A diastema is a visible space between two adjacent teeth, most often between the upper central incisors, and it is a description rather than a diagnosis. Its causes range from a tooth-size to jaw-size mismatch and a low labial frenum attachment to thumb sucking, tongue thrust, missing teeth and bone loss from periodontal disease. It is common in childhood: among 1,802 schoolchildren aged 4 to 16 examined in Nairobi, 35% had a midline diastema (PubMed 10530193). In adults it rarely closes on its own, and closure runs from aligners to direct composite build-ups.
- 01Diastema names a gap between teeth; midline, generalised and localised forms have different causes and different treatments.
- 02It is a normal developmental finding in children: 35% of 1,802 Nairobi schoolchildren aged 4 to 16, at a mean age of 7.6 years, had a midline diastema (PubMed 10530193).
- 03Diastema prevalence falls as the permanent dentition establishes, unlike crossbite, scissor-bite and crowding, which move the other way (PubMed 32567942, 77 studies).
- 04Composite closure has measured outcomes: 163 anterior direct composite restorations placed for fracture or diastema showed a mean annual failure rate of 1.43% and 88.34% survival up to 10 years (PubMed 28256273).
- 05In an adult, a space that appears or widens over time is a periodontal warning sign, because attachment and bone loss allow teeth to migrate.
Diastema definition and causes
What Is Diastema
Diastema refers to a gap or space between two teeth, most commonly seen between the upper front teeth. While some people consider it a unique feature of their smile, others view it as a dental concern that needs correction. Diastema is a common condition that can occur in both children and adults for various reasons.
Diastema Definition and Overview
Diastema is a term used in dentistry to describe a noticeable space or gap between teeth. The commonly affected area is the maxillary central incisors (upper front teeth). There are three types of diastema.
- Midline Diastema: Gap between the upper front teeth
- Generalized Diastema: Multiple gaps between several teeth
- Localized Diastema: A gap in a specific area of the mouth
Causes of Diastema
- Genetics: Inherited traits, such as jaw size and tooth size mismatches
- Frenum Attachment: An oversized labial frenum can prevent front teeth from coming together
- Tooth Size Discrepancy: Teeth that are too small for the jawbone
- Missing Teeth: Creates gaps and shifts in tooth positioning
- Periodontal Disease: Gum disease can lead to bone loss and gaps between teeth
- Thumb Sucking or Tongue Thrusting: Childhood habits that exert pressure on the front teeth
Frenum position is the classic childhood factor. Among 1,802 schoolchildren aged 4 to 16 examined in Nairobi, 35% had a midline diastema, and in children with an upper midline diastema the frenum was most often attached to the gingiva (PubMed 10530193).
Is Diastema a Medical Concern
Diastema is usually not harmful and is often a cosmetic issue. However, in some cases, it can be a sign of underlying dental problems, such as:
- Gum disease
- Malocclusion (bite issues)
- Tooth migration due to bone loss
Consulting a dental professional can help determine if treatment is necessary.
Diastema treatment options
Can Diastema Close on Its Own
In some children, especially during the transition from primary to permanent teeth, a diastema may close naturally. Diastema is one of the traits whose prevalence falls as the permanent dentition establishes, while crowding rises (PubMed 32567942). However, in adults, spontaneous closure is rare and usually requires dental intervention.
How to Fix Diastema: Treatment Options
Orthodontic Treatment
- Braces: Traditional braces can gradually close the gap between teeth.
- Clear Aligners (e.g., Invisalign): A discreet option for mild to moderate diastemas.
Dental Bonding
Tooth-colored resin is applied and sculpted to close small gaps in one visit. The procedure is quick and minimally invasive. Outcome data exist for this route: 163 anterior composite restorations placed for fracture or diastema had a mean annual failure rate of 1.43% and 88.34% survival up to 10 years, with fracture and color mismatch as the failure modes (PubMed 28256273).
Veneers
Thin porcelain or composite shells are placed over the teeth, which closes the gap and changes the look of the tooth surface at the same time.
Dental Crowns
Crowns are used for severe spacing or structural issues, and they provide durability and cosmetic improvement.
Frenectomy
A frenectomy is the surgical removal or repositioning of the labial frenum, and it is often used in conjunction with orthodontics.
Orthodontic vs. Cosmetic Correction
- Orthodontic Solutions: Suited to functional issues, significant gaps, or alignment concerns.
- Cosmetic Options: Bonding or veneers suit patients prioritizing speed and aesthetics.
Preventing Diastema
Not all diastemas are preventable, but early intervention for childhood habits like thumb sucking, regular dental check-ups to monitor gum health, prompt treatment of periodontal issues and good oral hygiene can reduce the risk.
Diastema aesthetics and patient guidance
Diastema and Aesthetics: Embracing or Correcting
- Embracing Diastema: Some individuals choose to keep their gap as part of their identity or cultural beauty standards.
- Correcting Diastema: Others may seek cosmetic or functional improvements, especially in professions emphasizing appearance.
Psychosocial Impact of Diastema
For some, diastema may contribute to self-esteem issues or social discomfort, particularly if the gap is perceived as a flaw. Addressing these concerns with a dental specialist can lead to improved confidence and overall well-being.
Pediatric Considerations
- Diastema in children is often part of normal dental development.
- Gaps may close naturally as permanent teeth erupt.
- Monitoring by a pediatric dentist can help determine if early intervention is needed.
Treatment Longevity and Follow-up
Orthodontic and cosmetic treatments require regular dental follow-up to keep results stable. Use of retainers or dental maintenance is crucial for preventing recurrence. In a randomised trial of retention after orthodontic treatment, relapse in the lower front teeth occurred in 68.2% of patients using removable retainers alone, against 13.6% with a rectangular bonded wire (PubMed 38424224). In an adult, a space that opens or widens over time is a reason for a periodontal assessment before any cosmetic closure.
Diastema is a common dental condition with both cosmetic and functional considerations. Whether you choose to embrace your natural smile or seek correction, modern dentistry offers a range of personalized solutions. Consulting with a dental specialist can help determine the suitable approach based on your goals and oral health needs.
By understanding the causes, implications, and treatment options, patients can make informed decisions about their dental care and overall confidence in their smile.
Let's plan the right treatment together.
Free Assessment→- 1.Kaimenyi JT. Occurrence of midline diastema and frenum attachments amongst school children in Nairobi, Kenya. Indian J Dent Res 1998;9:67-71. PubMed 10530193
- 2.Lombardo G, Vena F, Negri P, Pagano S, Barilotti C, Paglia L, et al. Worldwide prevalence of malocclusion in the different stages of dentition: A systematic review and meta-analysis. Eur J Paediatr Dent 2020;21:115-122. PubMed 32567942
- 3.Lempel E, Lovász BV, Meszarics R, Jeges S, Tóth Á, Szalma J. Direct resin composite restorations for fractured maxillary teeth and diastema closure: A 7 years retrospective evaluation of survival and influencing factors. Dent Mater 2017;33:467-476. PubMed 28256273
- 4.Kanizaj Ugrin S, Špalj S. Comparison of efficacy of thermoplastic retainer with round and rectangular bonded lingual wire retainer in the mandible two years after orthodontic treatment: a randomised controlled trial. Clin Oral Investig 2024;28:183. PubMed 38424224
