thrusting also contributes to teeth gapping, particularly in the lower jaw. When swallowing, the tongue pushes forward against the front teeth instead of pressing against the roof of the mouth. This consistent forward pressure, applied hundreds of times daily, slowly forces the teeth outward and creates spaces.
Prolonged habits from early childhood, such as thumb sucking or extended pacifier use, apply similar mechanical pressure. The sustained presence of the thumb or pacifier pushes the front teeth forward and apart. If these habits continue past the age when permanent teeth erupt, they can cause lasting misalignment and spacing issues.
Gapping Caused by Gum Health Issues
In adults, the sudden appearance or widening of gaps is frequently a symptom of underlying disease affecting the support structures of the teeth. Periodontal disease (gum disease) involves chronic inflammation that progressively damages the bone and tissue holding the teeth in place. The destruction of the alveolar bone, which anchors the tooth roots, compromises tooth stability.
When bone support is lost, teeth become mobile and are no longer held firmly in position. This loss of attachment allows for pathological tooth migration, causing teeth to drift or shift. Natural pressures from chewing and the tongue, normally balanced by strong bone structure, now push the weakened teeth apart, resulting in new or widening gaps.
This gapping is often accompanied by signs of advanced gum disease, such as swollen gums, bleeding when brushing, and increased tooth mobility. Treating the periodontal disease is the necessary first step to stabilize the teeth and prevent further migration before any cosmetic correction can be considered.
Addressing the Gaps
The choice of treatment for teeth gapping depends entirely on the root cause identified by a dental professional. For gaps caused by a tooth-to-jaw size mismatch or general misalignment, orthodontics remains the most common solution. Methods like traditional braces or clear aligners work by applying continuous, controlled forces to physically move the teeth together and close the space.
For smaller gaps, especially those caused by undersized teeth, restorative options offer a faster correction:
- Dental bonding involves applying a tooth-colored composite resin to the edges of the teeth.
- The resin is then sculpted to fill the space.
- Porcelain veneers are custom-made shells that cover the entire front surface of the tooth.
- Veneers improve size and shape, effectively closing the gap.
If an abnormally thick or low-positioned labial frenum is the cause, a minor surgical procedure called a frenectomy may be recommended to remove or reposition the tissue. This procedure eliminates the physical barrier and is often followed by a short course of orthodontics to fully close the resulting space. Consulting with a dental professional is necessary to accurately diagnose the specific mechanism and determine the most effective treatment approach.