Gaps between teeth - Problems and their solutions
Gaps between teeth
Even when there are slits between all of your teeth, it is important to know how those slits originated, because that largely determines which treatments are possible.
- The slits have always been present because the jaws are wide and there is too much room for the teeth.
- The gaps are caused by inflammation of the gums and jaw bone (periodontitis).
- The gaps are caused by the wrong position of the jaws in relation to each other.
- The gaps are caused by a wrong speaking or swallowing habit.
Gaps between the teeth due to an excess of space in the jaws
Your jaws are too wide for your teeth, or your teeth are too narrow for your jaws. Most people with so-called diastemic dentures do not bother themselves with the slits, but are happy with it. There will rarely be gaps between their teeth and molars, their teeth can be kept very clean. If you still have trouble with this position, there are possibilities for treatment. However, it is not very simple. It may seem simple to pull all the teeth together using a brace, but unfortunately this is not always an option. Pulling it together may still succeed, but will the teeth remain in their new position? That depends on the occlusion, the way in which your upper and lower teeth fit together. And that is something your dentist or orthodontist will have to look at for you.
Moreover, the width of your teeth is important; it often happens with diastemic dentures that the teeth are quite narrow. With the spaces in between, this gives a normal picture. However, if you place these narrow teeth tightly together, it may look strange. This is also something to take into account before starting treatment.
If the teeth are on the narrow side, filling up the slits is a good option. This is possible with the help of composite facings or porcelain facings. The filling will give all teeth a broader look. It is possible to estimate in advance whether this is beautiful, by making a set-up, or by image manipulation, as described below.
A set-up is a set of plaster models of your teeth on which the treatment has already been performed. Before making a set-up, your dentist will first take prints of your upper jaw and lower jaw to record your current situation. Gypsum models are made from these prints in the engineering office. Often the models are also duplicated (a second set is made), so that eventually models with your current situation will continue to exist, and models on which your dentist "does the treatment". So you get to see on the plaster models how your teeth are treated after treatment. However, it is difficult to determine how it will look in your face, especially for a layman. Because there are no cheeks and lips around the plaster model, the plaster positions always seem very large.
A set of plaster models with a test set-up of teeth.
Image manipulation gives a much better idea of the situation after treatment, but by no means every dentist will have opportunities for this in practice. For image manipulation a digital photo is taken of your face, with a broad smile, so that your teeth are clearly visible. This image is processed on the computer in such a way that it looks like your teeth have already been treated. So you can see your own face as it will be after treatment. The following applies to both image manipulation and set-up: the result is never one hundred percent equal to the treatment result. It remains an indication.
The gaps are caused by periodontitis
If the gaps between your teeth are caused by periodontitis, the periodontitis will first have to be treated and only then can the cosmetic treatment be started. Basically the same applies to this situation as described above under "I have a gap between my front teeth".
Gaps between all teeth by a wrong bite
If gaps have formed between all front teeth at a later age, you probably have a so-called fanning front.
A so-called fanning front.
Your upper teeth have always been a bit further forward, so that your lower teeth touched your upper tooth. That is the cause of your current tooth position. Your lower teeth bite your upper teeth out of their sockets. In this case too the solution is not simple. Just straightening the teeth or closing the cracks makes no sense. With that, the cause, the wrong bite, has not been eliminated. What must first happen is to change your bite so that the lower teeth no longer touch the gums behind your upper teeth. That can be done in different ways:
- Raising choosing your teeth;
- A combination of orthodontics and surgery.
Which way is best for you depends on many factors, for example the health of your teeth, whether there are many restorations, your age and of course your choice. You may already know for sure that you do not want braces or surgery. For a definitive choice you will have to consult extensively with your dentist and / or orthodontist. In particular, let all the alternatives be discussed, including those that seem less attractive at first glance. Then you will in any case be able to make an informed decision.
Raise the bite
The cause of your forward teeth is therefore biting the gums behind your upper teeth with your lower teeth.
The lower teeth bite the upper tooth.
To remedy this, your bite needs to be raised so that your lower teeth don't come that far anymore. Your dentist will first test whether you can tolerate this. Your jaw joints are used to this deep bite for years. The testing is done with a splint or a bite plate: a hard plastic plate that fits exactly on all your upper molars. You will have to wear this for at least two weeks to prevent you from getting cramps, joint problems or headaches from the changed jaw position. If you pass this test well, the treatment can begin.
The options for increasing your bite are:
- Apply a layer to the molars;
- Pull the molars further out of the tooth, by means of orthodontics.
You can apply a layer to the molars in different ways. Building with composite is a fairly simple, good option. The disadvantage is that composite wears out and the bite increase disappears over time.
The increase can also be made by choosing onlays, new porcelain tops for you, which are glued to the existing chewing surfaces. The advantage of this is that these restorations last much longer and are much more durable. Porcelain onlays are more expensive than composite increases. For both types of restoration, the molars must be fairly intact. If there are large restorations in the teeth, then it might be wiser to raise the bite with crowns. A combination of these three is also possible. It will depend on the state you are currently in and your financial options.
A porcelain onlay is made in the same way as an inlay. The difference: an onlay is on top of the tooth, an inlay is largely in the tooth.
An inlay (left) is in the molar, like a filling. An onlay (right) also replaces nodules of a tooth and partially overlies the tooth.
If your teeth and molars are pretty cool and you don't have any major restorations, such as bridges, then orthodontics is a good option. Removable equipment, a loose bracket, is not possible in this complicated case.
Which molars will be changed, those of the lower jaw or those of the upper jaw? That depends on a number of factors. Among other things, the position of your jaws in relation to each other and the position of your jaws in relation to your lips. The dentist or orthodontist will explain this to you during treatment. Incidentally, it doesn't matter much to you. If you get a brace, this is in the majority of cases in the upper jaw and lower jaw. The reason for this is that the position of the lower teeth and molars is related to the position of the upper teeth and molars. It is not without reason that the tooth-jaw system is discussed. So you cannot change something in the upper jaw with impunity without changing the lower jaw and vice versa.
As soon as space is created between the upper teeth and lower teeth, by raising the molars, a start can be made to put the upper teeth back in place. This is done by means of a bracket. If the raising of the bite is also done through orthodontics, it can be worked through in a hassle.
The gaps are caused by a wrong speaking or swallowing habit
An open bite, caused by a wrong swallowing habit, where the tongue comes between the teeth every time.
In this case a dental or orthodontic treatment has little effect, first the cause, the wrong habit, must be unlearned. Often the help of a speech therapist is called in, which you will learn to speak and / or swallow in a different way. Sometimes aids are used for this, such as a special plate to ensure that your tongue no longer ends up between your teeth when swallowing or when pronouncing certain letters. Only when your wrong mouth habits are unlearned does treating the abnormal tooth position have a lasting result.