Diastema

What is diastema?

Diastema is a medical term referring to a gap between teeth. These gaps can occur anywhere in the mouth but are common between the two front teeth, known as midline diastema. The gaps can range from small to large and normally do not negatively affect a person’s oral health. Nonetheless, it can sometimes indicate gum disease.

Symptoms

Diastema symptoms are mainly visual and can include the following:

• A noticeable space or gap between two teeth, particularly the upper front ones
• Misalignment or shifting of surrounding teeth
• Changes in biting and chewing efficiency
• Speech complications in serious cases

Causes

The main causes of diastema are:

• Genes: Family history can significantly influence the presence of diastema.
• Jaw and tooth size discrepancy: A discrepancy between jaw and tooth size can cause gaps.
• Frenulum attachment: An unusually large or tight labial frenulum (tissue connecting the upper lip to the gums) can result in a gap between the front teeth.
• Missing teeth: The absence of teeth can lead to the shifting of adjacent teeth, forming gaps.
• Gum disease: Periodontal disease may result in bone loss and spaces between teeth.
• Oral habits: Behaviours like tongue thrusting, thumb sucking, and improper patterns of swallowing can lead to the formation of diastema.

Diagnosis

Diastema diagnosis usually includes the following:

• Visual examination:This involves visual inspection of the teeth and gums to identify any gaps and check teeth alignment.
• Dental X-rays:Dentists use X-rays to assess the underlying bone structure and identify related problems, such as gum disease or missing teeth.
   
• Patient history:You will be asked about your family history, dental history, and any oral behaviours that might contribute to the condition.

Treatment Options

There are various treatment options to correct diastema, depending on whether it is caused by gum disease or is just a cosmetic problem.

Cosmetic treatments for diastema

Numerous cosmetic oral treatments are available if you have healthy teeth and only intend to close the space between teeth. They include:

• Dental bonding:A tooth-coloured composite resin component is applied to hide the space. The teeth are then shaped and polished to provide a natural look.
• Porcelain veneers:Porcelain veneers are customised ceramic shells that permanently adhere to the front surfaces of your teeth. These help close the gap and provide a uniform appearance.
• Braces:Large gaps may require braces or clear orthodontic aligners to press the teeth close to each other. In minor cases, the diastema can be fixed even without using braces.
• Frenectomy:The tissue band connecting the lips to the gums is called an oral frenum. A thick oral frenum can push the teeth apart, forming a space. A frenectomy helps release this tissue band and is usually conducted alongside other procedures like veneers or dental bonding.
• Dental bridge:If the diastema is a result of a missing tooth, a bridge can be used to replace it. To be eligible for bridge placement, one should have two healthy teeth on each side of the space. They will be modified to act as anchors for the newly placed restoration.
• Dental implant:A dental implant serves as a missing tooth replacement, just like a bridge. However, the implant doesn’t involve altering the adjacent teeth. The implant is made of a threaded titanium post, replacing the absent tooth root. Once it has healed, a dental crown restores and closes the space between teeth.

Gum disease treatments for diastema

If gum disease causes diastema, periodontal treatment is necessary to eliminate harmful bacteria. After managing the infection, cosmetic treatment can be used to close the space between teeth.

The most common gum disease treatment options are:

• Scaling and root planing:Deep dental cleaning (scaling and root planing) is recommended for minor gum disease. While this is similar to routine cleaning, it involves numbing to access bacteria deep beneath the gums.
• Gingival flap surgery:Surgery may be necessary for moderate to advanced gum disease. A periodontist performs the procedure by making an incision along the gum line and temporarily moving the gums back to view the tooth roots. Once the roots have been thoroughly cleaned, the periodontist repositions and stitches the gums back. If there is bone loss near a tooth, a dental bone graft may be placed to help restore bone tissue in the area.

Complications

Diastema that is left untreated can result in a number of complications:

• Oral hygiene challenges:Diastema can form spaces that trap food particles and promote plaque build-up. This increases the risk of developing cavities and gum disease.
• Bite problems:The gaps are likely to affect how teeth align, causing bite issues and irregular wear on teeth.
• Speech difficulties:Large gaps can impact speech, making it hard to pronounce particular sounds.
• Aesthetic concerns:Diastema can affect a person’s self-confidence and smiling appearance.

Prevention

Diastema prevention involves the following measures:

• Routine dental visits:Frequent check-ups and dental cleanings help monitor oral health and detect any problems early.
• Good oral hygiene:Brush teeth twice a day, floss daily, and use mouthwash to maintain healthy teeth and gums.
• Addressing oral habits:Avoid habits such as thumb sucking and tongue thrusting, as these can lead to diastema.
• Orthodontic assessment:Timely assessment by an orthodontist helps detect and correct any alignment problems.
• Treating gum disease:Manage periodontal disease through professional care and proper oral hygiene.

Prognosis

What can I expect if I have diastema?

Generally, diastema is not a cause for concern unless it results from infection. It does not negatively impact one’s oral health, and most people actually embrace the gap as a unique feature of their smile and beauty. However, if you wish to close the space between your teeth, there are numerous treatment options available to achieve your cosmetic objectives.

Does diastema increase with age?

Age should not contribute to an increase in diastema if you maintain good oral health. Contact a dentist if the gap in your teeth widens, as it might be a sign of gum disease.

Living With

When should I see a dentist?

If the space between your teeth bothers you, make an appointment with a dentist. During the visit, they will discuss the best treatment options for your condition with you. Generally, visiting a dentist at least every 6 months is important for routine dental examinations and cleanings.

A Note from MD.co.uk

Diastema is usually not a cause for concern, as it does not have a negative impact on oral function and health. Most cultures worldwide actually consider the gap between teeth a sign of beauty. However, if you prefer to close the gap, various cosmetic dental treatments are available to help you achieve the healthy, attractive, and long-lasting smile you desire.