Diastema, the medical term for teeth separation, refers to a noticeable gap between two or more teeth, most commonly between the two upper front teeth. While spacing can be a natural feature, the sudden or progressive widening of gaps suggests an underlying change in the oral environment. This separation can occur at any age due to inherent physical characteristics, long-term habits, or active dental disease. A professional dental evaluation is necessary to determine the source of the change and the most appropriate course of action.
Anatomical and Developmental Factors
Teeth separation can be related to the natural structure of the jaw and the size of the teeth, often having a hereditary component. Diastema results when teeth are proportionally smaller than the available space in the jawbone, a condition sometimes called generalized spacing. This mismatch, where the jaw is large or the teeth are small (microdontia), means the teeth cannot fill the entire dental arch, leaving spaces.
Another structural factor involves the labial frenum, the band of tissue connecting the center of the upper lip to the gum tissue between the upper front teeth. If this frenum is oversized or attaches too far down on the gum tissue, it can physically prevent the two central teeth from coming together. This results in a persistent gap that exists from early development. In some cases, the presence of teeth that are missing from birth or are abnormally shaped, such as undersized lateral incisors, can also lead to gaps forming as adjacent teeth drift into the newly available space.
Separation Caused by Oral Habits
Forces applied by habitual muscle movements can gradually exert enough pressure to push teeth apart over time. A common functional cause is chronic tongue thrusting, an abnormal swallowing pattern where the tongue pushes forward against the front teeth instead of resting against the roof of the mouth. This repeated forward pressure acts as a continuous orthodontic force, causing the front teeth to flare outward and create noticeable gaps.
Other habits, particularly those retained from childhood, also contribute to the separation of teeth. Prolonged thumb-sucking or pacifier use, especially beyond the age of four, places sustained pressure on the dental structures. In adulthood, forces from chronic lip or cheek biting or the misuse of objects like toothpicks can also contribute to localized tooth movement.
Gaps Related to Gum Health and Missing Teeth
The most concerning cause of new or rapidly widening gaps relates to the health of the surrounding gum and bone tissue. Periodontal disease, or advanced gum disease, destroys the alveolar bone that anchors the teeth. As supporting bone is lost, teeth lose stability and begin to shift, a condition known as pathologic tooth migration (PTM). This migration often manifests as the front teeth fanning out, creating new spaces or enlarging existing ones. New or increasing separation in an adult smile is a warning sign of active periodontal disease that requires immediate intervention.
Separation can also occur due to the absence of adjacent or opposing teeth that have been lost to injury or extraction. When a tooth is removed and not replaced, the remaining teeth are no longer held tightly by their neighbors. Teeth naturally drift or tip into the empty space, leading to gaps forming near the missing tooth and elsewhere in the mouth.
Professional Options for Closing Gaps
Once the underlying cause of the separation has been addressed, several professional treatments are available to close the resulting spaces. Orthodontic treatment, using traditional braces or clear aligners, is highly effective for closing multiple or complex gaps. This method applies consistent pressure to relocate the entire tooth within the jawbone over a period ranging from several months to a couple of years.
For smaller gaps, particularly those caused by tooth size discrepancies, restorative options offer a quicker cosmetic solution. Dental bonding involves applying a tooth-colored composite resin directly to the tooth surface, which is then shaped and hardened to widen the tooth and fill the space. Alternatively, porcelain veneers are custom-made, thin shells that are bonded to the front surface of the teeth, providing a durable and aesthetic way to change the size and shape of the teeth to eliminate spacing.
When the separation is caused by an oversized labial frenum, a minor surgical procedure called a frenectomy may be performed to release the restrictive tissue attachment. This procedure removes the physical barrier that prevents the teeth from closing and is often followed by orthodontic treatment or bonding to fully close the remaining space. If a missing tooth is the cause of the shifting, replacing it with a dental implant or a fixed bridge can prevent further drifting and restore stability to the dental arch.