Diastema: Definition, Types,Causes, and Treatment

Diastema is an extremely large space between one’s teeth. Such condition is usually seen at the top front teeth. These gaps vary in size and are spotted between any two teeth in the mouth at any one time. Midline and mandibular diastema are examples of diastema. It is affected by numerous circumstances including the size of the teeth, the absence of teeth or teeth that are too small, an enlarged labial frenulum, gum disease, improper swallowing reflex habits, and the loss of primary teeth. Dental bonding, braces, frenectomy, dental bridges and implants are the many therapy options for such conditions.

What is Diastema?

Diastema Definition

The space between teeth is referred to as diastema. Gaps develop anywhere in the mouth, but the most typical location for them is between the top front teeth themselves (central incisors). A disorder like such is often just a worry from an aesthetic standpoint, but in certain cases, it is linked to gum disease. Additionally, it is caused by a number of other variables, such as heredity, the size and form of the teeth, the location of the jaw, and the habit of sucking one's thumb. Dental bonding, porcelain veneers, and braces are some of the therapies available for diastema. Some individuals choose to have diastema closed via orthodontic treatment or dental bonding, while others choose to keep it in its natural state.

What does Diastema look like?

A medical word for space/gap at the center part of one’s teeth is diastema. Its most typical location is within the two anterior teeth (midline diastema). The said space is so little or rather big, and it does not often have a dangerous effect on an individual’s oral health.

What other terms are used to describe Diastema?

Diastema is synonymous with the terms "gap tooth" and "tooth gap." Some individuals characterize a diastema as having "separated teeth" or a "side teeth gap," despite these expressions are less precise and apply to gaps between any teeth and not simply the front teeth.

Who is affected by a diastema?

Diastema Definition

A diastema is a space that exists between two teeth, most often the two front teeth on the upper jaw. It is most often seen in children and teenagers. However, a diastema is not exclusive to the said age groups as it affects anybody. Additionally, the presence of certain orthodontic conditions, such as an overbite or an underbite, contribute to the development of a diastema. Furthermore, the probability of acquiring a diastema is increased by specific behaviors, such as sucking one's thumb or using a pacifier for an extended period of time.

Some populations have a much higher incidence of midline diastema. Those of African descent have a much higher risk of having a diastema in their teeth in comparison to persons of white or Asian origin. Moreover, different cultures have quite different notions of what constitutes beauty. It is often considered to be the ideal of beauty in nations like Ghana and Nigeria. Some individuals even go so far as to intentionally enlarge the space that exists between their two front teeth because they believe it to be a symbol of beauty and attractiveness in these cultures.

How does Diastema Affect Oral Health?

Oral health is negatively impacted in a number of different ways when a diastema is present. It makes it difficult to adequately clean the teeth and gums if the diastema is big, which leads to an increased risk of dental decay and gum disease. It is one of the primary problems associated with having a diastema, since it creates crowding of the teeth that are next to it. The gap itself is a collector of food particles and germs, both of which add further to the problems.

Additionally, diastemas have an effect on the bite and the way the teeth are aligned. It leads to an overbite or an overjet, both of which place extra strain on the jaw joint and the muscles that support it. It causes problems such as headaches, jaw discomfort, temporomandibular joint dysfunction (TMJ), and other symptoms that are associated with the condition. Furthermore, having a diastema has a detrimental influence on the look of the smile, which leads to concerns with self-esteem and confidence.

What are the types of Diastema?

There are lots of distinct kinds of diastemas, including the following:

  • Midline Diastema: The gap that develops in the upper front teeth’s center part is termed midline diastema, and is a subtype of the diastema dental condition. It is the most prevalent kind of diastema, and it is often brought on by either a hereditary predisposition or a variation in the upper jaw and teeth’s size.
  • Mandibular Diastema: The term mandibular diastema is used to describe a specific kind that is evident at the center part lower front teeth. Such kind of diastema is far less frequent than a midline diastema, and its etiology is commonly due to a combination of variables such as an injury, genetics, or the presence of additional teeth.

1. Midline Diastema

There is a specific kind of diastema that takes place in the middle of the upper front teeth and is known as a midline diastema. It is the sort of diastema that occurs most often. A diastema in the midline of the teeth is most often brought on by an imbalance between the size of the upper jaw and the size of the teeth in that jaw. It is believed to be inherited, or it develops as a consequence of behaviors such as sucking one's thumb or using a pacifier for an extended period of time. Such condition is brought on by the existence of an additional tooth, which is referred to as a supernumerary tooth.

