Diastemas – Do You Have One And If So, What Are Your Options?

What do pop sensations Madonna and Elton John, actors Lauren Hutton and Samuel L. Jackson, and late night talk show host, David Letterman all have in common? In addition to fame and incredibly large bank accounts, each of these superstars has a space between their two front teeth, also known as a diastema.

A diastema, by definition

Actually, the true definition of a diastema is an extra space between any two teeth. It’s just that these spaces are more commonly seen between people’s front teeth.

What causes a diastema?

There are several things that can create gaps between teeth including:

  • varying sized teeth;
  • a missing tooth;
  • an oversized labial frenulum, which is that web-like tissue that you can find between your gums and your lip;
  • thumb-sucking;
  • tongue thrust, which is what happens when an incorrect swallowing habit develops that causes the tongue to constantly push against one’s teeth, over time causing them to move;
  • periodontal disease, which can loosen teeth and consequently cause tooth movement;
  • orthodontic relapse, when one’s teeth start reverting back to the way they were before orthodontic treatment. This can happen within as little as a year or more than forty years after orthodontic treatment if retainers or permanent wires are not put in place to hold teeth in their new positions.

Treatment options

An obvious course of action for a diastema is simply doing nothing. Provided your dentist feels that your diastema is not in any way compromising your oral health, it is fine to leave things be. In fact, many people, including the celebrities I mentioned earlier, seem to be comfortable with their spaces, embracing them as a feature that makes them unique. Of course this is a matter of personal taste and one should not forget that what might look attractive on one person, might not necessarily be considered so on another.

If a diastema suddenly starts appearing in adulthood, you should see a dentist to make sure it is not being caused by periodontal disease. If he or she determines that gum disease is indeed the culprit, the health of your gums must be addressed and treated before moving forward with a treatment plan to address the newly developed space.

If you notice a diastema in your child’s primary teeth, it is most likely not something you should be overly concerned with, although all young children of this age should be seen by a dentist who can monitor the situation and provide advice for your child’s unique circumstances. If however, a diastema is identified in his or her second set of teeth, be sure to have your dentist investigate the situation. Often a diastema is a normal part of dental development and will close naturally when the canine teeth erupt. However, sometimes it is a sign of an underlying orthodontic problem. As your child is in the early stages of growth, the problem could be addressed with functional orthodontics very quickly, simply and cost-effectively.

For those individuals who aren’t fond of their spaces, there are several approaches that can be taken including:

  • Orthodontics which can include Invisalign, traditional braces and functional orthodontics in the case of younger children, all of which would ultimately remove the space by moving the affected teeth closer together and possibly rearranging other teeth in the mouth as well;
  • Bonding, when a tooth-coloured resin or plasticy-like substance is applied or “bonded” to the teeth to fill the space in question.
  • A Frenectomy, which is a fairly minor surgical procedure that reduces the size of the labial frenum, if that is the cause of the diastema. It is often used in combination with orthodontics.
  • Depending on the condition of the teeth, sometimes it is possible to use crowns or veneers to close spaces effectively. A veneer is an extremely thin shell-like coating which is custom-made in advance in a laboratory, and then adhered to the front of a tooth by a dentist. A crown is essentially a tooth-shaped cover that is placed over a tooth. Another name for a crown is a cap.

Each approach varies greatly in terms of cost, d­­­­uration of treatment and final outcome and only a dentist can determine which options would work for each particular case, depending on both the size and cause of the diastema.

Steven Deskin is a Brantford Dentist in general practice.

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