Gap between front teeth, also called diastema, is a very common problem. While some people find having a small gap between their teeth an attractive feature, many would prefer to have it closed.

Effective treatment of diastema requires correct diagnosis, with clarification of the reason for its appearance.

Reasons for the formation of diastema:

1. A discrepancy between the size of the jaw bones and the size of the teeth can be expressed either in additional space between the teeth (gap) or in crowding of the teeth. If the teeth are too small for the jaw, the spaces between the teeth will be wider. If the teeth are too large for the jaw, the jaw will have a “teeth overcrowded” appearance. Sometimes there are anomalies in the shape or size of the teeth: some teeth are missing or undersized. Most often, such anomalies in the shape and size of teeth are observed in the upper lateral incisors, which in turn leads to the formation of a gap between the upper central incisors.

2. Development gaps between front teeth contributes to the incorrect location of the rudiments of teeth, extremely rarely - neoplasms.

3. Diastema can also be caused by an excessively large frenulum, which is a bridge running from the inside of the upper lip to the gum; The frenulum is located just above the two upper front teeth. In some situations, the frenulum continues to grow and extends between the two front teeth. In such cases, the frenulum blocks the natural process of closing the space between the front teeth.

4. Bad childhood habits, such as pacifier or thumb sucking, can widen the gap between the front teeth.

5. An increase in the gap between the front teeth may be a consequence of an incorrect swallowing reflex. For most people, when swallowing, the tongue rests on the roof of the mouth. In some people, when they swallow, the tongue presses against the front teeth, which creates a traction effect and causes the front teeth to move forward and create a diastema between them.

6. Gaps between the front teeth can become complications of periodontal disease. The mechanism of formation of a gap between teeth is triggered by the loss of bone tissue that supports the teeth. People who have lost a lot of bone tissue have loose teeth.

7. Sometimes a gap between teeth can be recognized as a functional deviation in children with baby teeth. Often, when baby teeth fall out, the space between the growing teeth permanent teeth contracts to reach its final position.

Symptoms of diastema

Diastema, which results from a discrepancy between the size of the teeth and the size of the jaw, has no symptoms.

However, widening of the interdental space caused by tongue thrusting habits, frenulum growth, or periodontal disease will tend to widen interdental gap over time. With this continued increase in the gap between the front teeth, discomfort or pain may occur, especially when eating.

Diagnosis of diastema

Often a wide gap between the front teeth is visible when smiling in the form of a black triangle, and does not pose difficulties in making a diagnosis. An important part of the diagnosis is taking into account the reasons that caused this anomaly.

The patient himself may suspect a slow increase in the interdental space between the front teeth, noting an increase in space when brushing or flossing. Your dentist may see increasing gaps between teeth during an examination.

Carefully developed diagnostics and long-term planning allows you to select the most suitable treatment for each specific case, to meet the needs of the patient.

Clinical considerations, advantages, disadvantages, and alternative methods Treatments to close the gap between the front teeth are presented below.

Treatment of diastema

Many people with diastema feel very comfortable and do not look for ways to correct it. Some of them think it makes them look sexy. Even some famous actors and representatives show business did not regard their gap between their front teeth as a “shame”, viewing it as part of their personality. Among the stars with such a gap are Madonna, Vanessa Paradis, Elton John, Eddie Murphy, Lara Stone, Alla Pugacheva.

But if you do not belong to any of these groups, and you think that diastema has negative influence on your appearance, or causes discomfort, there are several options for correcting it.

The most common treatment options, depending on the type of case, cost factors, time, patient requirements and expectations, include:

1. Orthodontic treatment.

2. Veneers and crowns

3. Adhesive dentistry.

4. Frenectomy

5. Prosthetics and restoration (Orthopedic dentistry)

Orthodontic treatment

An orthodontist can close gaps between teeth using braces by slightly moving the teeth, thereby reducing the gap between them.

For large gaps between teeth, several teeth must be moved to the area of ​​the gap so as to form equal spaces between all teeth. Orthodontic treatment for diastema provides permanent results, but it may take long time(more than one year for large diastemas).

In some cases, treatment consists of using removable devices made of plastic instead of traditional metal ones. In other cases, lingual braces are used, which are almost invisible to others. However, this treatment may cost more and take longer than with other devices.

Although orthodontic treatment requires regular check-ups and a long period of time, it has the advantage of leaving natural teeth intact and providing a permanent solution to the problem of diastema, without requiring additional replacement of interdental correctors in the future.