A midline diastema, in certain instances, is deemed normal, and it is not necessary to seek therapy for it. However, treatment alternatives such as orthodontic therapy, dental bonding, or veneers are indicated if the gap is significant or creating other difficulties like trouble speaking or eating, or if a person is self-conscious about their appearance.

The location of the gap is what differentiates midline diastemas from other types of diastemas. The gap in midline diastema is in the middle of the upper front teeth, whereas in other types of diastemas, the gap occurs between any two teeth or it can be caused by a specific factor like trauma or habits.

2. Mandibular Diastema

The gap at the center area of the lower front teeth is a mandibular diastema. It is a kind of diastema that is more uncommon than a midline diastema and is produced by a number of circumstances including genetics, trauma, or presence of additional teeth (supernumerary teeth) in one’s lower jaw.

Furthermore, a mandibular diastema is brought on by a disparity of lower jaw and teeth’s size as well as by behaviors such as tongue pushing. It is possible that therapy is not necessary for a mandibular diastema since the condition is regarded as normal. One is advised to seek treatment if a person’s gap between their teeth is significant or causing them other difficulties, namely difficulty speaking or eating, or if they are self-conscious about their appearance. Treatment options include orthodontic treatment, dental bonding, and veneers.

The space location between an individual's teeth is the primary characteristic that distinguishes mandibular diastema from other forms of diastemas. Mandibular ones are located within the front teeth's bottom part, while midline diastema is found at the middle of the superior front teeth. Both forms of diastemas share comparable root causes as well as treatment possibilities. The difference between the two lies in the position of the gap.

What are the causes of Diastema?

Diastema Definition

A diastema develops as a consequence of the following:

  • The size of the teeth in relation to the one’s jawbone: Spaces form between their teeth if a person’s teeth are too little in proportion to the size of their jawbone. These spaces are called gaps. There is a good chance that the size of one’s jawbone and teeth is determined by genetics. It is one reason why diastemas tend to run in families.
  • Missing or undersized teeth: Diastema occurs when some teeth are absent or when some teeth are significantly decreased in size compared to the rest. It affects the upper lateral incisors, which are the teeth that are located on each side of the two front teeth seen in the upper jaw. A space forms between the two front teeth if the upper lateral incisors are absent or very tiny. The gap is rather noticeable.
  • Oversized labial frenum: The labial frenum is the tissue that runs from the inside of the top lip to the gum that is located above the upper front teeth. An enlarged labial frenum is a common cosmetic concern. It results in the formation of a space between these teeth in cases when the tissue is very big.
  • Gum disease: Tooth migration is a common symptom of severe gum disease, which is caused by periodontal disease. Inflammation causes damage to the bone that serves as a foundation for the teeth in patients who suffer from gum disease. The teeth gradually get dislodged, which results in the formation of gaps.
  • Incorrect swallow reflex: The tongue is expected to be pressing on the roof of the mouth when the swallowing reflex is functioning correctly. An individual instead presses the front of their tongue on their front teeth when swallowing. Such kind of repeated pressure on the front teeth causes them to be pushed forward over time, which results in the formation of a space between the teeth.
  • Habits: Habits such as thumb sucking, lip sucking, tongue thrusting, and other similar behaviors increase pressure on the front teeth and move them forward in the mouth. It results in gaps or diastemas.
  • Loss of primary teeth: A child develops temporary gaps in their smile called diastemas when they lose their primary teeth or baby teeth. These gaps are normally filled if the person’s permanent teeth or adult teeth come in. Dentists believe that the sort of space between teeth to be a natural and healthy part of children’s tooth growth. Medical intervention is not required in most cases.

How is Diastema diagnosed?

Diastema is most often identified and diagnosed by a trained dental expert during the course of a routine dental checkup. The dentist or orthodontist visually examines the patient's teeth and utilizes x-rays or other diagnostic techniques to get a better idea of the size and position of the gap in the patient's teeth.

Moreover, the dentist or orthodontist questions the patient about their medical and dental history, as well as any behaviors or environmental circumstances that have contributed to the formation of the diastema. The qualified expert searches for any indicators of tooth decay, gum disease, or any other oral health disorders that are connected to the diastema during the examination.

The dentist or orthodontist has a conversation with the patient about the various treatment options available as soon as a diagnosis has been reached. They make a recommendation, after which, regarding which course of action is most appropriate taking into account the patient's unique requirements and desires.

In summary, diastema is identified and diagnosed by a qualified dental practitioner during the course of routine dental examinations. The dentist physically examines the teeth, as well as utilizing x-rays or other diagnostic techniques, in order to determine the size and position of the gap, as well as analyze any oral health concerns that are associated with it.

