Gap between front teethGap between front teeth
Teeth can spread apart for several reasons. The bone under the gums may have sunk, the band inside the lip may be attached low, or the teeth may be small for the jaw. At Wonjin Dental Clinic, we check the cause before the gap, because if the cause is left and only the gap is filled, it opens again.
On this page
First, we look at the cause
Two cases can look the same and still need different treatment if the cause is different. If you fix only the shape and leave the cause, the same problem usually comes back in the same place.
Can the bone under the gums make front teeth spread apart?
Yes. If a gap appeared after age 30 where there was none before, this is the most common reason.
What holds a tooth in place is not the gum but the bone beneath it. As gum disease progresses, this bone breaks down. Front teeth that have lost support are pushed by biting forces and fan out forward. Because this happens without pain, by the time you see a gap, a good deal of bone has often already been lost.
This is when
A gap that was not there before has appeared over a few years. Your gums bleed when you brush, and they have receded so your teeth look longer.
Then
We do not start by filling the gap. While the bone is breaking down, anything we bond will spread apart again, and the remaining bone keeps shrinking in the meantime. We stop the progression first, then look at the shape.
What we look at first
Why does a gap between the front teeth that I have had since childhood not close?
If the band of tissue inside the upper lip reaches down between the two front teeth, it gets caught between them every time they try to come together.
There is a band of tissue that runs from the inside of the upper lip to the gum. It usually ends above the two front teeth. When it sits low and reaches in between them, the gap does not close even as you grow. This is not a disease. It is about where the band is attached.
This is when
When you lift your upper lip, the gum between the two front teeth pulls white. The gap has been in the same place since childhood.
Then
If the teeth are brought together and the band is left as it is, the gap opens again. We first take care of the band that keeps the gap open, then close the gap.
What we look at first
Can front teeth spread apart because the teeth are small?
Yes. If your teeth are small for the size of your jaw, there is space left over even after they are all lined up, and that leftover space shows as gaps.
In this case the gaps do not mean anything is wrong. They come from a difference in size. The total amount of leftover space is fixed, so closing one spot opens another by the same amount. It is often seen in people whose small teeth next to the front teeth are especially small or pointed.
This is when
There is not one gap but small gaps in several places. The teeth next to your front teeth are small with pointed tips.
Then
Moving the teeth alone does not change the total leftover space. We either make the teeth slightly larger to take up the space, or bring them together and fill the remaining space in one spot.
What we look at first
I had the gap closed with orthodontics, but it opened again. Why?
Because a force pushing on the teeth is still there. The most common cause is a habit of pushing the back of the front teeth with your tongue.
If your tongue pushes the back of your front teeth every time you swallow, hundreds of pushes a day add up in the same direction. Each push is very weak, but together they are enough to move teeth. Grinding and chewing on only one side have the same effect.
This is when
After the gap is closed, it is fine for a while, then the same spot opens again over time. Without a retainer, it comes back quickly.
Then
If the cause of the pushing force is not found, the gap returns no matter how many times it is closed. We first check what is pushing the teeth, and after closing the gap you wear a retainer for a long time.
What we look at first