Diastema (Gap Between Teeth)

Reviewed by the Faculty of

Columbia University College of Dental Medicine

What Is It?
A diastema is a space or gap between two teeth. It appears most often between the two upper front teeth. However, gaps can occur between any two teeth.

A mismatch between the size of the jaw bones and the size of the teeth can cause either extra space between teeth or crowding of teeth. If the teeth are too small for the jaw bone, spaces between the teeth will occur. If the teeth are too big for the jaw, teeth will be crowded.

Spaces develop for a few other reasons as well.

Sometimes some teeth are missing or undersized. This happens most often with the upper lateral incisors (the teeth next to the two upper front teeth). That can cause the upper central incisors to develop a space.

A diastema also can be caused by an oversized labial frenum. The labial frenum is the piece of tissue that normally extends from the inside of your upper lip to the gum just above your two upper front teeth. In some situations, the labial frenum continues to grow and passes between the two front teeth. If this happens, it blocks the natural closing of the space between these teeth.

Habits can also lead to gaps between the teeth. Thumb sucking tends to pull the front teeth forward, creating gaps.

Spaces can develop from an incorrect swallowing reflex. For most people, the tongue presses against the roof of the mouth (palate) during swallowing. Some people develop a different reflex known as a tongue thrust. When they swallow, the tongue presses against the front teeth. Over time the pressure will push the front teeth forward. This can cause spaces to develop.

Periodontal (gum) disease results in the loss of the bone that supports the teeth. In people who have lost a lot of bone, the teeth can become loose. This movement can result in gaps between the front teeth.

Children may have temporary gaps as their baby teeth fall out. Most of these spaces close as the permanent teeth reach their final positions.

Symptoms
A diastema that occurs because of a mismatch between the teeth and the jaw does not have symptoms. However, spaces caused by a tongue thrust habit or periodontal disease will tend to expand or grow with time. The teeth may become loose, and discomfort or pain may occur, particularly during biting or chewing.

Diagnosis
You may notice a space when brushing or flossing. Your dentist can see spaces during an examination.

Expected Duration
If the gap was caused by a mismatch between the permanent teeth and the jaw size, the spaces can be expected to remain throughout life.

Gaps caused by a tongue thrust habit or periodontal disease can get larger with time.

Prevention
Not all spaces can be prevented. For example, if the reason for a space is a missing tooth or a mismatch between the teeth and the jaw size, the spaces cannot be prevented without treatment.

Maintaining your gum health is essential to good oral health. Regular flossing and brushing will help to prevent periodontal disease and its related bone loss.

People with a tongue thrust habit can re-learn to swallow by pushing their tongue up against their palate. Breaking this habit can prevent widening of the spaces between teeth.

Treatment
Sometimes, a diastema is part of a set of problems that require orthodontic treatment. In other cases, a diastema is the only problem. However, some people may seek treatment for reasons of appearance.

Some people get braces, which move the teeth together. Often, no matter where the diastema is, you must wear a full set of braces — on both your upper and lower teeth. That's because moving any teeth affects your entire mouth.

If your lateral incisors are too small, your dentist may suggest widening them using crowns, veneers or bonding.

If you have a space because you are missing teeth, you might need more extensive dental repair. This might include dental implants, a bridge or a partial denture.

If a large labial frenum is causing the gap, the frenum can be reduced through surgery called a frenectomy.

If a frenectomy is done in a younger child, the space may close on its own. If it is done in an older child or an adult, the space may need to be closed with braces.

If the gap is caused by periodontal disease, then periodontal treatment by a dentist or gum specialist (periodontist) is necessary. When gum health is restored, in many cases braces can be used to move the teeth into place. A splint can be used to attach teeth to other teeth and prevent them from moving again. In some cases, a bridge will be required to close the spaces.

When To Call a Professional
If you have a space between your teeth or see one in your child's mouth, talk with your dentist. He or she will determine the reason for the space and may refer you to an orthodontist, a specialist in treatment with braces. The American Association of Orthodontists recommends that children be evaluated by an orthodontist by age 7. Treatment (if needed) may not begin right away. You and the orthodontist will discuss the overall treatment plan.

If your space is the result of periodontal disease, your dentist may refer you to a periodontist.

Prognosis
If a diastema is closed through orthodontics or dental repair, the space will tend to stay closed. However, to help prevent the space from coming back, wear your retainers as directed by your orthodontist. Your orthodontist may also splint (attach) the backs of the teeth to other teeth with composite (plastic) and a wire to prevent them from moving. Learn more about tooth whitening here.

