Everything you wanted to know about gaps between teeth: causes, solutions

About 20% of people on the planet face such a problem as gaps between teeth. Dentists call the gaps between the central teeth diastema, and between any other teeth - trema. Aesthetic dentistry can offer a way to get rid of this problem - and more than one.

Trema is not only a cosmetic defect that significantly reduces the patient’s quality of life, but a dangerous pathology that can lead to the development of serious dental diseases: trema negatively affects the stability of the teeth, exposing them to additional stress - this, in turn, leads to the appearance of caries, various gum diseases.

What is a gap from a dental point of view?

In dentists' language, the gap between teeth is called diastema (from Greek - “gap, distance”). According to statistics, varying degrees of this defect are present in every fifth adult on the planet. In childhood, increased interdental space is often temporary; it is observed in 50% of preschool children. Diastema refers to an abnormally large empty space between the incisors (can reach 10 mm).

Patients often confuse a diastema (a gap between “units”) with a trema (a gap between any teeth in a row), although formally these are completely different defects, although similar in essence. Accordingly, the approach to treatment/elimination is different in both cases.

Reasons for the appearance and enlargement of gaps between teeth

The gap between the front teeth is a result of internal or external factors. Most often it occurs as a result of:

  • poor heredity (if there were those in the family who had a gap, the risk of it appearing in the offspring is very high);
  • slow growth and formation of incisors located in the center of the row;
  • pronounced expression of interdental papillae;
  • pathologies associated with the arrangement of teeth in a row;
  • received mechanical injuries, where the main load fell on the front incisors;
  • incorrect location of the lip frenulum;
  • slow process of changing baby teeth to permanent ones;
  • gum pathologies;
  • abuse of bad habits;
  • partial or complete absence of teeth in a row (for cases where improper formation of the dental system is diagnosed).
  • The cause may also be the presence of microdentia, which inherently affects the symmetry of the teeth.

    An increase in an existing gap occurs for the following reasons:

    • abuse of chewing seeds;
    • progressive problems with the root system;
    • the appearance/development of various types of orthodontic pathologies;
    • Frequent chewing of hard food (particularly with the front teeth).

    Correct and recommended prevention will help maintain the diastema at the existing level (prevent the distance between the incisors from becoming larger), and the orthodontist will select an individual program for eliminating the defect.

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    Aesthetic defect or pathology?


    The presence of a gap is not perceived by the people as an obvious disadvantage, provided that the dentition is smooth and beautiful.
    But its owners most often consider this a reason for embarrassment and look for ways to eliminate it. For example, in the distant 80s of the last century, fans of A. Pugacheva’s talent were surprised when in the acclaimed film “The Woman Who Sings” AB, who had a gap between her teeth, suddenly appeared on the screen, shining with an ideal jaw. Considering the level of medicine at that time, ordinary people argued for a long time and wondered what they had done to the star, and how long the wonderful effect would last. Increased interdental space is observed in 20% of the world's population, half of these are among preschoolers, but in a child this phenomenon is often temporary and age-related. Dentists separate the concepts of diastema (the space between) and trema (the distance between any adjacent fragments of the row). Despite the similarity in the essence of the defects, they are eliminated in different ways.

    The reason for the gap is due to various factors:

    • heredity (if your ancestors also had such a deficiency);
    • pathologies of development and formation of the dentition;
    • mechanical injuries of the anterior incisors.

    The size of the gap may increase if you frequently chew hard food (including seeds) , there are symptoms of periodontal disease or pathologies in the development of the dental system.

    The orthodontist not only recommends practical prevention so that the diastema does not increase, but also selects a program and a method for eliminating it.

