As gaps can occur for several reasons the treatment chosen will depend on the cause.
In some cases, the gaps may be part of normal development and will close by itself. Others will remain and will require one or more of the treatment options listed below.
Why do I have gaps between my teeth?
A space between two teeth is called a diastema. It is most commonly seen between the two front teeth but can occur between any two teeth. There are a number of reasons why spaces can develop:
Small teeth or large jaws
When teeth are too big for the jaw they are in, they will be crooked or crowded. In the same way, if the teeth are too small for the jaw they are in, spaces between the teeth will occur.
Deep bite
When there is excessive vertical overlap of upper and lower front teeth, the forces pushing outwards on the upper front teeth can be so high that the teeth splay and spaces develop.
Missing or undersized teeth
Sometimes teeth can be congenitally undersized, or completely missing. This most commonly occurs with the teeth next to the two upper front teeth.
In some instances, teeth may be narrower at their biting edges than they are in the region of the gums. The roots of these teeth are most often in exactly the right position.
Extra teeth
Sometimes extra teeth form and they get in the way of other teeth within the bone. This can stop the correct tooth moving into its rightful position.
Oversized frenum
The labial frenum is the piece of tissue that extends from the inside of your upper lip to the gums just above the two upper front teeth.
Sometimes this frenum sits lower than normal and can actually pass between the two front teeth. This can stop the two front teeth coming together as they erupt into the mouth. A large gap between the two front teeth can take up valuable space in the jaw and lead to crowding of the front 4 -6 teeth.
Less commonly this can occur with the lower front teeth. The lingual frenum that attaches the tongue to the floor of the mouth can pass between these two teeth causing a space between them.
Habits
Habits such as tongue or thumb sucking, or the habitual placement of foreign objects between teeth (such as toothpicks or pencils) can lead to gaps.
Spaces caused by habits may continue to worsen over time.
Incorrect swallowing reflex
In most cases the tongue will contact the roof of the mouth while swallowing.
Some people retain a “tongue thrust” where the tongue presses on the back of the front teeth on swallowing. The regular pressure this places on these teeth can push them forward with spaces developing.
Gum disease
Gum disease slowly causes the loss of the supporting bone around teeth. When a lot of bone is lost, the teeth can become mobile and drift forwards.
The gaps will tend to grow over time and discomfort on chewing may develop as loosening increases.
Loss of support of the back teeth
The back teeth serve a very important function in supporting the bite and lessening the pressure taken by the front teeth. When back teeth are lost, excessive pressure behind the lower teeth can push them forwards with gaps developing.
What is the treatment for gappy teeth?
As gaps can occur for several reasons the treatment chosen will depend on the cause. In some cases, the gaps may be part of normal development and will close by itself.
Others will remain and one or more of the following treatment options may be appropriate:
Orthodontic braces
Braces are fixed to the teeth and elastics and wires are used to pull the teeth together.
If the teeth are small overall relative to the jaw, orthodontics may not be able to close gaps without compromising the bite.
Also, an attempt to close spaces in this situation can result in an unsatisfactory smile where the teeth seem to sit too far back.
Cosmetic dentistry will be required in these cases.
Cosmetic Dentistry
Many people cannot go through the orthodontic process – it just doesn’t fit in with their life. This is where Cosmetic dentistry comes to the fore. Within a few short weeks, a new smile can be designed and fitted, with more control and accuracy than ever before.
Cosmetic dentistry may be the only choice if you have undersized or small teeth relative to your jaw size where orthodontic treatment will not correct the issues. An increase in the size and an improvement in shape is readily achieved.
Porcelain crowns or veneers could be used. Read More
Alternatively, Composite veneers may be a more cost effective option. Read More
Missing teeth may need even more extensive care including dental implants, a fixed dental bridge or a removable partial denture. Read More
Restore back teeth
Replacing back teeth will require more extensive care and includes the use of dental implants, fixed dental bridges or removable partial dentures. Read More
After protective support for the front teeth is returned, orthodontics could be used to bring the teeth back to where they once were.
Alternatively, Porcelain veneers and crowns or Composite veneers could be the best solution. Read More
Frenectomy
The removal of the frenum is called a “frenectomy”. Its removal will be required to reliably close the space it has caused between the front teeth.
The procedure is generally very quick and easy and often only a local anaesthetic is required.
There is debate as to when the best time is to remove this frenum. Some believe it is before orthodontics starts, while others believe this may leave scarring or result in too much tissue removal. They believe that the scars could slow or stop the complete space closure, while too much tissue removal would lead to a displeasing gap in the gums in between the teeth after they are moved.
The space may still be closed without removing the frenum and completing orthodontics – again cosmetic dentistry has the answers.
The result would be considerably easier and quicker but possibly a little less aesthetically pleasing.
Porcelain crowns or veneers could be used. Read More
Alternatively, Composite veneers may be a more cost effective option. Read More
Gum treatment
If gum disease has lead to enough gum loss that teeth have moved, a thorough course of teeth cleaning by our hygienist will be required.
Sometimes the issue is so advanced that a referral to a specialist periodontist is required. Read More
Once the gums are stable, orthodontics may be possible. Alternatively, Porcelain veneers and crowns or Composite veneers could be the best solution. Read More
Even after thorough gum treatment, the teeth may remain mobile. In this case they may be best splinted to ensure they do not move again. Read More
Retrain swallowing
People with a retained tongue thrust can re-learn to swallow in the normal fashion. This will stop the gaps opening further, but the gaps will not close automatically.
They will need to be closed with:
Orthodontic braces. Read More
or
Porcelain veneers and crowns. Read More
Alternatively, Composite veneers may be a more cost-effective option. Read More
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