Porcelain veneers

Veneers offer the most revolutionary (but also most expensive) way to correct the gap between your front teeth. Porcelain veneers are made from a thin layer of porcelain that is no more than half a millimeter, then the veneers are bonded to the front of the tooth, immediately restoring the natural appearance and beauty of your smile.

Adhesive dentistry

Similar to the use of veneers, the use of lumineers, which are thin plastics made of composite resins, made to the shape of the diastema defect. They are custom-made and have the same color as the adjacent areas of enamel, so teeth with these composite plates look like a single natural tooth structure. The use of lumineers in closing interdental spaces is the most in a fast way correction of interdental gaps.

Despite the trend toward staining, such minor cosmetic dental adjustments are still often the treatment of choice. The benefit comes from eliminating the need to remove tooth structure, which is required with restorative options such as dental crowns and possibly porcelain veneers. When crowns are used, part of the tooth structure is inevitably removed as part of the restorative process, and what is inevitably called “shaping of the tooth for a crown” occurs.

At the same time, the use of lumineers is a temporary solution; in the future, the surface of the tooth is resurfaced and a new layer of composite resins is again placed on the teeth in such a way as to refresh the smile.

Orthopedic dentistry

If the cause of the diastema is a lack of size or number of teeth, the existing correction methods are supplemented surgical operations for the placement of dental implants, bridges or partial dentures.

Frenectomy

If a large frenulum serves as the basis for the formation of a gap between the front teeth, the frenulum can be reduced by surgical intervention called a frenectomy. If frenectomy is done in junior childhood, the space between the teeth may close on its own. If a frenectomy is performed on an older child or adult, the interdental space may be closed using braces.

Periodontal treatment

If the gap between the front teeth is caused by periodontal disease, then treatment by a periodontist is necessary. Once gum health is restored, braces can be used in many cases to move the teeth back into place. In some cases, a bridge may be required to close the gaps. The ultimate goal when closing a diastema is to create adequate interdental contact.

A common gap in people between centrally located teeth is called a diastema. These are slits of various widths (from 2 mm to 1 cm), separating mainly upper incisors, but sometimes also lower ones. They should not be confused with threes - another type of gap, albeit between other teeth, often “accompanying” this anomaly. But diastema is not a death sentence. With proper diagnosis and subsequent treatment, teeth can be given as close to the ideal shape as possible.

What types of diastemas are there?

In order for treatment to be most effective, the disease must be correctly classified. Diastemas can be divided into two groups:

The next classification is determined by the deviation of the teeth from each other.

• Symmetrical: with such a diastema, the incisors are deviated from each other by the same distance, mirroring each other.
• Asymmetrical: This arrangement involves the deviation of only one tooth, while the second remains in its normal position.

There is another division of diastema, into 3 types:

• WITH correct location roots, but laterally inclined central incisors.
• With lateral displacement of the teeth, forming a gap.
• With incisor deviation, located in the center, medially, and their roots - laterally.

But how to correctly identify diastema and determine ways to treat it.

How to identify diastema

A visual inspection allows you to make assumptions about the type and degree of deviation, and get an initial impression that will need to be confirmed using a hardware inspection.

After that, targeted radiography is performed, which will help to see the location of the roots and determine the presence of impacted teeth.

Using an orthopantomogram, a general picture of the dental system is created, where deviations from the norm, other curvatures and anomalies can be observed.

Taking impressions is also a common method not only for identifying a diastema, determining its type and stage, but also for creating a suitable bracket or plate.

In addition, in order to properly carry out treatment using the most suitable materials, you should focus on some other indicators:

• Condition of the bridle.
• The shape and position of the incisors and their roots.
• Character of the bite.
• The amount of space between the teeth.
• Symmetry or asymmetry of the diastema.
• The degree of development of incisors distant from each other.
• Stage of root formation.

Taking into account all this collected data, a treatment plan is created, individually selected for each person.

Treatment methods

Depending on the degree and form of severity of this anomaly, methods of influencing it are selected.

Therapeutic treatment

Provides for eliminating a small gap by building up missing walls composite materials, so-called artistic restoration.

This method is suitable for treating mild degree diastema, with normal form and the location of all teeth.

Surgical method

Used when established cause divergence of teeth is the connecting frenulum with upper lip. In this case, it is trimmed, which helps reduce the distance between the incisors. True, this procedure is somewhat painful and for some time after it you have to endure inconvenience while eating.

