News & Press
John C. Chao, D.D.S., M.A.G.D
Faculty, USC School of Dentistry
Cosmetic Dentistry: Closing Spaces Between Teeth
A space between front teeth that prevents the adjacent teeth from touching each other is called a "diastema." The two most common causative factors are (1) the bony arch that form the upper or lower jaw are larger than the teeth, and (2) there are teeth missing from birth. Although some people, including celebrities, accept diastema as a defining characteristic of their personality, many others feel that spaces or gaps between teeth are not desirable or attractive.
There are several options available to treat a diastema. Most of these options work well regardless of the number or size of the spaces. Orthodontics can be used to move the teeth into a more pleasing alignment. For minor tooth movement, Clear Invisalign orthodontic aligners are often used. The advantage of using orthodontics is that the front teeth, for the most part, will not need to be modified, as would be required if bonding procedures are used.
One of the disadvantages of orthodontic treatment is that it may take up to eighteen months or even longer to finish. Additionally, if the teeth are malformed or smaller than usual, cosmetic enhancement may still be needed after orthodontic treatment has been completed.
The other option is to have the teeth restored either with bonding or veneering. The bonding procedure generally requires only minor modification of the surface of the teeth, if any at all. Resin material that has the same color, shade and translucency of the teeth are bonded to the surfaces. The resin will be less expensive and work well to close small diastemas. The porcelain takes an additional visit, is more expensive, and is more appropriate for larger cases in which a more significant appearance modification is needed. This would include changing the color of the teeth, the length of several teeth, or the alignment of several teeth. As a rule of thumb for small spaces, a bonded resin will work well; for larger spaces, orthodontics and porcelain must be considered. Porcelain and resin both can be made to exactly match your existing tooth.
Each situation must be individually examined and evaluated before treatment. Often, your dentist will want to study model impressions to be made so that he/she can take measurements of the tooth length, width, and amount of separation between teeth. Using this method, your dentist can show you how you can look through the use of a diagnostic "wax up" showing the new shape of the teeth. In other words you will get a "mock-up" of the projected final result. Your dentist can modify this wax mock-up to suit your preferences, provided it is physiologically feasible.
An important point to remember is that if you also want a whiter smile, your dentist should complete the whitening process before the bonding or veneering is done. Teeth can be whitened, but dental materials such as porcelains and resins cannot be whitened. The restorations are placed to match your tooth color at the time they are placed, so whitening has to come first.
No matter how your smile looks now, you can also be one of many patients who regularly receive compliments about how great their smile is. Ask your dentist how this can be done.