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Diastema Treatment Choices

Frequently Mother Nature creates a few spaces between our top front teeth. These spaces are called disatemas. Some people are just fine with them while others think they look sexy. Even others find them unappealing and wish to have them changed or closed.

There are four basic choices in dealing with diastemas:
  • Do nothing and enjoy the characterization of your personality while smiling

  • See an orthodontist who can close these spaces down through braces and essentially move all your teeth around over the course of treatment. Treatment may take one to four years depending on the case. This is a very good choice and provides the least intervention to the individual tooth.

  • Choice three involves the use of porcelain veneers. These are micro thin pieces of porcelain that are bonded to the outside of the tooth. They are an excellent choice in many situations. However, frequently they require the shaving or carving down of the outside and in-between surfaces of your teeth. Also known as Instant Orthodontics.

  • The fourth choice is using what is called a conventional crown and bridge. There is, in certain circumstances, a very specific need to adopt this technology. Shaving or precision carving down of your tooth is done here as well, to an even larger extent than porcelain veneers. There are nonetheless significant advantages for this technology. There is a far greater control in the manipulation of the "apparent’ location of the teeth. This translates to a greater ability to "move" the tooth from a perception perspective and therefore create a better esthetic result. Even more important than this, again, where indicated, there is less flexure of a tooth with a porcelain crown than a porcelain veneer.

Important Considerations for Choosing Treatments

If there is not a sturdy, largely un-compromised tooth under a veneer, the tooth will flex during chewing and porcelain will fracture. This occurs often. Patients who grind their teeth can also be at risk for damaging certain types of veneer applications.

When you have a porcelain crown there is more substructure over the tooth that resists this flexing and therefore less likely to fracture.

Roger Anderson, DMD, FAGD




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