By Dr. Eli Gherman, DDS
While attending The American Association of Orthodontics annual meeting in California, I spotted some great T-shirts for my girls. They had The Gap logo, and some braces, and read “Closing the Gap”. This referred to closing spaces that patients often have between their teeth. A week later I realized the great panic I had caused, when many of our friends wondered why their teenage girls were pressuring them to get to the malls quickly before The Gap closed down.
What causes people to have spaces between their teeth?
Genetics is often the main reason. Such as having a large jaw with small teeth, missing teeth from birth, a large tongue that pushes the teeth apart or a strong muscle between your lip and gum called a frenum, which can cause a space. Other reasons include habits such as thumb sucking, pen chewing and tongue thrusting. Bone loss is another reason the teeth can start to space.
Should all spaces be closed?
I once had a patient that I was treating for a bad bite. The least of his problems was a space he had between his front teeth. As we were getting to the end of his treatment, I put on the finishing touches and closed the space between his front teeth. When I handed him the mirror I noticed he was very concerned. I asked him if anything was wrong with his smile. “No” he said, “it looks great Doc, but can I have my space back?”
He explained that the space was a family trait, a sign of royalty. His father had a space, his grandfather and great grandfather going back for many generations. I calmed him down by explaining that the same way I closed the space I could re-open it, and that the space would stay in his family for generations to come. That space would stay open for cultural reasons.
Often in a young child there are spaces that are normal and should stay open. Some spaces that are due to missing teeth will also need to stay open, and often widened to allow the dentist to restore the space with the proper size implant or bridge. Most large spaces, however, that are not due to missing teeth, should be closed.
Most often adults come to close spaces for aesthetic or social reasons. A study by Dr. H Kerosuo in the European Journal of Orthodontics found that people with significant spacing between their front teeth were perceived to be less intelligent and of a lower social status, when compared to the same individuals when the space was closed. Closing spaces, however, is not just for aesthetics. Large spaces can block other teeth from coming into the mouth. Some large spaces prevent the forces on the teeth from distributing properly and can cause collapse of those teeth that are unsupported. Closing large spaces can also help to reform new bone.
Here are two patients I treated. In both cases the space was so large that we decided to close nearly all the space, but then to add bonding material to the side teeth to give a more esthetic result and prevent the spaces from re-opening.
When a patient with spacing comes into The Rechavia Dental Center, we analyze the reasons for the spacing, which spaces and how much of those spaces should be closed for the best aesthetic and most long lasting result.
Dr. Gherman has been practicing orthodontics for over 15 years. He is a graduate of Montefiore Medical Center, an American Association of Orthodontics accredited Post Graduate program.
Call us to set up an appointment. There is no charge for your first consultation.