The above article is from colgate.com

Lim and Yabu  
Geraldine Lim, DDS & Eric Yabu, DDS   
4174 Park Boulevard, Suite A  
Oakland, CA 94602  
(510) 530-7000  
OaklandLaserDentist.com

Dental Emergency

Accidents happen, and knowing what to do when one occurs can mean the difference between saving and losing a tooth.

Here are some tips for common dental emergencies: 

• For a knocked-out permanent or adult tooth, keep it moist at all times. If you can, try placing the tooth back in the socket without touching the root. If that’s not possible, place it in between your cheek and gums, in milk, or use a tooth preservation product that has the ADA Seal of Acceptance. Then, get to your dentist’s office right away. 
• For a cracked tooth, immediately rinse the mouth with warm water to clean the area. Put cold compresses on the face to keep any swelling down. 
• If you bite your tongue or lip, clean the area gently with water and apply a cold compress. 
• For toothaches, rinse the mouth with warm water to clean it out. Gently use dental floss to remove any food caught between the teeth. Do not put aspirin on the aching tooth or gum tissues. 
• For objects stuck in the mouth, try to gently remove with floss but do not try to remove it with sharp or pointed instruments. 

When you have a dental emergency, it’s important to visit your dentist or an emergency room as soon as possible.

Here are some simple precautions you can take to avoid accident and injury to the teeth:   

• Wear a mouthguard when participating in sports or recreational activities. 
• Avoid chewing ice, popcorn kernels and hard candy, all of which can crack a tooth. 
• Use scissors, NEVER your teeth, to cut things. 

Most dentists reserve time in their daily schedules for emergency patients. Call your dentist and provide as much detail as possible about your condition.

The above article is from mouthhealthy.org

Lim and Yabu  
Geraldine Lim, DDS & Eric Yabu, DDS   
4174 Park Boulevard, Suite A  
Oakland, CA 94602  
(510) 530-7000  
OaklandLaserDentist.com

What to Do About Chipped Baby Teeth?

Children are naturally rambunctious with all their high-energy antics such as running, jumping, diving, or just biting down too hard on something. It goes without saying that a chipped baby tooth is a common experience during these early stages, especially a chipped front tooth.

If your child chips his or her tooth, don’t panic. Unless your child is in pain, a chipped baby tooth is usually nothing serious. Nevertheless, when a chipped tooth does occur, it’s wise to call the dentist and schedule an appointment. Because the sooner you deal with the problem, the better. After all, sometimes your child may not even realize what just happened, and there may be damage that you can’t see.

Chipped Baby Tooth Repair
There are many ways to deal with a chipped tooth and it’s worth reiterating that you should always see a dentist as soon as possible after the event, no matter how severe. A chipped tooth can cause pain and discomfort when chewing or when exposed to very hot or cold temperatures. Below is a list of methods on how best to deal with a chipped tooth.

• Stay calm: Chipping a tooth is a common thing among children. When such an event happens, there’s no need for alarm. Also remember not to make your child feel self-conscious about their chipped tooth, even if it’s noticeable.
• Check your child: You’ll want to check and see if your child is in pain or crying. Also check for blood.
• Call the dentist: Remaining calm, explain what happened and follow any instructions your dentist may give you before scheduling an appointment.
• Rinse / cold compress: Aside from calling the dentist, you’ll want to rinse your child’s mouth with cold water and apply a cold compress to reduce any potential swelling. You’ll also want to collect any teeth fragments from the scene of the accident and bring them to your dentist. In a case where you cannot find any teeth fragments and your child is having difficulty breathing, immediately take them to an emergency room to make sure they didn’t inhale any teeth fragments.
• Pain relief: If your child continues to feel pain after the event, an advised amount of children’s ibuprofen is appropriate. If you are not sure, ask your dentist or doctor what the correct dosage before administering any medication.
• Keep an eye on it: In some cases, the damage from the lost tooth will become visible later, such as a chipped baby tooth turning grey. Also make sure their gums do not become infected.

While it’s never fun when your child gets a chipped tooth, sometimes these things happen, and having a plan is essential in such an event.

The above article is from crest.com

Lim and Yabu  
Geraldine Lim, DDS & Eric Yabu, DDS   
4174 Park Boulevard, Suite A  
Oakland, CA 94602  
(510) 530-7000  
OaklandLaserDentist.com