Diastema is the space or gap between at least two teeth, primarily affecting the anterior upper teeth. The space size varies from patient to patient, based on the cause and other factors. For some people, a diastema improves the beauty of their smile, so they are comfortable with it. However, some become self-conscious of their smile and general appearance because of the condition, leading them to seek treatment. Addressing diastema is cosmetic and helps improve speech, oral hygiene, health, and confidence. If you are considering treatment for diastema, here is what you need to know about the condition and how a dental expert can assist.
Overview of Diastema
Diastema is a generalized or localized space between two teeth. While you can develop these gaps anywhere on the jawline, the most common diastema develops between the two central incisors of the anterior upper teeth, hence the name midline diastema.
The size of the spaces between teeth varies from one patient to another. Some are large; others are small. In some patients, diastema can be frustrating because of the social embarrassment. Because of the adverse effects the condition has on some patients, it triggers them to seek treatment to improve their smile.
The scope of diastema’s clinical significance extends past aesthetics. While many patients undergo treatment for enhanced appearances, detailed evaluation is critical to establish whether there could be another cause of the gaps. The condition could indicate an underlying oral concern like gum disease, where advanced periodontitis causes jawbone loss and subsequent teeth migration, creating spaces between two or more teeth. Although cases of diastema stemming from periodontitis are minimal, if you start developing diastema at 30 or above, or the existing spaces begin to widen, it could be a sign of chronic periodontal disease, hence the need for a detailed evaluation.
Diastema affects people of all ages, although it is more prevalent among children than in adults. Besides, maxillary midline diastema (MMD) is more prevalent in the black population than in the White and Asian populations.
The condition is prevalent, such that in some families, the gaps are inherited traits dictated by genetic patterns. Diastema is very common, and many dental practitioners consider it a variation in the standard development of the dental structure.
In most cases, diastema does not adversely impact your oral health. However, when the gaps start developing or enlarging in adulthood, it could indicate chronic periodontitis. You need a thorough dental evaluation to identify the gum disease and receive early treatment.
Diastema Symptoms
A healthy mouth's common sign of diastema is gaps between two teeth. However, in rare cases, the gaps can indicate chronic gum disease. The gaps can trigger or exacerbate chronic gum diseases and functional problems in the mouth.
When the condition stems from gum disease, the common symptoms you might experience include pain or discomfort, gum inflammation, redness, and receding gums, to mention a few.
Physiological causes are the main reason many dental patients, especially adults, seek treatment for diastema. If patients consider the spaces embarrassing, their confidence drops, making speaking or smiling in social spaces challenging.
If your MMD is extremely large, it can allow unchecked airflow, creating an escape path for the air in the mouth, leading to speech problems. Therefore, speech issues can also be a sign of diastema. If the gap impedes your speech, correcting it can restore everyday speech.
Diastema Causes
MMD is multifactorial and can stem from an interplay of gingival tissue, skeletal, developmental, and functional factors that interrupt normal dental structure development. To successfully correct the condition, it is crucial to identify its cause and develop a practical therapeutic approach. The common causes of diastema are:
Small Baby or Adult Teeth
When baby teeth begin to pop in children, sometimes they can be too small to fill the entire jawbone space, creating tooth gaps. Besides, when children start losing their baby teeth and the adult teeth start to come in, if the adult teeth replacing the baby ones are too small, they do not cover the entire space left by the baby teeth, leading to diastema.
Dental development in children and teenagers causes tremendous transformation. The child loses the baby teeth and develops adult teeth. The baby naturally creates tooth spacing. When a child loses a baby tooth too early and it takes a long time for the permanent ones to pop and take up the roots of the primary teeth, the adjacent teeth start shifting towards the open socket, leaving behind spaces. Besides, when the permanent tooth starts to erupt, it might be affected by the adjacent teeth that have shifted, leading to additional oral concerns like misalignment and crowding.
Genetic Influence
Genetics also has a hand in diastema development. In some families, MMD is a family feature, passed down from generation to generation because of genetic predisposition. If gaps between teeth are common in your family and have been observed in previous generations, then it could be because of the genes. In the same way genes influence the eye color and nose shape in families, they can also impact the width and size of the teeth and jawbone.
Habitual Factors, Like Tongue Thrusting
Oral habits like tongue thrusting or thumb sucking exert constant and abnormal force on the anterior incisors, pushing them apart, interfering with the natural approximation, and interrupting the standard equilibrium often kept constant by the tongue, cheeks, and lips. If you have these oral habits, you could develop a diastema.
Using pacifiers can also exert abnormal pressure on the teeth, causing them to grow apart.
An Oversized Labial Frenulum
The frenulum is the connective tissue linking the upper lip to the gums close to the central incisors in the anterior teeth. The connective tissue band protrudes from the alveolar ridge to the incisive papilla when it is too thick. The band acts as a barrier to the central incisors in the upper anterior teeth, preventing them from correctly moving together, leading to diastema.
Advanced Periodontitis
Dental patients with chronic periodontitis are also at risk of developing diastema. The conditions erode the gingiva tissue, cause tooth loss, and lead to loss of jawbone density. Losing alveolar bone density causes tooth migration, leaving significant gaps behind. If you already have a natural diastema, the tooth migration caused by bone loss will enlarge the gaps further, increasing the self-consciousness of your smile.