    Types of diastemas

    How the gap between the teeth can be removed depends on the reasons why the gap appeared. Therefore, it is very important to correctly identify the species. Diastemas are classified according to three main characteristics:

    1. By time of occurrence of the defect
      :
        False
        . It is diagnosed in children when the bite is not yet fully formed. The problem disappears on its own without third-party intervention after replacing baby teeth with permanent ones.
    2. True. Diagnosed in adolescents and adults in the period after the formation of the bite. It occurs due to periodontal pathologies, injuries or the absence of some frontal teeth in a row.
    3. By location
      :
        Symmetrical
        . The location is determined relative to the conditional center of the dentition (usually oriented along the frenulum). The position of the incisors relative to each other is also taken into account.
    4. Asymmetrical
      . Most often, one of the incisors is in its place, and the second is deviated relative to the conditional center.
    5. According to the position of roots and teeth
      :
        Literal deviation of crowns
        . The defect is most often observed in people with a superset of teeth. In this case, the position of the roots is correct, but the incisors themselves deviate. Usually the gap in this case is no more than two millimeters.
    6. Hull literal offset
      . A common cause of the defect is excessively compacted bone tissue of the middle suture, which does not allow teeth to erupt in the place where they are needed. It is expressed in the lateral displacement of both the root and the incisor.
    7. Medial tilt
      . The most complex defect that can occur with the central incisors. As in the previous case, teeth and roots shift, but they can grow not only to the sides, but also with a displacement around their own axis.

    To understand how to remove the gap between the front teeth and which method is best to choose, the dentist must correctly determine the type of diastema. Keep in mind that it is impossible to get rid of a gap on your own or at home - you cannot do this without the help of a specialized doctor.

    Surgical plastic surgery

    For many patients, the determining factor in choosing a method for eliminating diastema is the cost of therapy. Be sure to consider your financial resources when you and your doctor select a method for correcting a dental gap. Choose the method that suits you best, but do not skimp on your health, as otherwise you may not achieve what you want and spend even more money on eliminating the negative consequences of unsuccessful treatment.

    A tooth gap can also be removed using surgical plastic surgery. This technique involves installing dental crowns. Dentists correct the defect by placing ceramic veneers or crowns on the front teeth. This intervention allows you to achieve an excellent aesthetic effect that lasts for many years. Some disadvantage of this technique is its rather high price.

    If for one reason or another you cannot use this technique, the doctor can fill the front teeth for corrective purposes, as a result of which the gap will be eliminated. Pay attention to the above method if the diastema occurs a second time or the installation of staples does not bring the desired result.

    How can a gap be dangerous?

    A small gap between the teeth can be a highlight and be regarded solely as an aesthetic defect. This problem does not bother some people, even those who are often under the gun of video cameras (for example, E. Temnikova, Madonna, K. Novikova, V. Paradis, K. Raikin, etc.). However, in some cases, diastema can cause serious functional disorders. Without therapeutic intervention, the size of the gap will increase, which has the following consequences:

    • speech defects (their degree depends on the size of the diastema);
    • violation/change in bite (due to uneven chewing load on the upper and lower jaw);
    • caries (pathogenic bacteria and hard deposits accumulate in the interdental space; regular home cleaning is not always enough to combat them);
    • inflammation and other gum diseases (due to direct contact of the gums with chewed food).

    An experienced orthodontist can determine exactly how to remove the gap between the front teeth and whether it is necessary for medical reasons. If the defect is purely aesthetic, then only you can decide whether it needs to be eliminated.

    How to remove a gap between teeth

    The main task that a dentist faces when solving the problem of diastema is to achieve the most even alignment of the central incisors. Depending on the chosen method, this process may take 2-3 dental procedures or last several years (the duration of treatment depends on the complexity and causes of the problem, the age of the patient and other factors).

    Modern dentistry offers as many as 10 progressive methods of combating the gap between the front teeth:

    1. Surgical plastic surgery.
    2. Bracket systems.
    3. Records.
    4. Veneers.
    5. Lumineers.
    6. Cosmetic correction.
    7. Artistic restoration.
    8. Crowns.
    9. Implants.
    10. Mouthguards.

    It would not be superfluous to study in detail the features of each technique, comparing their effectiveness and other characteristics.

    Surgical plastic surgery

    This method is used in the case of a congenital defect associated with an incorrect position of the labial frenulum (it is because of this that the incisors cannot close correctly). Surgical plastic surgery of the frenulum will not remove the gap, but will create conditions under which the teeth will be able to take the correct position. And after this, the dentist selects an effective method of correction. This technique has several nuances related to the patient’s age:

    • This procedure is most effective for children 5-8 years old - after the operation, the incisors will close on their own without additional dental intervention.
    • After surgery, older patients will be forced to wear orthopedic structures (some of which are fixed not temporarily, but permanently).

