What is a diastema?
A diastema is a space between two teeth, and the term is most often used for a gap between the upper front teeth. Plenty of people have one and are happy with it. If you would like it closed, the first step is understanding what has caused it, because a gap that is simply the way your teeth are made is treated differently from one that has appeared recently.
What causes a gap between the front teeth?
There is rarely a single reason. The usual causes are these:
- Tooth size and jaw size. Teeth that are small for the jaw leave spaces between them, and so do front teeth that are narrower than average.
- A labial frenum. This is the small band of tissue that joins your upper lip to the gum above your front teeth. If it is thick or sits low, it can sit between the teeth and hold them apart.
- Gum disease. When the tissues and bone that hold teeth in place are damaged, teeth can loosen and drift apart.
- Missing or undersized teeth. A tooth that is absent, or a small side tooth, can leave space that the front teeth spread into.
- Habits. Thumb sucking and tongue thrusting, where the tongue presses forward against the teeth when you swallow, can push teeth forward and apart over time.
Your dentist can usually tell which of these applies during an exam, sometimes with an X ray. If you are not sure, a gap that has changed shape or size is worth having looked at.
Gum disease and gaps: who should see a dentist first
Gum disease is an infection of the tissues that support your teeth, and it is one of the causes of gaps that cannot be solved cosmetically. According to the British Society of Periodontology, unhealthy gums cause the tight cuff around the teeth to loosen, leading to bone loss and resulting in tooth movement, and gum disease needs to be treated before other procedures. The NHS also lists loose teeth among the later effects of gum disease. You can read more about the signs of gum disease.
Please book an exam before considering any cosmetic treatment if:
- the gap is new, or has widened over time;
- your gums bleed when you brush, look swollen or feel sore;
- a tooth feels loose or has changed position;
- you have a missing tooth near the gap;
- you notice a bad taste or persistent bad breath.
Closing a gap with bonding, veneers or aligners over unhealthy gums is not a good plan, because the underlying problem carries on. Your dentist will usually treat the gums first and then come back to the gap.
Treatments that can close a gap between front teeth
There are four main routes, and sometimes a combination works best. Fees below are the starting figures from our website and are for guidance only.
| Option | How it closes the gap | Fee listed on our website |
|---|---|---|
| Composite bonding | Tooth coloured resin is added to the sides of the teeth | From £295 per tooth |
| Veneers | Thin shells are fitted to the front of the teeth | Composite from £750 per tooth, porcelain from £1,250 per tooth |
| Invisalign clear aligners | Removable aligners move the teeth together | Invisalign Lite £4,950 for both arches, Invisalign Full £5,500 for both arches |
| Braces | Fixed brackets and wires move the teeth together | Metal braces from £3,000 for both arches, ceramic braces £3,500 for both arches |
Bonding for gaps
Composite bonding for gaps means building up the edges of the teeth beside the space with tooth coloured resin, which is shaped and polished to look natural. It does not move your teeth, so it suits smaller gaps where adding a little width to the teeth works visually. You can read about the process in more detail under composite bonding.
Veneers for gaps
Veneers are thin shells of composite or porcelain that cover the front of a tooth. Because they widen and reshape the tooth, they can close a gap and change the shape and colour of the teeth at the same time. They are a bigger commitment than bonding, as some enamel is usually removed. Our veneers pages explain the types and how they are fitted.
Invisalign for gaps
Invisalign for gaps works by moving the teeth themselves, so the space closes without adding material to the teeth. Clear aligners are removable, which many adults prefer, and our Invisalign pages list the fees and the process. Your dentist will assess whether aligners are suitable for your teeth and bite, and which version of Invisalign fits your case.
Braces and orthodontic retainers
Fixed braces also move teeth together and are an option when a gap is part of a wider alignment problem or a case needs more control than aligners offer. Our orthodontists can explain the types we provide. After teeth have been moved, they tend to shift back towards where they started, so a retainer is normally fitted to hold the new position. Our retainers include fixed, clear removable and Vivera retainers. On our fee page, Vivera retainers are £650 for both arches, fixed retainers are £675 per arch, and removable clear retainers are £350 per arch for existing patients finishing treatment with us or £550 per arch for other patients.
