What is Diastema ?
What Is Diastema?
Condition involving
a noticeable gap between the teeth that is wider than 0.5 millimeters (0.02
inch). Most commonly, these gaps occur in the front teeth, but diastema
can involve the back teeth as well. A diastema is very common in childhood
until the permanent teeth come in. When present in the permanent teeth, it can
be corrected for aesthetic or functional reasons.
Symptoms
When the gaps occur in the lower
teeth, it’s referred to as mandibular diastema.
The presence of a gap between the two
maxillary (upper) central incisors is called a maxillary midline diastema (MMD).
MMD is considered normal development
in children and does not require treatment.
Midline diastemas occur in
approximately 98% of 6-year-olds, 49% of 11-year-olds, and 7% of 12–18-year-olds. So, as a child ages, the incidence of MMD
decreases.
Causes
There are several contributing
factors that may play into the cause of diastema, these include
- Teeth that are too small for
the mandible (lower jawbone) or
maxilla bone (upper jaw bone), resulting in gaps between the teeth
- A mandible (jaw) that is too
big, resulting in improper alignment of the teeth (because there is too
much space, causing gaps)
- Hereditary factors that come
into play because the size of a person’s teeth and jaw bones is influenced
by genetics and can run in families
- Overgrowth of the frenum
(the skin between the top lip and the front teeth) which can cause a gap
(diastema) between the two front teeth
- Periodontitis (severe gum disease
caused by poor dental hygiene) can lead to bone loss in the jaw; the bone
loss ends up allowing the teeth to shift, creating gaps. Note, symptoms of
periodontitis include red, swollen, bleeding gums, loose teeth and bone
loss.
- Peg lateral is a condition
in which the second incisor (a tooth located next to the very front two
teeth) develops improperly; the defective tooth is very small and pointed,
causing gaps on either side. Note, a peg lateral can be repaired with
crowns, veneers or implants.
- Thumb sucking which commonly
causes a midline diastema (a gap between either the upper or lower two
central teeth)
- Tongue thrusting which often
causes mandibular (lower jaw) diastemas from the tongue pushing against
the two central lower teeth
Thumb sucking and tongue thrusting can be corrected to prevent diastema.
Diagnosis
A diagnosis of diastema is made by a dentist who performs an oral examination. Keep in mind that children commonly have
gaps in their teeth that don’t require treatment; these gaps will resolve
themselves as the child grows and the permanent teeth come in. The adult teeth are larger and
often naturally fill in the spaces. But if gaps are left after the
permanent teeth come in, a dentist should be consulted.
Getting treatment can help a person's
self-esteem and lend itself to improving the overall quality of life for many
people. In fact, a 2014 study found that among young people who had a
correction of midline diastema, 50% reported that the procedure remarkably
improved their quality of life.3
Fixing the spaces between the teeth
may not only improve a person's self image, it can also restore the normal
functionality of the teeth. Any type of space can cause misalignment of the
teeth. Biting and chewing problems may result. This can disrupt a person's
ability to eat and digest food properly, impacting your overall health. By
filling the gaps between the teeth, the proper structure of the mouth is
restored.
Treatment
If you decide against having
restorative or orthodontic treatment to repair diastema, keep in mind that any
time there are gaps between the teeth, additional oral hygiene may be needed.
This is because often food becomes trapped. Some experts recommend the use
of a water flosser to make it easier to clean
between the teeth.4
For most people, the repair of
diastema is a painless, uncomplicated process. There are several treatment
methods that can close the gaps in the teeth; in fact, according to Dentaly.org
each person’s case is individual, and the dental care practitioner will
formulate a treatment plan, depending on several factors.4 These include:
- Where the gaps are located
- How many teeth are involved
- How large the gaps are
- If there are missing teeth
- The underlying cause of the
gaps (such as peg lateral, a condition involving an adjacent tooth that is
too small or periodontal disease)
- The overall health of the
teeth
- The patient's desire for
corrective treatment
- More
The dentist will formulate a plan for
the best treatment for diastema, depending on a person’s individual situation.
Next, the dentist will discuss the treatment options with the patient, going
over the benefits and drawbacks of each option.
Examples of treatment options
for diastema include:
Braces can be used to move the teeth and
close the gaps; braces are commonly used for large gaps. Braces are only
an option after all the adult teeth have erupted.
Invisible braces such as Invisalign is a treatment option for those
who do not want braces to be visible. They are a treatment option for
those with mild to moderate gaps. Invisible braces are removable, so they
are a good option for people who are in the public eye (such as professional
speakers, actors, models or more).
At-home clear aligners are a cheaper version of invisible
braces that have been used to close small gaps between the teeth. Clear
aligners are less expensive, more comfortable and aesthetic than metal braces.
But there is controversy as to the safety of at-home clear aligners,
particularly when an orthodontist is not consulted, because they can cause
severe complications in some instances (such as when a person has periodontal
disease). Keep in mind that there are very few published studies about the
safety or effectiveness of at-home clear aligners
(which differ from clear aligners used
by professionals such as Invisalign).
Veneers or composite bonding are two methods for treating
diastema. Veneers and composite bonding involve a layer of material (such
as a porcelain or composite material) placed over the tooth. A composite
material is a substance made from two or more materials with significantly
different chemical properties. When combined, these materials harden to
form a hard, tooth-like substance. Veneers and composite bonding are best
used for closing just one or two gaps.
Porcelain
veneers may be used to fill small gaps between
teeth, a dentist will make the veneer (tooth covering) larger than the tooth,
so that the excess material will fill in the space. There are normally two
visits required to get veneers; one visit will involve the dentist preparing
for the veneer to be made and the final visit will be needed for the dentist to
fit the veneer/s once they are made by the lab.
Composite bonding/veneers involves a synthetic material made by
the dentist that fits over the tooth. The procedure does not usually require a
second visit because the dentist builds the composite, giving it the right
shape and appearance during the office visit. When the entire tooth is
covered by composite material it is called a composite veneer. In either
instance, there is usually just one visit needed for the procedure, because the
lab is not involved in making the veneer.
Crowns or bridges crowns may be used as an option to fill
in large spaces or when the tooth (located next to the gap) is cracked, chipped
or otherwise damaged. Dental bridges may be used when there are missing
teeth. Crowns and bridges can help to restore the proper bite and chewing
functionality.
Periodontal procedures in some instances orthodontia or
restorative treatment (such as veneers or crowns) alone will not fix the
problem, but periodontal procedures (such as scaling, surgical or other
treatment of the gums) may be necessary.
Some people have been known to try to
close the gaps between teeth themselves by using rubber bands. According
to the experts, there is really no way of effectively performing a
do-it-yourself procedure at home. In fact, some types of self-treatment (such
as using rubber bands) can even be harmful.
Comments