A person with diastema has a space or gap between two or more teeth. Gaps can range from barely noticeable to large, and some people first notice a tooth gap while brushing or flossing.
Midline diastema, which appears as a gap between the two upper front teeth, is the most common. Gaps can also develop between any teeth in the mouth, not just the upper front teeth.
Some people have small or large gaps between all of their teeth, but this condition is relatively rare. Many children also have spaces between their primary (baby) teeth, but they often disappear once the baby teeth shed and permanent teeth grow in.
Ninety-eight percent of 6-year-old children have midline diastema, typically in their primary teeth. However, as permanent teeth fully erupt, the percentage of diastema decreases to about 49 percent in children between 10 and 11 years old. Only 7 percent of adolescents between 12 and 18 years of age have midline diastema.
Diastema can be attributed to genetics, bad habits, and/or abnormal skeletal development:
Yes, it can be. Some people have permanent teeth that are too small for their jawbone. When permanent teeth fully grow in, there may be spaces between a few teeth, the two upper front teeth (midline diastema), or all of the teeth. Teeth and jawbone sizes are usually genetic, which means diastema can be passed down through generations.
Tooth gaps are not always determined by genetics. Some people may experience an overgrowth of gum tissue between two or more teeth. This overgrowth is often triggered by gingival hyperplasia (gum enlargement), which is generally caused by advanced gum disease. If the condition becomes severe, gaps can form between teeth.
Diastema can be caused by a discrepancy in tooth size or missing teeth. An oversized labial frenum, which is the tissue that connects from the inside of the lip to the gum tissue surrounding the two top front teeth (central incisors), can also cause midline diastema.
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To fix this condition, a periodontist may recommend a frenectomy. During this procedure, your frenum is cut and repositioned, allowing for more flexibility.
Irregular swallowing reflexes and poor chewing habits can cause diastema. If a child already has gapped teeth due to genetics, these habits can also worsen the condition.
Diastemas can be caused by sudden loss of primary (baby) teeth. However, these diastemas are temporary and will go away once the permanent tooth grows in.
A diastema treatment plan depends on the patient’s age and whether the gap(s) is mild, moderate, or severe. Common diastema closure procedures include:
Tooth gaps typically do not pose any complications or health concerns. If this is the case, patients can choose to keep the diastema.
Dental braces are commonly used to fix tooth gaps and other forms of misalignment in children.
If a patient has gapped teeth and another form of malocclusion (misalignment), an orthodontist will typically recommend braces over dental restorations or cosmetic procedures.
Clear aligners are a type of orthodontic treatment that corrects diastema and other forms of misalignment in children, teens, and adults. Aligners are a virtually invisible alternative to braces and cost about the same.
Dental bonding is an affordable restorative treatment option that fixes chipped, cracked, spaced, or damaged teeth. Treatment consists of a special adhesive, a high-intensity curing light, and tooth-colored composite resins. The materials are bonded to the teeth and fill any imperfections.
People who have a few gaps between their teeth can opt for bonding treatment over invisible aligners or braces. However, if a patient also has moderate to severe teeth misalignment, a dentist will recommend braces or aligners instead of dental bonding.
Composite veneer bonding and porcelain veneers are common cosmetic treatment options for diastema. Dental veneers are thin, customized shells of tooth-colored materials.
They fit over the front of teeth and improve a patient’s appearance by changing the shape and color of teeth. Treatment is expensive and can cost up to $1,500 per tooth.
Restorations, including crowns, bridges, or implants, can treat many cases of moderate diastema in adults. Dental restorations, bonding, or veneers may be recommended over braces or clear aligners if a patient has normal occlusion.
Removable retainers can close small gaps between teeth without the use of braces. Depending on how severe your diastema is and how it formed, you may benefit from a retainer. Talk with your dentist or orthodontist to determine the best option.
Diastema typically does not cause issues if left untreated. However, if the underlying cause of diastema is due to advanced gum disease, you'll need prompt treatment for the condition. Scaling and root planing is likely necessary in these cases.
Cobourne, Martyn T., and Andrew T. DiBiase. Handbook of Orthodontics. Elsevier, 2016.
Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.
Kamath, Mketaki, and Av Arun. “Midline Diastema.” International Journal of Orthodontic Rehabilitation, vol. 7, no. 3, 2016, p. 101., doi:10.4103/2349-5243.192532.