In some cases, a gap between the teeth may be more than an aesthetic issue; it can indicate an underlying spacing problem, bite imbalance, or oral health condition that should be addressed by your orthodontist. There are several treatment options for closing a diastema, with orthodontic treatment providing the most effective and long-lasting results.
What Causes a Diastema?
Identifying the root cause of the diastema before determining and beginning treatment is a pivotal step; not every gap between the teeth develops for the same reason. There are numerous causes, including:
Genetics
Diastemas are inherited. Differences in tooth and jaw size can leave extra space between teeth. Gaps may naturally develop throughout the smile if the teeth are smaller compared to the jawbone itself.
A Low-Attached Labial Frenum
The labial frenum is a small band of tissue that connects the inner surface of the upper lip to the gums above the front teeth. The tissue can sometimes develop too low or be thicker than usual; this can prevent the upper front teeth from meeting, resulting in a persistent gap.
Missing or Undersized Teeth
In some instances, the adult/permanent teeth never develop or are lost due to injury or extraction; the adjacent teeth may shift, creating spaces elsewhere in the mouth. Similarly, unusually small teeth can leave excess room that contributes to spacing.
Gum Disease
Advanced periodontal disease can damage the bone around the teeth, weakening their support; teeth may begin to shift, creating new gaps that were not originally visible.
Tongue Thrust
Some people habitually push their tongue against their front teeth when swallowing or speaking. Over time, this repetitive pressure can gradually move the teeth apart, leading to a diastema.
Childhood Thumb-Sucking or Pacifier Use
Thumb-sucking or extended pacifier use during childhood can impact the developing bite and encourage spacing between the front teeth. Childhood gaps can close naturally as permanent teeth erupt; habits can contribute to long-term spacing issues.
Do All Diastemas Need Treatment?
Not necessarily. A small gap may cause no functional problems, and many people may find it a personal characteristic and not seek treatment to correct it.
Treatment may be recommended if the gap:
- Continues to widen over time
- Is associated with bite problems
- Causes speech or chewing concerns
- Results from gum disease
- Affects your confidence when smiling
Seeking an evaluation from a professional will help determine whether the gap is purely a cosmetic concern or an orthodontic problem that requires additional treatment.
Orthodontic Treatment Options
Orthodontic treatment is typically the most common approach to address tooth position rather than masking the gap.
Invisalign®
Clear aligners like Invisalign are an excellent option for correcting mild or moderate spacing concerns.
Invisalign is most commonly used for patients whose spacing is limited to the front teeth and who have minor bite concerns. If additional bite correction is needed, treatment plans can often address both issues simultaneously.
Traditional or Ceramic Braces
If there are multiple gaps or spacing issues between the teeth, along with more complex bite concerns, traditional or ceramic braces are the preferred option to produce lasting results.
Braces provide excellent control over tooth movement and can correct:
- Multiple spaces throughout the mouth
- Significant bite discrepancies
- Tooth rotations
- Complex alignment issues
- Jaw alignment problems
Cosmetic Alternatives
In recent years, patients have been exploring cosmetic dental treatment options to close the small gaps without moving their teeth.
Dental bonding and porcelain veneers are the two most common cosmetic options for improving the appearance of a small gap. Dental Bonding uses a tooth-coloured composite resin to build up the sides of the adjacent teeth, making it a quick, minimally invasive treatment that is more affordable in most cases. Dental Veneers are thin porcelain shells bonded to the front surface of your teeth and can close small gaps while enhancing the size, shape and colour of your teeth.
Why Orthodontic Treatment Is Often the Better Long-Term Solution
Cosmetic treatments can only improve the appearance of the smile, while orthodontic treatment can address the underlying root cause and offers greater long-term results.
Orthodontic treatment can close the space by moving the teeth into a preferred alignment; this approach can often improve bite function, reduce uneven tooth wear and create a healthier overall smile.
Retainers Are Essential After Treatment
Closing a diastema is only the beginning of the process.
As with all orthodontic treatments, the most important part is retention. Diastemas tend to reopen over time if retainers are not worn consistently.
Following on from braces or Invisalign treatment, you will be provided with retainers designed to hold your teeth in their new positions while the surrounding bone and tissue settle into their new positions.
Depending on your individual case, you may receive:
- Removable clear retainers
- Hawley retainers - removable dental device
- Bonded (fixed) retainers behind the front teeth
Many patients are surprised to learn that long-term or even lifelong nighttime retainer wear is commonly recommended. Consistent retention helps protect the time and investment you've made in achieving your new smile.