MIDLINE DIASTEMA(GAP TOOTH):A MALOCCLUSION




Diastema in an adult

 

 

 

Diastema is the space btw two teeth when seen in more than one spot in the dentition it is pluralized (diastemata). It can be seen between any two teeth in the dentition .

The most common site and recognized is that found between the two upper anterior teeth. It can also exist between the two lower anterior teeth. Diastema occurs in the dentition of children and adults. While it is considered a normal occurrence in children because it closes up as the bigger permanent teeth erupt into the mouth.

Diastema in a child

 

In dentistry, diastema seen in adult dentition is considered a malocclusion which may necessitate closure while some societies see it as fashionable.

In Nigeria it is associated with fashion especially when seen in women. Some women have patronized nonprofessionals to have this gap tooth created for them on the premise that it adds to their beauty however the danger inherent in creation of an artificial diastema is not known to them.

 

Dentists are not trained to create diastema rather trained to close the gap to correct the malocclusion when requested by patients.

Causes of diastema

1.     Genetics

There is a familiar tendency to have diastema, in which case it occurs in members of same family.

2.     Jaw size /tooth discrepancy

When the jaw size is big and the teeth sizes are small hence spaces in between the teeth. Jaw size could be of normal proportion while the teeth are smaller.

3.     Frenal attachment

Low frenal attachment

4.     Habit

Tongue trusting habit exerts pressure on the upper anteriors or lower anteriors depending on the direction of the force.

5.     Periodontal diseases

This involves bone loss around the teeth hence drifting which can create gap between teeth.

Dangers of creating an artificial gap tooth

The layers of the teeth have varying thickness

Enamel is the outermost protective layer and the hardest substance in the human body-

Dentine is the inner layer which is the sensitive part of the tooth

Pulp is the innermost layer containing the blood vessels and nerves “life” of the tooth

When artificial gap tooth is created, part of the protective layer of tooth is striped thus nearness to the dentine if not exposed.

Improper calculative removal of enamel may leave it unsupported which leaves it prone to fracture. An exposed dentine becomes sensitive to air, drinks (hot/cold) and over a long time pulp may get infected. The tooth may eventually die, then progresses to an abscess, cellulitis and probably eventual loss of the tooth.

Effects of diastema

1.     Speech impairment

In cases when the diastema is too wide it causes speech defect, proper pronunciations become difficult

2.     It makes space unavailable for the eruption of the last teeth (wisdom teeth) hence impaction which predisposes to pericoronitis, cyst and tumour formation.

TREATMENT: Depends on the cause

Genetics

If there is no associated difficulty with speech, you may leave alone.

If you feel uncomfortable with your smile /speech you could close the gap with orthodontic treatment, crown placement or veneers and dental bonding depending on the best option suitable for your case.

Low frenal attachment

Frenectomy suffices.

Periodontal diseases

Periodontal treatment is indicated

 Jaw/tooth disproportion

Jacket crowns, veneers and dental bonding will play major roles

Habits

Habit breaker is indicated

Tooth loss

Replace missing tooth

Orthodontic closure of diastema

 

WHAT IS THE CAUSE OF YOUR DIASTEMA?

ARE YOU COMFORTABLE WITH YOUR DIASTEMA?

HAVE YOU THOUGHT OF CREATING A DIASTEMA?

Hear your thoughts and opinion.