Understanding the cause of your condition is critical in administering the proper treatment, as therapeutic solutions vary based on the cause of the gaps.
Diagnosis and Clinical Evaluation of Diastema
Dental experts diagnose diastema through routine dental examinations, although sometimes they go beyond the visual examination to establish the cause of the condition and devise a precise management plan.
When you visit the dentist for an assessment, they will request your dental healthcare records and evaluate them to determine if you have any bony or soft tissue defects that could be causing the gaps. Additionally, the dentist will measure the gap using a digital caliper. You will be diagnosed with a diastema if it exceeds the standard width. The size of the gaps guides your dental expert in creating a management plan.
Therapeutic Management of Diastema
There are many ways to correct a diastema, depending on the cause. You can use restorative dentistry solutions, orthodontic solutions, or surgical solutions.
Restorative Solutions
You can correct MMD by increasing the width of the teeth to close gaps. However, you can only use restorative solutions if the treatment is purely cosmetic. The common restorative treatments are:
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Dental Bonding
In dental bonding, your dentist directly applies bonding material, such as composite resin, on the visible surface of the central incisors or other affected teeth. The bonding material mimics the color of the natural teeth. So, you not only manage the condition, but you also improve the appearance of your smile. Dental bonding is preferred by many because it is minimally invasive. Little or no tooth preparation is required, helping you preserve the structural integrity of your teeth. However, you can only use this option if your spaces do not exceed 2 mm. Also, you cannot use the treatment if soft tissue defects, like the oversized frenulum, cause the gap. You will need surgery to remove the oversized band before dental bonding.
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Porcelain Veneers
Porcelain veneers are ultra-thin, bespoke ceramic shells bonded to the tooth's anterior surface. These are more durable and appealing than dental bonding. Your dentist can use them for diastema closure, giving your teeth a more uniform appearance. Even though porcelain veneers are more durable and provide color stability, they are more expensive and invasive, as the dentist must reshape the teeth to accommodate the shells.
Discuss these restorative solutions with your dentist and select the most suitable option.
Orthodontic Solutions
Orthodontic solutions involve shifting or migrating teeth for diastema closure. The available devices you can use to manage the disease are:
Traditional Braces
Traditional or metal braces are orthodontic treatments that correct dental malocclusions, like gapped teeth. Therefore, if you have a large diastema, your dentist can use metal braces to fix the problem. Mild gaps do not require braces, as these are applied in severe cases. The devices have metal brackets attached to the teeth using rubber bands to retain the archwires. The dentist adjusts these wires from time to time to migrate the teeth to the desired position. As the teeth shift, the gap closes until the right fit is attained.
Clear Aligners or Invisalign
For mild diastema, you can use invisible or clear aligners. These porcelain trays put constant pressure on the teeth to move in the desired direction. Removable and frequently replaced with trays of different sizes, depending on the achieved movement.
Orthodontic solutions are expensive, with treatment ranging from $3,000 to $5,000, depending on your unique situation. Therefore, compare quotes from different orthodontists, select those with reasonable rates, and offer uncompromised services. Also, find out if your health insurance can cover part of or the full cost of treatment.
Surgical Management
When an oversized frenulum causes the gaps, surgical intervention will be necessary. One of the surgeries you might require is a frenectomy to remove the excess band of connective tissue that is creating the gap between the central incisors in the upper anterior teeth. Frenectomy is only necessary after full diastema reclosure using orthodontic solutions to discourage postoperative tissues that could interfere with tooth movement during an orthodontic procedure.
However, when the band is too traumatized or swollen, it can cause severe pain during orthodontic treatment. In these circumstances, it might be necessary to surgically remove it before performing other procedures.
Periodontal Disease Treatment
In rare cases, gum disease can cause diastema when teeth are forced to migrate because of alveolar bone loss. When this happens, the dentist must address the underlying conditions first. The available solutions include scaling and root planing and gingival flap surgery.
Expectations When You Suffer from Diastema
Naturally occurring diastema should not be a cause for alarm if you have healthy teeth and it does not affect your smile or appearance. A large population has embraced diastema as a family trait or sign of beauty. However, if your gap affects your speech and appearance and is caused by habitual factors or oral health issues, you should close it. Your dentist will discuss the available treatment options based on your needs.
If you have a natural diastema and are comfortable with it, you should watch out for any enlargement as you age. When the gaps become wider, it could be due to gum disease that causes bone deterioration and subsequent teeth migration.
Diastema Prevention
In many cases, diastema is passed down from generation to generation. Gum disease and habitual factors can only cause the condition in a few cases. So, even though you cannot prevent the gaps, you can drop harmful dental habits like thumb sucking and maintain regular dental visits for examination. Regular dental visits and proper oral hygiene lower the risk of gum disease. Besides, it enables early diagnosis, meaning the condition is arrested early because it leads to severe complications like bone loss associated with teeth migration that leads to diastema.
Find a Reputable Dental Practice Near Me
Having a diastema should not worry you, as the condition rarely causes oral health or function concerns. In many cultures, the gap is even deemed a mark of beauty. However, if you do not feel that way about the gap, or if it has developed or enlarged over the years. Your dentist can manage the condition based on the case.
At Lasting Impressions Dental Spa, we will conduct a thorough diagnosis and design the best treatment that addresses the underlying condition, if any. Call us at 818-751-5100 to discuss your case with our dental experts in Encino.
