Front teeth Gap / Diastema – Treatment and Management in Delhi

Every individual has a different personality. Each one of us have a unique skin and hair colour, height and weight too varies from one individual to another and same holds true for our teeth also. Almost all of us have some or other kind of minor teeth alterations and variations that gives us a unique smile and a facial architecture. Most of these alterations are minor and does not interfere with our health and do not require any dental treatment or interventions.

Today my focus is too provide information on one of the most common, most visible and most easily correctable form of cosmetic dental problem i.e. Front teeth gap or Diastema

What is Front teeth Gap

Front teeth gap is also known as Diastema. A gap of more than 0.5 mm between upper two middle / central incisors is known as diastema. Each of the photographs shown below is of a person having a front teeth gap and was looking for its correction through dental treatment.

Front teeth Gap

Before moving forward it is important to understand whether you are a potential candidate for front teeth Gap treatment or not. So below is a checklist for various cases that may require front teeth gap correction and presence of anyone or more factors is an indication that you may seek dental opinion for diastema correction

  • Your diastema makes you conscious when you smile or speak.
  • Your diastema has been increasing with time.
  • Apart from diastema you have gaping in between other teeth also.
  • Diastema has developed after trauma to your face or teeth.
  • Diastema exists along with other cosmetic dental issues like fluorosis, chipping and staining.
  • Diastema exists along with abnormally short or long central incisors.
  • Central incisors are tilted forwards or backwards compared to other teeth.
  • Diastema is due to a correctable and known cause like tongue thrusting, gum inflammation and bone resorption etc

Causes of Front Teeth Gap or Diastema

It is not always necessary that every case of diastema will have an associated cause, it is just there. However in those cases where a cause can be identified, following may be present

Skeletal causes

This is a genetic cause and put forward simply it is a mismatch between sizes of the jaw bone holding the teeth and the size of the teeth. The size of the teeth is smaller and so the gap, but in this case diastema may be associated with gaps between other teeth as well.

Frenum

Frenum is a small gum tissue that extends from gum line to occupy space between central incisors and therefore gives rise to spacing between central incisors during our growing stage. 

Frenum

Frenum

Habits 

Diastema in these cases is present since childhood and it increases with the passage of time. Some habits known to cause front teeth gap are thumb sucking, tongue thrusting. In thumb sucking the sucking force generated by the mouth forces the central teeth forwards and in tongue thrusting tongue constantly pushes the central incisors forwards.

Missing teeth

Loss of teeth from upper jaw (Maxilla) will create an empty space. Now teeth have more space to move into and this process of shifting of teeth can give rise to a diastema.

Gum Disease (Periodontitis) 

Infection and inflammation of the gums can lead to spacing between the teeth. Your gums may be infected if oral health is neglected, resulting infection and inflammation may cause loosening of teeth and concomitant gaps or diastema. It should be remembered that healthy gums holds the teeth in place. Gaps occurring due to gum infectious are usually progressive and are associated with other symptoms like bleeding gums, bad breath, loose and mobile teeth and gum pain.

Bone Disease

Gum inflammation usually precedes bone infection. Chronic presence of gum infection also infects underlying bone and loss of bone density. Now two structures (Gum and Bone) that holds the teeth in place are weak and thus teeth will move forward and cause gap/s which was not present earlier.

 

Treatment of Front teeth Gap or Diastema

Treatment of diastema can be grouped into two categories

  1. Diastema without associated gum and bone disease: Various treatment options are Dental Bonding, Dental Veneers, Dental Crowns, Frenectomy, Conventional Braces, Invisible Braces
  2. Diastema with associated gum / bone diseases: Any of the above along with the treatment of underlying cause. Some common treatments available for gum and bone infection are Scaling, Deep cleaning, Curettage and Flap surgery.

Most of the diastemas except those associated with gum or bone disease do not cause any oral or general health problem and getting them corrected is an individual’s choice. Please note that I have mentioned corrected instead of using word treatment. It is important to understand the different treatment options in brief before the choosing the one for yourself.

