Diastema is a gap between your teeth. This can happen between any of your teeth. Because of its position, it’s most noticeable when there’s a gap between your upper front teeth.
Causes of Diastema
There are many different causes of diastema.
You may have a gap between your teeth because of a combination of some of the following factors:
Normal growth. A gap between the two front teeth is often a part of the normal development of children’s teeth. It’s estimated that about half of children aged 6 to 8 have gaps between their front teeth. It usually closes by the time the upper canines form.
Size, shape, and position of your teeth. Teeth that have an unusual size, shape, or position may have spaces between them. For instance, if your canines aren’t in their normal position, it means your two front teeth lack the pressure that keeps that from drifting apart. This can cause gaps to form between teeth.
Gum disease. Gum disease or periodontitis is an infection of your gums. It can damage the tissue and bone that support your teeth. This can cause your teeth to loosen and gaps to form.
Some symptoms of gum disease include:
- Swollen, tender gums
- Gums that are bright red or purplish
- Gums that easily bleed
- Pain when chewing
- Spitting out blood when flossing or brushing
- Loose teeth
- Bad breath
Obstructions in your mouth. Gaps can form if you have extra (supernumerary) teeth or you have baby teeth that don’t fall out. Cysts can also cause gaps. Another cause is a large frenum. This is the tissue that lies between your upper front teeth and your gum line.
Bad habits. Some bad habits can cause gaps in your teeth. If you regularly bite your lower lip or suck on your fingers, this puts pressure on your front teeth and causes them to push outwards.
A gap between the teeth can even be caused by bad habits with a tongue piercing. One adult with a tongue stud habitually placed the stud between her upper front teeth, causing a diastema to form.
Tongue placement. While having a gap between your upper front teeth is more common, it can also happen between your lower front teeth. The main cause of a diastema in your lower front teeth is when your tongue presses too far forward in your mouth ( tongue thrust).
Treatment Options for Diastema
Treatment for a gap between your teeth may not be necessary. For some people, the gap is cosmetic and doesn’t cause many problems. Some researchers say that the difficulty is not in treating the diastema, but in preventing it from happening again.
Children. For diastema in children, the gap may close on its own. Your dentist will evaluate various factors such as tooth sizes, spacing between the teeth, development of teeth, and more. The gap is more likely to close naturally when there's no more than 2 millimeters of space between the teeth.
Control the gum disease. If your gap is due to gum disease, your dentist will first work to get the disease under control.
If it’s not too advanced, your dentist may use some less invasive methods like:
- Antibiotics. Because there’s a bacterial infection, your dentist may prescribe antibiotics. There are topical antibiotics like mouth rinses or gels that are inserted into the spaces between your teeth and gums. Oral antibiotics may also be needed.
- Scaling. This removes bacteria from your teeth and your gums.
- Root planing. Your dentist will smoothen out the surfaces of the roots of your teeth. This removes bacteria and helps to prevent the buildup of more tartar and bacteria.
Surgical treatments for gum disease include:
- Bone grafting. This is used when gum disease has destroyed the surrounding bone. The graft may be from synthetic, donated, or your own bone.
- Soft tissue grafts. The soft tissue may be removed from the roof of your mouth and attached to the affected gum. This can help cover exposed roots and reinforce the damaged tissue.
- Flap surgery. In this procedure, your dental professional will make tiny cuts and lift a section of your gum. This exposes the roots of your teeth and makes it so scaling and root planing can be done more effectively.
- Tissue-stimulating proteins. Your dentist will apply a gel to a damaged tooth root. This encourages the growth of healthy bone and tissue.
- Guided tissue regeneration. To help the regrowth of destroyed bone, your dentist will place a special fabric between bone and teeth. This stops tissues from entering and lets bone grow back properly.
Surgery. If your diastema is due to a large or low frenum, or a cyst, surgery may be needed before orthodontic treatment can be done. Having the surgery doesn’t mean that the gap will close on its own, however. Further treatment may be needed to close the diastema.
Braces. This is a common treatment for diastema. Braces are a fixed appliance that uses brackets, wires, and bands to move your teeth. They put pressure on your teeth to gradually move them into the right position. Once your teeth are in the right position, the braces will be removed.
Because of the possibility of your diastema coming back, your dentist may recommend a permanent retainer. A removable retainer may not be suitable because of possible tooth movement when you're not wearing the retainer.
Prostheses. If the diastema is caused by missing teeth, your dentist may use fixed or removable implants or crowns to help close the gap. This will likely be done after orthodontic treatment.
Composite resin. This is a minimally invasive procedure to fill the gap between your teeth. It looks like natural tooth structure and is long-lasting.
Prevention of Diastema
Not all diastemas are preventable. But there are some ways to reduce the risk of getting one:
- Help your child break any bad habits like sucking on their thumb.
- Brush your teeth twice a day, and floss once a day to prevent gum disease.
- See your dentist for regular cleanings. You may not be able to remove all the plaque even if you brush and floss regularly. Hardened plaque can only be removed during your dental cleaning.