Gaps in your Smile (Closing Spaces)

People who have gaps in their smile and are happy about the spaces that they have – Madonna is a very typical example. Madonna likes the space between her two front teeth and has gone to lengths with her dental care to maintain this space. The opinion from the observer’s point of view is also divided with many people who like the space between people’s front teeth. This sort of gap is known as a diastema.

People who have gaps in their smile and don’t want any spaces. Here at Belle Dental, we can close the spaces, but the objective is to close the spaces evenly and not make the teeth look out of proportion with regard to height and width. If we are to make teeth wider, it is often necessary to increase the height of the crown of the teeth to compensate for the increase in width – thus keeping the teeth in proportion.

Some people don’t necessarily want to eliminate the space. A classic example of this is someone who has a relatively large space between the top front teeth and a somewhat smaller space between the lower front teeth. If the gap between the lower front teeth is not a concern to this individual, it may be better (from a cosmetic/consistency standpoint) to close the space slightly on the top teeth to match the space on the lower front teeth.

Irregular spaces are the most difficult to fix, and usually the most cosmetically detrimental. There are generally two different reasons for irregular gaps:

• A space has closed up, so that a tooth on one side of the smile needs to be smaller (or rotated) in order to fit into the space left for it.
• All the teeth are shifted to one side or the other. In both cases, the midline of the top teeth and bottom teeth usually doesn’t correspond. If the midline is ‘off’ by less than 2mm, the midline shift is usually not noticeable (often the individual with the midline shift is not aware of it). As the midline shift becomes more than 2mm, the shift becomes more noticeable to both the individual with the midline shift as well as those looking at the smile. Usually, the gold standard of care in either of the two situations outlined above is orthodontic treatment with braces or an alternative. This kind of tooth movement will even out the spacing of the teeth, thus allowing us to place veneers evenly on the teeth to close the remaining spaces. If orthodontics is not an option, then some grinding away of tooth is necessary to ‘shuffle’ the teeth in the desired direction and undo some of the crowding. This is obviously the least desirable option as it requires removal of some healthy tooth structure. It’s important to remember that once a tooth or part of a tooth is lost, it never grows back which is why we will always recommend composite veneers before ceramic veneers, which have a higher biological cost.