What is important for treatment is how the gap between the teeth originated. The two most common options are:
- The gap has always been present because the jaws are wide and there is too much room for the teeth.
- The fissure is caused by inflammation of gums and jaw bone (periodontitis).
The gap has always been present
If the gap has always been present, the three most common solutions to the problem are:
- Close the gap with composite;
- Close the gap with porcelain facings;
- The two front teeth to have a crown.
Closing the gap, or central diastema as it is officially called, with the aid of a bracket is also possible in certain cases.
Close the gap with composite
Has the gap always been present and your gums healthy?
In this situation it is fairly easy to close the gap with building up of composite (white filling). In general this will be the first treatment proposal. The method is relatively inexpensive and easy to do in one session. You can then get used to your new appearance. Closing a gap between your front teeth has a lot of effect on your smile, some people want the gap back after treatment! This is easy to achieve with this method.
If the gap is closed with composite, this means that a bit is put on both teeth that adjoin the gap. The purpose of this is to maintain symmetry. Putting a piece on one tooth gives a strange asymmetrical teeth.
Your teeth naturally become wider by turning on the extra pieces. It must be determined in advance whether your front teeth will not fall out of tune compared to the rest of your teeth.
Close the gap with porcelain facings
Instead of using plastic, the teeth on either side of the gap can also be made wider with the aid of porcelain veneers. The facings not only fill the gap space, as with the composite treatment, but cover the entire front tooth like a shield.
Placing porcelain facings is more expensive than making composite structures and the treatment takes longer, but the end result is beautiful and the restorations will not discolor.
Porcelain facings are made by a specialized porcelain technician, your dentist does not do this himself. It is a so-called indirect restoration. So you will always have to come to the practice at least twice, once for the preparations and once for the placement.
The two front teeth to have a crown
Both front teeth with a crown is an extensive treatment. For this, quite a lot of one’s own teeth must be sharpened. This treatment is eligible if not only is there a gap, but the teeth are also very filled or discolored. A crown is stronger than a porcelain facing, which can also be a reason to make crowns. For example when there is grinding or nail biting. Just like porcelain veneers, crowns are indirect workpieces, the dentist does not make them themselves. You will therefore have to come to the practice at least twice, once for all preparations and once for placing the crowns.
Close the gap with orthodontics
Sometimes orthodontic treatment is a possibility, especially if there is also space between the lower and upper teeth, a so-called overbite. Because all teeth and molars of your teeth are in relationship with each other, it will always have to be seen how this relationship will change as a result of the orthodontic treatment. Even if you are only interested in two teeth, a new and especially stable situation between all the teeth must be the end result in your mouth. Your dentist or orthodontist can see for you whether orthodontics is a real treatment option for you.
The cleft is caused by periodontitis
If the gap between your teeth is caused by periodontitis, then it is a different story, this is an unhealthy situation. Your teeth probably stood up earlier and changed location later in life. They are also a little loose and occasionally your gums will bleed when brushing. Teeth that have been weakened by periodontitis always require treatment of the inflammation before the cosmetic treatment can be continued.
The development of periodontitis
If plaque remains on and around the teeth and molars for a long time, the gums will become inflamed. Paste is the stubborn, sticky layer that is continuously formed on your teeth. If you do not brush away the plaque every time, so many bacteria and waste products are present within a short time that your gums become irritated and inflamed. Gingivitis is called this inflammation, recognizable by the red color of your gums and bleeding when brushing.
Something to remember: if your gums bleed when you brush, there is always something wrong. It used to be said that bleeding gums were the result of good and firm brushing, this is not the case. It is precisely the result of brushing too little or in the wrong way. Gingivitis does not hurt. Actually, that’s a shame, because it doesn’t alert you. Unfortunately, many people think that it cannot be serious. If you let the gingivitis or bleeding gums exist for a long time without doing anything about it, the inflammation can spread to your jaw bone. This is called periodontitis. Periodontitis is the cause of detached teeth.
Are your teeth loose and the gums around it are red? Then there is a good chance that you have periodontitis. Cosmetic treatments are still possible, but your dentist will first have to treat the inflammation.
Treatment of periodontitis
A detailed description of the treatment of periodontitis falls outside the scope of the book. However, since the treatment is necessary as pre-treatment before restoration can be started, the course is briefly described below.
During your first session, your own dentist, or a dentist-periodontist, will start by measuring the damage caused to your bone and gums by the inflammation. A dentist periodontist is a dentist who specializes in gum disease. The measurement is done with a small measuring rod that is slid along each tooth and molar into the space under the gums.
This way it can be measured how far the bone has fallen. The dentist also looks at where the gums bleed, where plaque is present and where extra dirt is left in your teeth. After this measurement and recording the initial position, extensive dental cleaning and instructions for cleaning at home follow. The professional cleaning will be repeated a number of times. Once the condition has stabilized, aesthetic treatment can be started. In principle, all cosmetic treatments are possible. However, extra consideration must be given to the fact that the teeth are looser than usual and probably have a shorter lifespan. A costly restoration such as a facing or crown will therefore only be considered if the treatment of the periodontitis is successful and the condition is stable. Furthermore, it is sometimes advisable to fix the loose tooth (s) to one or more neighboring elements after treatment by means of splints. Splints offer the teeth a hold for longer periods of time, called semi-permanent retention.
Close the gap with orthodontics
If the gap between your teeth is caused by periodontitis at a later age, then orthodontics, after the periodontic treatment, is the appropriate method to put the teeth back in their original position. So a brace. Fixed or removable, that you usually do not have to choose yourself, but depends on the position of your teeth. After the orthodontic treatment, a wire splint will most likely be stuck behind your teeth to hold the teeth in place. This wire splint is permanent (forever), or at least for a period of years.
Due to the presence of the wire splint you can no longer floss between your teeth and you will have to use stokers or brushes. Especially for your teeth, which is apparently sensitive to periodontitis, cleaning is of the utmost importance.