What important is for a treatment is how the gap in front teeth arose. The two most common options are:
- The gap in front teeth has always been present because the jaws are wide and there is too much space for the teeth.
- The gap in front teeth is caused by inflammation of the gums and jawbone (periodontitis).
Gap in front teeth has always been present
If the gap in front teeth has always been present, the three most common solutions to the problem are:
- Closing the gap in front teeth with composite;
- Closing the gap in front teeth with porcelain veneers;
- Placing a dental crown for the gap in front teeth.
Closing the gap, or central diastema as it is officially called, with the help of a bracket is also possible in certain cases.
Closing the gap in front teeth with composite
In this situation it is quite easy to close the gap in front teeth with composite build-up (white filling). In general, this will be the first treatment proposal. The method is relatively cheap and simple and can be done in one sitting. You can then get used to your new front teeth. Closing a gap in front teeth has a lot of effect on your smile, some people want the gap back after treatment! That is easy to achieve with this method.
If the gap in front teeth is closed with composite, this means that a piece is set on both teeth adjacent to the gap. This is to maintain symmetry.
Your teeth will of course become wider by putting on the extra pieces. It must be checked in advance whether your front teeth will not be out of tune compared to the rest of your teeth.
Closing the gap in front teeth with porcelain veneers
Instead of using plastic, the teeth on both sides of the gap can also be made wider with the help of porcelain veneers. The veneers not only fill the space of the gap, as with the treatment with composite, but fall like a shield over the entire front tooth.
Placing porcelain veneers is more expensive than making composite build-ups and the treatment takes longer, but the end result is beautiful and the restorations will not discolour.
Porcelain veneers are made by a specialized porcelain technician, your dentist does not do this yourself. It is a so-called indirect restoration. You will therefore always have to come to the practice at least twice, once for the preparations and once for the placement.
Placing a dental crown for the gap in front teeth
Both front teeth with a dental crown is an extensive treatment. For this, quite a lot of your own teeth have to be removed. This treatment is suitable if there is not only a gap, but the teeth, for example, are also very filled or discolored.
A dental crown is stronger than a porcelain veneer, which can also be a reason to make dental crowns. For example when there is grinding or nail biting. Like porcelain veneers, dental crowns are indirect workpieces, the dentist does not make them himself. You will therefore have to come to the practice at least twice, once for all preparations and once for placing the dental crowns.
Closing the gap with orthodontics
Sometimes an 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 related to each other, it will always be necessary to consider how this relation will change due to the orthodontic treatment. Even if it only concerns you with two teeth, a new and above all stable situation between all teeth should be the end result in your mouth. Your dentist or orthodontist can determine for you whether orthodontics is a realistic treatment option for you.
Gap in front teeth caused by periodontitis
If the gap in front teeth is caused by periodontal disease, it is a different story, this is an unhealthy situation. Your teeth have probably straightened earlier and changed place later in life. They are also slightly loose and occasionally your gums will bleed when brushing. Teeth weakened by periodontal disease always requires treatment of the inflammation before continuing with the cosmetic treatment.
The development of periodontitis
If plaque remains on and around the teeth for a longer period of time, the gums will become infected. Plaque is the stubborn, sticky layer that continuously forms on your teeth. If you don’t brush away the plaque every time, it will quickly contain so many bacteria and waste products that your gums will become irritated and inflamed. This inflammation is called gingivitis, which can be recognized by the red color of your gums and bleeding when brushing.
If plaque remains on and around the teeth for a longer period of time, the gums will become infected. Plaque is the stubborn, sticky layer that continuously forms on your teeth. If you don’t brush away the plaque every time, it will quickly contain so many bacteria and waste products that your gums will become irritated and inflamed. This inflammation is called gingivitis, which can be recognized by the red color of your gums and bleeding when brushing.
Something to remember: if your gums bleed when brushing, there is always something going on. 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. That is actually a shame, because you will not be alarmed that way. Unfortunately, many people think that is why it cannot be serious. If you let the gingivitis or bleeding gums last for a long time without doing anything about it, the inflammation can spread to your jawbone. It is then called periodontal disease. Periodontal disease is the cause of detached teeth.
Are your teeth a bit loose and the gums around them red? Then there is a good chance that you have periodontal disease. Cosmetic treatments are still possible, but your dentist will have to treat the inflammation first.
Treatment of periodontitis
During an initial session, your own dentist, or a dental periodontist, will start measuring the damage done to your bone and gums by the inflammation. A periodontist is a dentist who specializes in gum disease. The measurement is done with a small measuring stick that is placed along each tooth and molar in the space under the gum.
This way it can be measured how far the bone has descended. The dentist also checks where the gums are bleeding, where plaque is present and where extra dirt remains in your teeth. After this measurement and recording of the starting position, an extensive dental cleaning and instruction for cleaning at home follow. The professional cleaning will be repeated a number of times. Once the condition has stabilized, the aesthetic treatment can be started. In principle, all cosmetic treatments are possible. However, additional consideration should be given to the fact that the teeth are looser than usual and are likely to have a shorter life.
A costly restoration such as veneers or dental crown will therefore only be considered if the treatment of the periodontitis has started properly and the condition is stable. It is also sometimes advisable to fix the loose teeth to one or more neighboring elements after a treatment by means of dental splints. Dental splints offer the teeth a hold for a longer period of time, called semi-permanent retention.
Closing the gap with orthodontics
If the gap in your front teeth has arisen later in life due to periodontal disease, orthodontics, after the periodontic treatment, is the appropriate method to return the teeth to their original position. So a brace. Fixed or removable, that is usually not something you can choose yourself, but it depends on the position of your teeth. After the orthodontic treatment, a wire splint will most likely be placed behind your teeth to keep 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 are apparently sensitive to periodontal disease, cleaning is of the utmost importance.