Orthopedic method

It is used to mask the distance between teeth, while using ceramic veneers or crowns made of various materials. They help to quickly and effectively correct not only the diastema, but also the shape and color of adjacent teeth.

True, this method of treatment has a rather high price, but it guarantees quick results.

Orthodontic treatment of teeth

It is the most gentle method. Leveling occurs by installing various braces, plates or self-adjusting rings with levers. In order to install these devices, there is no need to grind or grind the teeth, so this procedure will not cause much discomfort even to children. True, the result will have to wait several years.

Sometimes, to obtain an ideal result, there are situations that require a combination of several methods.

Causes of appearance and preventive measures

What can be done so that you don’t have to resort to medical care and avoid the appearance of gaps between teeth?

Prevention methods:

• Regular visits to the dentist will help not only diagnose diastema as early as possible, but also avoid other problems with oral cavity. This is especially true for children, since it is in early age it is much easier to correct such deviations.
• Getting rid of bad habits, such as prolonged feeding with a pacifier, biting various objects.
• Control by adults over the appearance of molars and the loss of milk teeth, as well as their shape and position.

But they still exist objective reasons the appearance of diastema, which cannot be prevented, but only corrected in time.

Causes of diastema:

By getting rid of a diastema, you can acquire not only an attractive appearance and gain self-confidence, but also avoid problems such as speech defects, diseases of teeth and gums.

IN aesthetic dentistry there is a separate problem that is often ignored by patients. Diastema or a large gap between the teeth is perceived by many as an ordinary defect that does not require attention. In fact, the pathology greatly affects the ability to pronounce certain sounds clearly and correctly and spoils the smile. IN adolescence and in the weaker sex, the defect becomes a cause of embarrassment, forcing one to communicate less frequently and appear among strangers. Modern technologies make it possible to bridge this gap minimal costs time.

Causes of diastema

A large gap between the teeth is a defect and is not considered normal development. This is a noticeable gap between two crowns and most often occurs in the front of the upper jaw. This most common pathology is recorded in 20% of people in mild form(from 1 to 5 mm), and in 8% it is severe (up to 10 mm distance). Sometimes the problem affects the teeth of the lower row, and is combined with curvature, destruction of enamel and similar congenital anomalies.

Dentists have noticed that a gap in the dentition is transmitted genetically in every second case. Other causes of the defect include:

• congenital anomalies of the frenulum of the tongue or upper lip (it may be too short or thick);
• later in time;
• cleft palate (cleft lip and other similar pathologies of newborns);
• absence of tooth buds (edentia), when there is free space on the jaw.

Often, diastema between the teeth becomes a consequence of the child’s negative habits during the formation of milk crowns: constant sucking of the pacifier, gnawing on the hard edge of a toy, prolonged feeding from a bottle. The incorrect placement of crowns is affected by the lack of calcium and other minerals in the baby’s diet, without which it is impossible to build strong molars or incisors.

People can experience gaps between their teeth even at a fairly mature age. This is influenced by the habit of constantly chewing a pencil or pen, and eating sunflower seeds. Sometimes this is a consequence of a jaw injury in which the bone has not healed properly or the connecting plate has broken. In rare situations, a diastema appears in patients after chewing molars fall out: the dentition becomes sparse and the crowns begin to diverge.

Tremas are large gaps between the lateral teeth. They are formed for the same reasons as diastema.

Classification of pathology

When diagnosing such a defect, dentists distinguish between false and true forms. The first option often accompanies the germination of baby teeth and does not require special treatment. Usually, after replacing molars with molars, the cleft closes and stops bothering the baby. It is advisable to visit the orthodontist more often during this period to monitor the process and adhere to a balanced diet.

With the true form of diastema, the atypical distance between the teeth only increases every year, and curvatures and other irregularities may appear. Here, several subtypes of pathology are conventionally distinguished:

1. With symmetrical, the anterior crowns diverge parallel to each other and remain relatively even when external inspection. More common when too short bridle on the upper lip.
2. With an asymmetrical appearance, the teeth not only have a gap, but are also at an angle. The curvature can affect only one crown. This happens after traumatic removal of a unit or dense intergingival papillae.

In this case, the gap between the front teeth or in another part of the jaw can only be removed through complex prosthetics and long-term treatment.

