A diastema is a gap between the teeth. It is not harmful, and it appears in children and adults. In children, the gap typically closes when their permanent teeth come through.
A diastema is a gap between teeth that is wider than 0.5 millimeters. It can develop between any teeth.
Treatment is not usually necessary for medical reasons. But if a person dislikes the appearance of their diastema, it is possible to close or narrow the gap.
In this article, we explore the causes of diastemas and describe their treatment and prevention.
A diastema may result from the following:
The size of the teeth in relation to the jawbone
If a person’s teeth are too small, relative to the size of their jawbone, gaps may develop between the teeth.
Jawbone and tooth sizes can be genetic, which is one reason that diastemas can run in families.
Missing or undersized teeth
If some teeth are missing or smaller than others, a diastema can develop.
This often involves the upper lateral incisors — the teeth to either side of the two upper front teeth. If the upper lateral incisors are missing or relatively small, a gap can develop between the two front teeth.
Oversized labial frenum
The labial frenum is the tissue that extends from the inside of the upper lip to the gum above the upper front teeth.
If this tissue is especially large, it can cause a gap to form between these teeth.
Tooth migration is a typical sign of advanced gum disease.
In people with gum disease, inflammation results in damage to the bone that supports the teeth.
Eventually, the teeth may become loose, and gaps can appear.
Incorrect swallowing reflex
When the swallowing reflex happens correctly, the tongue presses against the roof of the mouth.
A person may instead push their tongue against their front teeth when they swallow. Over time, this repetitive pressure against the front teeth pushes them forward, causing a gap to form.
Thumb sucking, lip sucking, tongue thrusting, and similar habits can put pressure on the front teeth, pushing them forward.
This can lead to diastemas.
Loss of primary teeth
Children can develop temporary diastemas when their primary teeth, or baby teeth, fall out. When their permanent, or adult, teeth come in, these gaps typically close.
This type of gap is common enough that dentists consider it to be a normal developmental phenomenon in children. No treatment is usually necessary.
A 2012 study reports older findings that these diastemas may be present in approximately two-thirds of children in whom only the central incisors have erupted. The central incisors are the two flat teeth at the front of the upper jaw.
The only indication of a diastema is a visible gap between teeth.
If the teeth become loose because of gum disease, the person may experience pain and discomfort, especially while eating.
Other symptoms of gum disease include:
- bright red gums
- swollen, tender gums
- bleeding gums
- receding gums
- bad breath
- loose teeth
Diagnosis of a diastema is straightforward — the dentist spots the gap while examining the teeth.
Typically, the individual will notice the gap first, while brushing or flossing.
Treatment for a diastema may not be necessary — especially if the gap arises from a mismatch between the size of the teeth and the jawbone, or if it results from the loss of primary teeth.
If treatment is not medically necessary, but the person wishes to close the gap for aesthetic reasons, a dentist can help determine the best approach.
Treatment options include:
Dentists commonly treat diastemas with braces. The braces put pressure on the teeth, closing the gap over time.
It may be necessary to wear a full set of braces, even if there is just one gap, because moving any teeth affects the entire mouth.
Veneers or bonding
As an alternative to braces, a dentist can fit veneers or perform dental bonding.
These options may be especially suitable if the diastema results from having smaller teeth.
Dental bonding involves applying resin to the surface of the teeth, then hardening the resin with a light source.
Fitting veneers involves securing thin, custom-made pieces of porcelain to the surface of the teeth.
Dental implants or a bridge
If a diastema exists because the person is missing teeth, they may need more extensive dental work, such as implants or a dental bridge.
Placing dental implants involves inserting metal screws into the jawbone and attaching the replacement teeth.
A dental bridge is a false tooth held in place by a device that attaches to the teeth on either side of the gap.
When a diastema results from an oversized labial frenum, the dentist may recommend a frenectomy — a procedure to remove the excess tissue.
Older children and adults may then require braces or another treatment to close the gap. In younger children, the space may close on its own.
Gum disease treatment
Gum disease requires treatment to stop the infection and prevent complications such as tooth loss.
Treatment may include scaling to remove tartar from the gums. Scaling also removes the bacteria causing the infection. In addition, topical or oral antibiotics may help.
In severe cases, surgery may be necessary to remove deep tartar from beneath the gums.
Once the gums are healthy again, the dentist may use one of the above treatments to close the gap.
It is not possible to prevent all cases of diastema.
However, if gum disease or habits are the cause, it can help to practice good oral hygiene, by:
- brushing the teeth twice daily
- flossing daily
- seeing a dentist for regular examinations and cleanings
- avoiding thumb sucking and helping children break the habit
- correcting improper swallowing reflexes
The outlook varies, depending on the underlying cause. However, treatment can eliminate or reduce most diastemas.
The gap will typically remain closed after treatment, unless the individual returns to habits such as thumb sucking or does not follow their dentist’s instructions.
People should speak to their dentists if they or their child have a diastema and are concerned about it.
The American Association of Orthodontists recommend that orthodontists evaluate all children by the age of 7.
A dentist or orthodontist can diagnose the underlying cause and, if necessary, recommend a course of treatment.
A diastema is a gap between the teeth.
A range of factors can cause a diastema — from gum disease to the ratio of tooth size to jawbone size. A dentist can determine the exact cause.
In many cases, treatment is not necessary. Some people decide to have treatment anyway, for aesthetic reasons.
There are many methods of treating a diastema, and the results are usually permanent.