    The plastic surgery itself is safe for health and painless. Does not require long time for rehabilitation and recovery.

    Bracket systems

    They are non-removable orthodontic structures designed to straighten the dentition. Parts of the structure are fixed directly on the teeth (from the outside or inside). The use of braces to eliminate gaps between teeth has its own nuances:

    • The method is most effective for patients under 16 years of age, when the jaw tissue is not yet fully formed. For older patients, wearing braces may not help (depending on the individual characteristics of the problem).
    • The duration of treatment can be up to three years. Braces cannot be removed until the end of the period prescribed by the doctor. In addition, regular visits to the dentist are required (to tighten the braces and change the arches).

    It is worth noting that to eliminate a diastema, it will not be possible to place braces only on the incisors - the structure is installed on the entire dentition at once.

    Records

    One of the most affordable and effective methods for correcting interdental space. These removable structures are made of high-quality plastic and are secured to the teeth using screws, hooks and springs. Due to the created load, the incisors are gradually attracted to each other. The features of this technique include the following facts:

    • Efficacy is guaranteed in patients under 12 years of age. It is up to this age that the bone tissue of the jaws is perfectly amenable to correction.
    • The plates are not able to cope with significant defects. For example, when the gap is caused by serious dental diseases.

    It is worth keeping in mind that, in fact, the plates do not move the teeth like braces, but simply hold them in a given position.

    Veneers

    Installing veneers can be considered the most efficient option for solving the problem with a chip. They are thin ceramic plates that are used to cover the front surface of teeth. That is, formally the gap is not removed, but closed. The procedure has its own characteristics:

    • Veneers do not correct, but disguise the gap, therefore they are suitable only for those cases where the diastema is not a medical, but an aesthetic defect.
    • Average service life is about 10 years. After this, the veneers will have to be changed.
    • Before installing veneers, a small grinding of the incisors will be required.

    Ceramic plates come in a variety of colors, so you can choose ones that will not differ from natural enamel.

    Lumineers

    Orthopedic onlays are as similar as possible to veneers, but thinner. They are also fixed on the teeth, closing the gap. Features include:

    • longer than veneers, service life - up to 20 years;
    • installation does not require extensive grinding of teeth.

    As in the case of braces, lumineers do not solve, but mask the problem. In addition, they are not suitable for everyone, so you need to pay attention to the list of contraindications.

    Cosmetic correction

    A budget option that allows you to get quick results. The essence of the procedure is that the gap between the teeth is filled with a filling, which makes the diastema visually invisible. This correction is safe for health, painless and is carried out in one visit to the dentist. The features include the following facts:

    • the problem is solved temporarily - the seal has a relatively short service life (5-7 years), so it will need to be replaced;
    • The filling material changes color over time, which visually begins to differ from the native enamel;
    • There is a risk of developing caries at the junction of the incisors.

    Those who choose cosmetic correction to eliminate the gap will have to control the load on the “units” so that the filling remains unchanged and does not break.

    Artistic restoration

    The method is similar to cosmetic correction, but guarantees a longer lasting result. Using composite materials, the dentist builds up the tissue of the front teeth, closing the gap. As a result, the visual impression is created that the incisors are tightly closed. Features of artistic restoration:

    • the most natural appearance after the procedure (photopolymers are matched to the color of the native enamel);
    • Just one visit to the dentist is enough to get the desired result;
    • the procedure is safe for health and has no contraindications.

    The main similarity with cosmetic correction is that after artistic restoration you will also have to control the load on the incisors when eating.

    Crowns

    Plastic, ceramic or metal-ceramic crowns perfectly solve the problem of diastema. In this case, the cap-shaped design completely covers the teeth (in the case of a gap, it is necessary to apply crowns to both) and does not stand out in any way in the row. Features of installing crowns:

    • average service life 10-15 years (depending on the material);
    • safe for health;
    • preliminary turning of the cutters is required.

    The installation of crowns for diastema is not used as often as other methods.

    Implants

    Implantation is used if the cause of the gap between the incisors is the absence of one or more teeth in a row. Filling the empty spaces will not allow the “ones” to continue to “spread out.” But, even if the dentition is replenished, the gap will remain and will have to be eliminated using some other of the listed methods.