What are the options for treating Diastema?

The following are some of the potential treatments for diastema:

  • Dental bonding: Dental bonding is a cosmetic surgery that involves applying a tooth-colored substance to the surface of the tooth in order to fill in the gap.
  • Braces: Braces, in orthodontics, refers to a procedure known as the use of brackets and wires to straighten the teeth and fill gaps between them.
  • Frenectomy: Frenectomy is a surgical treatment that refers to the removal of the frenulum, which is the tissue that links the lip to the gums, or a reduction in the size of the frenulum. It is done in order to close the gap.
  • Dental bridge: A dental bridge is a prosthetic device that bridges the gap in the teeth and is attached to the teeth on either side of the space.
  • Dental implant: A dental implant is a surgical technique that involves the implantation of a tiny titanium post into the jawbone to support a replacement tooth and fill in the space left by the missing tooth.

1. Dental Bonding

The cosmetic dentistry technique known as dental bonding involves applying a tooth-colored composite resin to the surface of a tooth in order to close gaps, repair chips or fissures, or enhance the overall look of the tooth.

Dental bonding has a variable lifetime, however it normally lasts anywhere from 3 to 10 years depending on the placement of the bonding, the amount of wear and tear it undergoes, and the patient's oral care practices. The lifespan of the dental bonding is shortened by activities such as tooth grinding, the use of tobacco products, and the consumption of foods and liquids that stain easily.

Dental bonding’s cost depends on a variety of factors, including the dentist's level of expertise, the number of teeth that need to be bonded, and the location of the dental clinic. Between £63 and £486 is the typical price range for bonding a single tooth. It is the average cost. However, the cost is much higher in some locations or dental practices.

Dental bonding is a process that is not only incredibly successful but also creates results that seem quite natural. It is used to enhance the look of teeth that have been stained, broken, fractured, or are not properly aligned. The process is normally finished in a single appointment at the dentist's office since it is not a particularly lengthy one. It is less intrusive and requires a lower financial investment in comparison to other cosmetic dental operations, such as veneers.

2. Braces

Braces are a kind of therapy which encompasses usage of brackets as well as wires to align a person’s teeth, and address abnormalities with bite. Such brackets are cemented onto one’s teeth and attached to each other using wires. The wires are repositioned over the course of treatment, in order to progressively shift the teeth into their ideal locations.

The amount of time that a person wears braces is determined by the specific circumstances of their case. Nevertheless, the typical duration of therapy ranges from 18 months to 2 years. Cases that are more complicated, such as those with significant malocclusion or jaw discrepancies, need more time.

The price of orthodontic treatment ranges widely due to factors such as the kind of braces offered, the location of the clinic, and the level of expertise held by the orthodontist. Braces made of ceramic or transparent materials cost between £1,243 and £6,487, whilst traditional braces made of metal cost between £1,432 and £5,676. Clear aligners like Invisalign are believed to be more costly than conventional braces, with the cost ranging anywhere between £1,243 and £6,487.

Braces are a very successful therapy for a wide variety of problems relating to the bite and the alignment of the teeth. They are used to treat conditions including overbite, underbite, crossbite, open bite, and crowding of the teeth. Additionally, braces enhance the general function of the jaws and teeth, which results in better dental health and higher levels of self-esteem for the patient. An orthodontist performs careful observation of the therapy to ensure that the teeth are progressing in the appropriate direction and that the ultimate outcome is as favorable as possible.

3. Frenectomy

A frenectomy is a surgical treatment that eliminates or lowers the size of the frenulum, which is the tissue that links the lip to the gums. Such tissue is removed entirely or its size is reduced. The technique is performed on both the top and lower lips at the same time.

The technique is often regarded as a permanent remedy, and patients do not need to undergo any further therapy after undergoing it. However, the process of healing takes some time, and the patient is advised to refrain from engaging in certain activities and consuming particular foods while the affected region recovers.

The price of a frenectomy changes significantly depending on a number of factors, including the location of the dental or oral surgery practice, the level of experience of the dentist or oral surgeon performing the procedure, and whether or not the procedure is being performed for medical or cosmetic reasons. The price of a frenectomy varies anywhere from £45 to £2,432 on average.

The surgical procedure known as frenectomy is a successful therapy for a number of disorders, including tongue-tie (ankyloglossia) and lip-tie (labial fraenum). Tongue-tie is a condition that occurs when the frenulum is abnormally short or overly tight, which restricts the mobility of the tongue. Lip-tie, on the other hand, is a condition that occurs when the frenulum is abnormally short or tight, which restricts the mobility of the upper lip.

