Diastemas

Diastema is the term used for a gap or space between two adjacent teeth. The most commonly affected area is the maxillary (upper) central incisors, but diastemas can occur between any teeth. In children, small diastemas separating the front teeth are common and often part of normal development; they frequently close as the dentition erupts and the jaws grow. In adults, diastemas may persist or arise from other dental conditions.

Causes of diastema include tooth size-to-arch length discrepancies (a tooth that is too small for the jaw), spacing associated with missing teeth or late eruption, and abnormal attachments of the labial frenum between the central incisors. Other contributing factors are tooth misalignment or unusual crown shape, habits such as tongue thrusting or prolonged thumb sucking, and periodontal disease or tooth loss that allows teeth to drift apart. In some cases, a diastema reflects a combination of these factors.

Diagnosis involves a clinical dental examination and radiographs, along with assessment of occlusion, tooth size relationships, and frenum attachment. Treatment decisions depend on the cause, severity, and patient concerns.

Management options range from observation (in many pediatric cases) to interventions for esthetic or functional goals. Orthodontic approaches (braces or clear aligners) can close gaps, while restorative methods (bonded composite resin, veneers, or crowns) can rebuild a tooth to reduce space. If a prominent labial frenum contributes to the space, a frenectomy or frenuloplasty may be considered. Retention after any treatment is important to prevent relapse.