Tooth gap: when it stays and when it is closed
A gap between the front teeth is something different from a gap where a tooth is missing.
The term tooth gap covers two very different things. The diastema is the space between the two upper front teeth in an otherwise complete set of teeth. The gap from a missing tooth is the gap where a tooth is absent – never formed or lost.
The diastema
In the mixed dentition, a gap between the front teeth is normal; it usually closes when the canines erupt and claim space from the outside. If it remains, a strong labial frenulum pulling in between the teeth is often behind it. It is then released – and the gap is closed orthodontically, otherwise it opens up again.
The gap where a tooth is missing
Here there are two ways: close the gap by moving the neighbouring teeth into it orthodontically. Or keep it open and fill it later with replacement teeth. Which is better depends on the missing tooth, on age, on the available space and on how the bite will stand afterwards.
When a tooth never developed at all
Most often the upper lateral incisors or the second premolars are missing. This is often only noticed on an X-ray. The decision – close or keep open – should be made early, because it determines the entire course of treatment.
The connection to replacement teeth
If the gap is to be restored later with an implant, the space must be prepared precisely by orthodontics – too narrow, and the implant will not fit; too wide, and the crown looks too broad. For details on implant treatment, see the Implantat-Berater.
The key points at a glance
- Tooth gap means two things: the space between the front teeth (diastema) and the gap where a tooth is missing.
- In the mixed dentition, a diastema is normal and usually closes when the canines erupt.
- If it remains, a strong labial frenulum is often behind it – it is released, and the gap is closed.
- With missing teeth there are two ways: close the gap, or keep it open and restore it later. The decision is made early.
Answered briefly
Frequently asked questions
In the mixed dentition, often yes. After the change of teeth is complete, usually not any more – then it stays if nothing is done.
Medically, usually not. It is an aesthetic decision, and statutory health insurance generally does not cover it. It is different if the gap is part of a larger finding.
The neighbouring teeth tip into it over time, and the opposing tooth grows into the gap. Both make later restoration more difficult. Anyone who wants to keep the gap open needs a space maintainer.
With a lateral incisor, the gap can often be closed elegantly by moving the canine into its place and reshaping it. With molars, closing is more involved. The decision should be coordinated between orthodontist and dentist, not taken one after the other.