Although adjacent natural teeth do have some physiological gap between them, an abnormally large gap between two teeth is known as Diastema. Apart from the dental problems arising due gap in the teeth, many consider them acosmetic feature. A Diastema is considered by some to be an attractive and desirable feature. Some women would go so far as getting these gaps created. In France, gapped teeth are regarded as “lucky teeth,” while children with gap in their teeth are considered future owners of endless fortune.
However, these superstitions have no scientific or logical basis. Many gap-toothed people nowadays are embarrassed to publically speak or smile, afraid of showing their midline Diastema. Current dental practices have made it possible to correct this abnormality, enhancing self-confidence and satisfaction.
Where Does Diastema Occur?
A Diastema usually develops between the upper front teeth; however, it is not uncommon to find gaps between any adjacent teeth in the oral cavity.
Causes of Diastema
The most common cause of a midline Diastema is the overgrowth of labial frenulum. The labial frenulum is the connective tissue that binds the teeth to the gums, and an excessively thick frenulum can push adjacent central incisors apart and create gaps
Alternatively, a mismatch between the jaw bone and tooth size may also cause tooth gap. Teeth that are smaller, in comparison to the size of the jaw bone, can have a gap created next to each other.
Abnormal habits in children and adults can also lead to a Diastema. Thumb sucking is frequently observed in many children; this causes the front teeth to protrude outwards, creating a gap. Also, some adults adopt the habit of “tongue thrust,” swallowing by thrusting their tongue out, on the palatal side of the upper central incisors, to generate pressure during swallowing. This excessive pressure gradually creates an “over jet” in the front teeth in addition to gap formation.
Sometimes, patients may have naturally missing teeth. Upper lateral incisors are the most commonly found missing congenital teeth. A missing tooth creates a “natural Diastema”. In other cases, a gap might also be created as the result of a tooth extraction.
Diastema in Children with Primary Teeth
Many worried parents come to their dentists with concerns that their children have gaps between their teeth. However, the concern is unfounded, since milk teeth naturally have gaps present between them, to allow for extra room, and minimize chances of overcrowding once the larger and more numerous permanent teeth erupt.
Treatment of Diastema
Treatment of a Diastema generally involves a team effort by a general dentist, an orthodontist, and an oral and maxillofacial surgeon. However, simple surgical procedures requiring correction of diastemata are frequently performed by general dentists.
In case of a Diastema caused due to para-functional habits, cessation of the habits, such as thumb sucking and tongue in conjunction, with orthodontic therapy will result in reversal of the gap. However, in case of natural causes of Diastema, orthodontic therapy or even maxillofacial surgery might be required.
The overgrown labial frenulum can be surgically removed to prevent further gap formation. Afterwards, an orthodontic appliance may be provided to rectify the problem.
In case of tooth and jaw bone size mismatch, “functional appliances,” that utilize the growth spurt in growing children to redirect jaw bone development, provide excellent results. However, after the growth spurt has ceased, maxillofacial surgery might be the only option left.
After the repair of a Diastema, there are high chances that a gap might form again between teeth unless they are retained in the corrected position by an orthodontic appliance known as the retainer. Hence, a removable or fixed retainer is worn by the patient, for a period of three to six months, in order to prevent treatment reversal.
When to Ask for Professional Help?
Professional help should be sought immediately upon the sighting of symptoms pertaining to a gap in teeth. If parents find excessive gaps in their children’s teeth, the American Association of Orthodontists recommends children be evaluated by an orthodontist at the age of seven. It should, however, be noted that treatment might not be needed right away, perhaps till Diastemata persists in the permanent dentition.