    Mouth guards

    They are removable orthopedic structures that are manufactured using 3D technology. They look like original “cases” that are put on the teeth and are visually invisible. The mouthguard creates pressure, forcing the “ones” to move in the desired direction, which leads to their closure.

    The duration of use of mouth guards (depending on the complexity of the problem) is from three months to three years. During this period, sequential replacement of the aligners is carried out, carried out as the “ones” move. From time to time, the mouthguards are allowed to be removed.

    Treatment

    When treating a wedge-shaped tooth defect, the doctor first restores its integrity, then prevents its further destruction. If necessary, dentists of narrow specializations are involved in the treatment of a wedge-shaped defect: therapists, orthodontists, orthopedists.

    The following will help restore the condition of the tooth:

    • Installation of seals. The doctor removes the altered tissues in the cervical area, and installs filling material in their place. When restoring medium and complex defects, the doctor uses a light-curing fluid composite and compomer materials. They are quite elastic and can partially compensate for the load on the teeth. The best fillings are installed using the sandwich technique: the bottom layer is made of dental cement, the top layer is made of composite materials. For better aesthetics, your doctor may suggest installing ceramic veneers.
    • Fluoridation and remineralization. The procedures restore the mineral content in the enamel, this heals the tooth and slows down the process of destruction;
    • Prosthetics. If the tooth is severely damaged and there is a risk of fracture at the base of the crown, the doctor will be forced to install a denture. Usually this is permanent prosthetics made of metal-ceramics or using ceramic crowns.

    If the wedge-shaped defect has just begun to develop, the following will help slow down the process:

    • Remineralizing therapy. Applications with calcium and sodium preparations are applied to the affected part, and the patient is recommended to take a course of vitamin-containing complexes. Remineralization courses must be repeated regularly and they only help at the initial stage of the disease;
    • Fluoridation. Effective in cases of deep damage to the enamel, applications with fluoride preparations seal the tubules of the tooth tissue and reduce its sensitivity;
    • Laser therapy. Reduces tooth sensitivity and inhibits the development of the disease. Laser treatment is recommended for pregnant and lactating women and patients with allergies.

    For home care, the doctor will recommend pastes and gels enriched with a special mineral composition.

    Preventive actions

    As you know, preventing the onset of a disease is always easier and cheaper than treatment. To prevent the appearance of gaps between teeth, you must follow basic rules:

    • control the habit of chewing hard objects (for example, seeds, nuts, crackers, threads, wire, etc.);
    • carry out proper hygienic care of the oral cavity (to maintain the health of the gums and prevent the spread of bacteria, it is very important to brush your teeth correctly, carefully brushing not only the chewing units, but also the canines and incisors);
    • Conduct timely examinations with a dentist (this allows you to diagnose any deviation in time and begin treatment at an early stage).

    If the cause of the appearance of interdental gaps is a genetic predisposition, it is very important to begin correction as early as possible. Maximum effectiveness is possible during the period when the teeth are still mobile in the gums and can be rebuilt.

    Now you know exactly how to remove the gap between your front teeth, what methods are used for this and how long it takes to eliminate the defect. All that remains is to consult with an orthodontist and, after examination and research, choose a method for eliminating the diastema that is right for you.

    What symptoms of a wedge-shaped defect should you pay attention to?

    Painful sensations during caries appear when destroyed dental tissues (the so-called carious cavity) are no longer able to protect the neurovascular bundle located in the pulp chamber. With a non-carious defect, the affected area and decaying dentin are covered by the gum, and the walls of the formed wedge-shaped cavity remain smooth and hard. Therefore, the patient does not begin to experience unpleasant sensations immediately, but only in the third or fourth stages. Treatment of advanced pathology turns out to be more complex, costly, and in some cases ineffective.

    Therefore, you should definitely see your doctor if you have:

    • individual teeth have become hypersensitive and react to external irritations with sharp, piercing pain;
    • the enamel has become cloudy, pale or more pigmented;
    • The gum line has changed and the necks of the teeth are exposed.

    Read also

    How to place veneers

    The installation of veneers is performed for the purpose of aesthetic restoration of the dentition.

    How long do you wear braces and what affects the timing?

    When deciding on the use of orthodontic structures, patients are often interested in how long they wear braces on their teeth.

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