Symptoms and signs

In the vast majority of identified cases, the defect is wedge-shaped and the teeth are located under acute angle relative to each other. During the examination, pathologies in the development of the frenulum, too tight a bridge or a short length are detected. Other symptoms depend on the degree of development of the disease:

• a wide gap or a sharp wedge between two adjacent teeth is visually determined;
• a person has defects in the pronunciation of certain sounds, especially “whistling” and “growling”;
• observed malocclusion, breaking the symmetry of the chin and face.

In advanced situations, with a cleft between the front teeth, their darkening, damage by caries and other pathologies are observed. They destroy enamel and lead to early loss of crowns. Pathology can also affect neighboring teeth, causing them to overlap each other. In addition, it has been proven that in people with such a deviation, the risk of developing periodontal disease increases several times.

Features of the examination

Diastema between teeth is easily detected during a dental examination. But pathological process may not be limited to the gap, but affect other areas. To complete the picture, the patient is x-rayed and pictures of the roots of the teeth and jaw are taken. The following methods are no less informative:

• pictures using a special device from an orthodontist (orthopantomography);
• taking and making an impression that completely imitates the bite;
• measurements of the distance between the teeth, the angle of divergence and other features.

If a problem is identified in children, a consultation with a speech therapist-defectologist, an examination by an orthodontic surgeon and other specialists is required.

Methods for removing gaps between teeth

New dental techniques make it possible to cope with even the most unusual violations and remove aesthetic defect in a mature person. The choice of method depends entirely on the width of the passage between the teeth. In the mildest situation, when a gap of no more than 3 mm is diagnosed, complex extensions with photopolymer materials can be used. The dentist carefully increases the area of ​​the crowns, aligns the edges and creates beautiful effect on for many years. This procedure is performed in 1–2 approaches and does not require long-term rehabilitation.

Another option is used if the cause of the gap between the front teeth is a hard frenulum between the upper lip and the gum. In this case, treatment begins with trimming or plastic surgery of the mucosa. After complete healing, the molars can independently come together and take the correct position. Otherwise, you cannot do without polymer extensions, which will help give the correct shape and suitable appearance.

IN difficult situations patients are offered orthopedic treatment. It is necessary if the gap between the teeth exceeds 4–5 mm and is very noticeable, affects pronunciation and brings moral discomfort. The technique consists of making veneers - individual overlays for molars, which are made from ceramics. Resistant to abrasion and temperature changes, such prostheses are attached to the anterior crowns and cover the defect.

Sometimes the only way treatment is the installation of complex structures. These can be special plates or braces that help straighten the entire dentition. The disadvantage of this technique is time: it takes from six months to 2.5 years to completely eliminate the pathology. In the process, the patient has to frequently visit the dentist for correction and tightening of metal parts. Sometimes the doctor will remove healthy molars to make room for rotation. After removing the system, you will have to wear plastic mouth guards for a certain period at home and leave them for several hours so that they “get used” to the new position and the gap does not appear again.

Gaps between teeth bring not only aesthetic discomfort, but also affect diction, disrupt the chewing process, and also contribute to the development of problems with soft tissues. Minor gaps are not dangerous, but large discrepancies must be corrected.

There are two types of clefts between teeth:

1. Diastema - the distance between the teeth on the upper and lower jaw. Its size ranges from 1 mm to 1 cm.
2. Trema is a large gap between the teeth in the far row - molars and premolars.

Important! Often in children there is a gap between the primary incisors. This is the so-called false diastema. When replaced with molars, it disappears. If this does not happen, they speak of a true diastema.

This is what a diastema looks like.

A gap between teeth appears in several reasons:

1. Low location or increased size of the frenulum of the upper and lower lips.
2. Microdentia is the growth of too small incisors and fangs.
3. Bad habits: long weaning of a child from a pacifier, thumb or pencil sucking.
4. : curvature, crowding.
5. Long-term change of teeth.
6. Excessive number of teeth: an anomaly occurs in 2–3% of people, characterized by the growth of additional canines, incisors and molars, most often on the upper jaw.
7. Complication of gum disease.
8. Loss of teeth: the remaining units are pulled together in place of the removed one, as a result, the integrity of the row is disrupted.
9. Swallowing dysfunction: 5 - 7% of people, when swallowing, rest their tongue not on the palate, but on the upper incisors.

Important! To prevent the development of diastema in babies, they need to be weaned off the pacifier from the age of one and a half years.

Restoration methods

Depending on the cause of their appearance, as well as the size of the spaces between the teeth, gaps are eliminated in one of the following ways: orthodontic treatment, composite restoration, prosthetics, or surgery.

This is trema.