The effectiveness of speaking, breastfeeding, and general oral function are enhanced by such therapy. Furthermore, it helps to enhance the overall aesthetic of the region that was impacted. One first has to undergo an in-depth consultation with a physician to determine whether or not they would benefit from having the operation, before one even thinks about undergoing a treatment like a frenectomy.

4. Dental Bridge

Dental bridge is a prosthetic device which bridges the space left by missing teeth, and is placed to the surrounding natural teeth or dental implants. Dental bridge is either fixed or removable depending on the patient’s needs. The usual materials used to construct a bridge are porcelain that has been fused to metal or materials that are entirely ceramic.

A dental bridge lasts anywhere from 5 to 15 years, depending on how well it is maintained, although the average longevity is closer to 10 years. The length of time that a bridge remains in place in a patient’s mouth is contingent not only on where the bridge is placed in the mouth but on the amount of wear and tear that it is subjected to, as well as the client’s level of commitment to maintaining good oral health.

The price of a dental bridge fluctuates widely depending on a number of factors, including the location of the dental practice, the level of expertise of the treating dentist, the materials that are used to construct the bridge, and whether or not the teeth that are adjacent to the gap need to be reshaped or prepared in order to support the bridge. A typical dental bridge is anywhere from £616 to £4,054, on average, depending on the complexity of one’s case.

Dental bridges are an extremely efficient method for replacing teeth that have been lost. They improve the teeth’s look as well as their function and overall health. Bridges serve to retain the form of the face by preventing the remaining teeth from shifting out of place and by restoring the natural appearance of the smile. Additionally, they make it simpler to chew food and talk clearly. However, it is essential to keep in mind that bridges get their support from the natural teeth that surround them. It is critical to ensure that the natural teeth are in good enough shape to hold the bridge in place.

5. Dental Implant

Dental implant is a little titanium-made post that is installed surgically into the jaw’s bone, holding the dental bridge or replacement tooth. These are used in aiding dentures. Implants are developed to eventually fuse with the surrounding bone tissue in order to serve as a stable base for the artificial tooth it supports, acting as the tooth's root.

Dental implants last long if properly cared for. Research has revealed that the success rate of dental implant is over 95% after 10 years, and after 20 years, that number drops to over 90%. On the other hand, it is essential to keep in mind that the longevity of an implant is influenced by a variety of elements, including the patient’s dental hygiene, the standard of the implant procedure, and the sort of implant that was used.

The cost of getting dental implants range widely based on factors such as the geographic location of dental practice, dentist’s expertise, material’s quality, and the quantity of teeth needing replacement. One dental implant costs anywhere from £416 to £4,865 on average. It is necessary to take into mind other charges such as the cost of the abutment, which is the connection piece that links the implant to the replacement tooth, as well as the cost of the replacement tooth itself.

Dental implants are an extremely efficient method for replacing teeth that have been lost. They are made to resemble real teeth in both appearance and performance, and they have the potential to enhance a patient’s ability to chew food and communicate verbally. Additionally, they assist to preserve the natural form of the face and stop the teeth that surround them from moving. Getting dental implants does not need the grinding down of any of the teeth in the surrounding area in contrast to dental bridges. However, it is essential to keep in mind that they call for an operation as well as a certain period of time for the patient to recover from the operation. Furthermore, not all individuals are good candidates for such kind of therapy.

How much does it Cost for treatment of Diastema?

The cost of treating a diastema varies significantly based on the precise treatment option that is selected as well as the location of the practice. Dental bonding varies in price anywhere from £63 to £486 for a single tooth. It is the typical cost. Braces run anywhere from £1,432 to £6,487 in price. The price of a frenectomy varies anywhere from £45 to £2,432, while the price of a dental bridge costs anywhere from £616 to £4,054. Lastly, the price of a single dental implant ranges anywhere from £416 to £4,865.

The price of treating diastema is determined by a number of different variables. The materials that are used during the diastema surgery are one of the primary contributors to the overall cost of the procedure. The price of therapy changes based on the components that are used. For instance, the cost of a dental bridge constructed entirely out of ceramic materials is more than the cost of a bridge constructed entirely out of porcelain that has been fused to metal. Similarly, the cost of a dental implant shifts based on the specific kind of implant that is placed (e.g. zygomatic, mini, or traditional).