For ease of understanding I have lined up treatment options starting from the lowest cost procedure for diastema correction

Dental Bonding for front teeth gap correction

This procedure is also done to correct chipping, discolouration, and shape correction and for concealing fluorosis patches. In this procedure the same material that is used for cavity filling is applied on the tooth that needs correction. Since the filling material is paste like it can be given the desired shape. The dentist subsequently uses a blue light to solidify this material. Finally the dentist by using various cutting, polishing and shining tools gives a desired shape to the material, smoothens it, rounds off the edges and gives it a shiny surface. This procedure can be completed in one visit. This procedure is low cost but it is good to last for 3-5 years before discolouring or chipping off.

Dental Veneers for front teeth gap correction

Veneers are thin shells of ceramic which are customised to give a desired shape to the teeth under the treatment. A small amount of teeth surface is shaved off from front of the tooth to make space for the Veneer. These may be expensive but they don’t discolour and can last 15-20 years. This procedure can take 2-3 appointments.

Dental Crowns for front teeth gap correction

Dental crown is commonly known as tooth cap. Though veneer is given on front surface of teeth, crown covers the entire tooth from all surfaces. So apart from improving front appearance of tooth they also give strength to the teeth and issues such as tilting of teeth, short of long teeth, broad or thin teeth can also be corrected by crowns. The cost of crown treatment is almost similar to veneers and procedure can take 2-3 appointments.

Gap correction with crownCEREC crown

 

Frenectomy for front teeth gap correction

Frenectomy is the removal of the frenum. This procedure is required if gap is due to frenum and additional treatment for gap closure is also required. Depending upon the expertise of the dentist and availability of equipment with him, frenectomy can be done by cutting the tissue with a blade or ablating it with a diode laser. Laser frenectomy heals faster, is painless, bloodless and heals without scarring.

Braces for front teeth gap correction

It is the simplest and the most natural way of correcting the teeth gaps in general or for closing the diastema. Braces do take a longer duration of time to give you the desired results and the time duration varies from one patient to another, but a braces treatment may require at least 9 months to complete.

It is a common misconception that braces are required only for front teeth in diastema closure, however contrary to this belief braces are required on both lower and upper jaw because when front teeth will move other teeth also require movement to maintain alignment.

People going for braces may choose Metal or ceramic braces or lingual braces as per their choice and budget. Recently transparent braces also known as aligners are also available to circumvent the cosmetic concerns due to wearing braces especially in working and socially active adults.

Advances in Dentistry for front tooth gap correction

Advances in dentistry and availability of sophisticated equipment and computer software have made it possible to get such treatment possible in a single day. Use of software has made it possible to visualise treatment on the computer screen and execute the treatment plan without any deviation. Laser has made soft tissue management more predictable and painless. Though dental clinics with all these facilities are not many but still such clinics and dentists with such skill sets can be found in many cities of India specially Delhi.

Shade detection

With the availability of digital equipment like VITA EASY SHADE shade of your natural teeth can be recorded and same can be used to give you a new veneer or a crown although such colour matching is not possible in Dental Bonding. Goel Dental uses CEREC OMNICAM for shade detection.

Dental Materials

Commonly any clinic sources it dental work to an associated dental laboratory where technicians under the supervision of a prosthodontist carries out the desired work. But with the availability of dental materials like Composite blocks, Ceramic Blocks, Zirconia Blocks, Hybrid Blocks from World’s best brands like EMax, CEREC, Katana, 3M and much more any dentist working on inhouse CAD / CAM system can give you results which are next to none. Goel Dental uses CEREC CAD/CAM for carrying out front teeth gap corrections in Delhi.

CAD/ CAM

It stands for Computer Aided Designing and Computer Aided Manufacturing. Clinics in possession of such technology are far and few. Provision of CAD/CAM in clinic allows for a digital measurement of the teeth, analysis of impressions, software based planning of the final product, choice of finest dental materials, same day fabrication and delivery. Goel Dental uses CEREC CAD/CAM inhouse system for Composite based Dental Bonding, Veneers and Crowns. Goel Dental also uses CEREC 5.2.2 for designing and planning purposes.

Laser

Laser dentistry is based on availability of Soft tissue Diode Laser. Management of Gum tissue has become faster and bloodless with the use of Laser. Procedures like Frenectomy, excision of tongue tie can be accomplished in minutes. Goel Dental uses BIOLASE soft tissue Laser Epic 10 for laser based procedures.