Important! If a gap between the front teeth appears due to a non-standard size of the frenulum, first surgical plastic surgery. Only after this they begin restoration.

Bracket system

Braces are used for severe malocclusions. They are usually installed on children and adolescents. But with the help of the design, curvature is also corrected in adults. Average duration therapy – from 6 months to 2 years.

Important! The duration of treatment directly depends on the size of the pathology and the age of the patient. The younger the client and the shorter the distance, the less time it will take to remove the chip.

Types of bracket systems.

TO pros bracket systems include:

1. Saving natural look and integrity of the dentition.
2. Safety.
3. There is no need for depulpation and grinding of enamel.

Design disadvantages:

1. Expensive.
2. Duration of treatment.
3. Painful sensations at the beginning of therapy.

Made from metal, ceramic and sapphire. The cost depends on the materials of construction, the manufacturer and the pricing policy of dentistry. On average, installing a turnkey bracket system will cost from 20,000 to 75,000 rubles.

Invisalign

Invisalign is a transparent aligner for correcting teeth.

Invisalign system– a new word in orthodontic treatment. A transparent mouthguard made of high-strength plastic is placed on the patient’s jaw. The design gently and gradually tightens the teeth, eliminating the gaps between the teeth. Thanks to this, minor curvature or chipping can be eliminated.

The Invisalign system is used as an alternative to braces. Compared to orthodontic braces, it has a number of advantages:

1. Gentle effect on the jaw, no severe pain.
2. Convenient – ​​the mouth guard can be removed while brushing your teeth and eating.
3. High aesthetics - the transparent design is almost invisible.

Important! The mouth guard will have to be changed every 3 to 4 weeks. This “ties” the client to dentistry.

The disadvantages of the system are its high cost and the impossibility of installation in case of severe curvature and crowding. Prices for Invisalign start at 200,000 rubles.

Composite restoration

Often, dentists, when patients ask how to close the gap between the front teeth, recommend reconstruction with composite materials. This method is used only to eliminate gaps between incisors, canines and slight curvature.

Result after correction.

Composites are elastic photopolymer materials. They are applied in layers and harden under a special lamp - a photopolymerizer. At the end, the dentist must remove excess fillings, polish and grind.

Pros composite restoration:

1. Fast: recovery takes from 30 minutes to 2 hours.
2. The procedure is carried out in one visit.
3. Painless.
4. No need to grind down the enamel.

Important! retains the opportunity to correct the bite in other ways at any time. The method gives time to think about what to do next in case of serious defects.

Composites have significant cons:

1. Average service life is 5 years.
2. Restored teeth will need to be polished and fluoridated regularly.
3. Fragility.
4. Due to their porous structure, composites change color within 2–3 years.

The price of a composite restoration depends on the complexity of the restoration and how many units need to be fixed (one or more). On average, the cost varies between 5,000 – 7,000 rubles.

Vining

Large gaps between teeth are preferably corrected with veneers – ceramic plates. Their thickness does not exceed 0.7 mm, they are attached to the enamel and completely restore the aesthetics and functionality of the jaw.

Important! Veneers are made from individual impressions by a dental technician. The color and size of the plates fully correspond to the patient’s natural bite.

Veneers are one of the methods for correcting gaps between teeth.

Advantages of veneers:

1. The plates are indistinguishable from natural teeth.
2. Long service life - from 10 years.
3. Increased strength.
4. Allows you to correct many crooked teeth at the same time.

Flaws:

1. The enamel is ground down.
2. The duration of the procedure is 2 – 3 weeks.
3. After the installation of the plates, restoration using other methods other than prosthetics is impossible.

The cost of veneering varies from 15 to 25 thousand rubles.

Crowns

Another way to close gaps between teeth is dentures. single crowns. They are made from medical porcelain using casts and installed on a pre-ground incisor or canine.

Important! Only crowns made of ceramics and zirconium dioxide are installed on incisors and canines. Metal ceramics do not convey the required transparency and are translucent.

Crowns are often used when it is necessary to restore one tooth or severely damaged incisors. They are durable, identical to the natural bite and shade. However, they have several disadvantages:

1. The tooth is severely ground down and depulpation is carried out.
2. Duration – the procedure takes from 2 weeks to a month.
3. Once a crown has been installed, restoration by other means is not possible.

One crown costs about 15,000 rubles.

Gaps between teeth can be filled with composite restorations, orthodontic treatment, or dentures. The method of restoration depends on the financial capabilities of the patient and the clinical picture.