The sections of the body that are engaged in the diastema surgery have an impact as well on the total cost of the procedure. The proportion of the body that requires treatment determines the overall cost of the procedure. For instance, the treatment cost for a diastema in the front teeth is more than the treatment cost for a diastema in the rear teeth. Additionally, the cost is going to be greater if the treatment is going to be performed on numerous teeth or various body parts.

The cost of diastema surgery is affected not only by the kind of operation that is conducted but by the type of technique that is performed. For instance, the cost of a dental implant is more than that of dental bonding, but the cost of braces is higher than that of a frenectomy.

It is essential to make note of the fact that insurance coverage and financing choices are offered as ways to assist in covering the expense of therapy for diastemas. It is in everyone's best interest to meet with a dental expert and go through all of the available alternatives together.

How long does it take to Recover from Diastema Treatment?

The time of recovery depends on what kind of diastema closure treatment time course followed. It takes 6 months to even a few years for the gap to close if a person gets braces. On the other hand, it takes from 2 weeks to a month for the condition to get fixed if a person has surgery for some underlying gum condition.

The length of time needed for recovery is proportional to the kind of diastema closure therapy time course that was carried out. It may take anywhere from 6 months to perhaps a few years for the gap in their teeth to narrow when a person receives braces. On the other hand, it takes anywhere from 3 weeks to a month for the condition to become better after the procedure if a person undergoes surgery to treat an underlying gum issue.

Does Diastema have long term side effects?

No, the condition of diastema does not, on its own, bring about any long-term consequences. However, there are some issues in the short term. One of them is bleeding. It is a side effect that often accompanies a treatment cycle for diastema during the first few days, although it is nothing dangerous and is stopped manually. Additionally, the region of the face that is closest to the surgical site continues to show signs of swelling for at least the first couple of days after the treatment has been performed. It is completely natural and is alleviated by alternating the use of hot and cold packs. The gums, tongue, and lips of the patient are rendered numb for a period of many hours following the operation as well, as a result of the use of long-acting local anesthetics during the surgical treatment.

The condition inevitably leads to other complications over time if it is not addressed. It causes the teeth to wear down unevenly and bring on jaw discomfort, if a diastema is brought on by a malocclusion. Furthermore, spaces between the teeth encourage the accumulation of plaque and germs, which raises the likelihood of developing periodontal disease and tooth rot. A patient's entire oral function, as well as their self-esteem and confidence, are negatively impacted if they have a diastema that is not addressed.

It is essential to keep in mind that different treatment choices, such as braces, dental bonding, and dental implants, each come with their own set of negative effects, both short-term and long-term. It is always recommended to talk with a dental expert before making a choice about which treatment option to go with in order to explore the possible dangers and advantages of each treatment option.

Does the size of tooth gaps increase with aging?

No, the size of spaces between teeth does not grow with advancing age in most cases. However, the teeth might move or wear down due to normal wear and tear as individuals become older, which causes gaps in their smile to form or become more obvious. Additionally, the teeth seem to be longer when the gums recede, which causes the spaces between them to become more noticeable.

It is essential to be aware that spaces in between teeth are produced by a wide range of circumstances, including heredity, trauma, orthodontic treatment, and the natural attrition of teeth. Some of these problems, such as the loss of teeth, are more likely to occur as a person advances in age.

It is vital to practice proper oral hygiene on a consistent basis, see the dentist on a regular basis, and attend to any dental issues at an early stage in order to reduce the risk of any future harm. It is easier to determine the source of the gaps in one's teeth and the therapy to be administered after consulting with a dental specialist.

Is Diastema related to Gum Disease?

Yes, there is a connection between gum disease and< diastema. Diastema traps food debris and germs, contributing to plaque accumulation as well as gum irritation or gingivitis. Gingivitis, if not treated, develops into periodontitis, a more serious type of gum problem that results in tooth loss.

Gum disease is to blame for the space developed at the center of the teeth in certain circumstances. Inflamed and infected gums cause the gums to pull away from the teeth, which results in a space being created between the teeth and gums.

It is essential to practice proper dental hygiene on a consistent basis and to make routine trips to the dentist in order to both prevent and cure gum disease. A dentist or periodontist examines and analyzes the teeth gap, and provides treatment recommendations based on the findings afterwards.

Dentist Dr. Dt. Erdem CETIN
Dentist Dr. Dt. Erdem CETIN

He started his professional career in a private practice in Antalya in 2005 and served there until 2012. Between 2012 and 2016, he continued his work as a partner at the institution named KlinikAntalya. In 2016, he founded Myra Dental Centre Turkey and continues his professional activities there. Additionally, he has strengthened his expertise in the field with his membership in the International Congress of Oral Implantology (ICOI).