Short answer: Diastema is the name given to a gap between teeth, and it is most often seen between the two upper front teeth. The cause may be the lip frenum, a mismatch between tooth and jaw size, habits or gum disease. The treatment option depends on the cause; orthodontic tooth movement is the main method in most cases.
Is a gap between the teeth always a problem?
Not every gap needs treatment. In children, a temporary gap may appear between the upper front permanent teeth as they erupt, and in most cases it closes by itself as the neighbouring teeth come through. The clinician assesses whether the gap is part of this developmental process or a lasting problem.
Main causes
- Lip frenum: If the tissue that connects the upper lip to the gum is attached low, it can make it difficult for the two front teeth to come together.
- Tooth–jaw mismatch: When the teeth are small and the jaw is wide, gaps are left between the teeth.
- Missing or small teeth: A missing lateral incisor, or one that is smaller than normal, can create a gap.
- Tongue thrust and thumb sucking: Constant pressure can push the front teeth forward and create spacing. We touched on this in our article on the tongue thrust habit.
- Gum disease: Weakening of the tissue that supports the teeth can make teeth that previously had no gaps fan out.
- Genetics: Similar gaps may be seen among family members.
What is assessed at the examination?
- The size of the gap and the position of the teeth
- How low the lip frenum is attached
- Gum health and bone support
- Whether there are missing or extra teeth (with an X-ray)
- Tongue and swallowing habits
Treatment options
Orthodontic treatment
The teeth are slowly brought closer together with braces or clear aligners. For the general workings of clear aligner treatment, see our page on orthodontic treatment with clear aligners. If the gap is in a single area, treatment can often be planned to be shorter; even so, the duration varies from person to person.
Adjusting the lip frenum
If the frenum prevents the gap from closing, adjusting it with a small surgical procedure before or after orthodontic movement may be considered. The orthodontist and the surgeon determine the timing together.
Aesthetic restorations
When the teeth are small, treatments such as bonding, which is similar to a filling, or laminate veneers can complement orthodontics. The position of the teeth is arranged first, and then, if necessary, an aesthetic step is planned.
Can the gap open again?
Diastema is one of the problems in orthodontics with a high tendency to reopen. For this reason, retention after treatment is important and should be used for the period the clinician recommends. For general information on gaps between teeth, you can also look at our page on treatment of gaps between teeth.
Gaps between teeth in children
A gap between the upper incisors as they erupt can be part of normal development. As the lateral incisors and canines erupt, the gap often becomes smaller. However, if the gap is noticeably large, if an extra tooth is suspected, or if the lip frenum is thick and attached low, it is useful for the child to be assessed by an orthodontist. For early monitoring, see our page on orthodontics for children.
What should be considered in a clear aligner plan?
- As the teeth move closer together, space may need to be created at the side teeth.
- If the teeth are small, proportions may change once the gap is fully closed; for this reason, the clinician assesses this beforehand on the simulation.
- When needed, supporting procedures such as attachments or IPR can be planned.
The daily wear time of the aligners is important for treatment to progress smoothly; you can find the details in our article on how many hours a day clear aligners should be worn.
Do not neglect gum health
In adults, the cause of a newly formed or growing gap may be gum disease. In this case, gum treatment and an assessment of bone support are needed first; it is important to bring inflammation under control before moving the teeth. Regular cleaning and clinician check-ups are therefore an integral part of treatment.
Questions you can ask yourself when deciding
- Does the gap bother me aesthetically, or is there a functional problem such as chewing difficulty or food trapping?
- Has the gap been the same for years, or has it been getting bigger recently?
- Do I have bleeding, recession or looseness in my gums?
- Am I ready to wear a retainer after treatment?
Your answers to these questions help determine the plan at the examination. If the gap is getting larger, it is recommended that you see a clinician without waiting.
Frequently asked questions
Does a gap between teeth close by itself?
In children, temporary gaps related to development often become smaller. In adults, such a gap generally does not close by itself.
Can a gap between teeth be closed with clear aligners?
In many cases, yes. The plan is made by the clinician according to the cause of the gap and the tooth–jaw relationship.
Is it enough to close the gap with an aesthetic procedure alone?
Closing it with a surface treatment alone, without correcting the position of the teeth, can in some cases make the teeth look out of proportion. The decision is made according to the examination.
How can you find out what suits you?
The information here is general; the right plan for you is determined by examination and clinical assessment. At our clinic in Oran, Çankaya, Ankara, we go through your questions together during the first orthodontic examination.
