Diastemas can be defined as a space between two teeth, although special reference is made to the space between the upper central incisors (also known as pallets). However, a diastema can appear in other teeth such as the lower incisors and can be of different magnitudes.
They are usually a reason for consultation in orthodontics for aesthetic reasons, but in reality they do not only affect aesthetics but also oral function.
When it comes to the primary dentition, diastemas are not considered a problem because they exist to maintain space for the future eruption of the permanent teeth, and in many cases, they will close as the natural development of the dentition progresses.
When should they close and how can we know that they begin to represent a problem? Well, we could establish that once the permanent canines erupt, the diastemas should have self-corrected, and that otherwise they should be considered a dental malocclusion, making it necessary to take into account the causes in order to solve it.
When addressing a patient's treatment plan, it is essential to know the cause, otherwise, if we do not correct what caused the problem, it will reappear sooner or later. The possible causes of dental diastemas can be classified as congenital or acquired, i.e. birth (or genetic) or habit.
Congenital causes of diastemas
Labial frenulum with low insertion, excessive width of the dental arch, agenesis or asymmetrical teeth, among others.
Acquired causes of diastemas
Habits such as tongue thrusting, mouth breathing, bruxism, dental trauma or periodontal disease with tooth mobility, among others.
Treatment of dental diastemas
The therapeutic options for diastemal closure can be diverse, ranging from an aesthetic restoration with resin or porcelain veneers to orthodontic treatment, thus restoring lost function and aesthetics.
Among the most conservative options, orthodontics, whether fixed or with clear aligners, offers us the possibility of closing these spaces as long as the dental anatomy allows us to do so and the causes mentioned above have been treated. However, there are occasions when the treatment can be a combination of orthodontics and aesthetics, thus guaranteeing excellent results.