HOW TO FIX GAP IN TEETH (Without Braces) Queries Answered


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Evidence Based - Facts Checked

You brush your teeth twice daily, even do the flossing but still not happy with your smile because of the spacing in teeth? No worries!! This article will provide insight into the treatment options available to fix the teeth gap and answer the most common queries related to it.

How to fix a gap in teeth

The gap in the teeth can be fixed with the help of braces and without braces. First, we shall discuss various ways to fix the gap without using braces

Fixing Gap in Teeth Without Braces

Yes, it is possible to fix the gap without using braces. Facial aesthetics is a significant concern for people nowadays and applying braces may not be suited well for a few of us1Alam, Mohammad & Haque, Farzana & Islam, Mushrath & Jamil, Md. Mashfique & Hossain, Mohammad & Islam, Rafiqul & Nishi, Shamima & Sujon, Mamun & Fareen, Nashid & ShailaZaman, & Nowrin, Shifat & Haque, Sanjida. (2017) 'Spaced Dentition Corrected by Fixed Orthodontic Treatment: A Case Series' Source.  Therefore, dentist may try to correct the crooked/spaced teeth with the following techniques if you do not want to apply braces for fixing the gap:-

1- Dental Bonding

What is Dental Bonding?

It is a conservative, practical, and an economical way of fixing gap in teeth in which a resin-like material is applied directly onto the tooth. Dental bonding can be done in a single visit as it does not require any lab work2HG;, H. H. (1985). 'Use of composite resin for restorative and orthodontic correction of anterior interdental spacing.' Source.

How Dental Bonding Helps in filling the Gap In Teeth?

The color of the resin mimics the color of the tooth. When the resin is applied on the sides of a tooth (as shown in figure below), the tooth’s size becomes proportionally larger than its original size, and therefore the gap in between the teeth gets filled.

How Is Dental Bonding Done?
a) Preparation

Your dentist shall start the process by choosing a shade that approximately matches the natural tooth color.

b) Application of material

After choosing the right shade, your dentist shall make the tooth’s surface a little rough by scratching it with an instrument. Once the tooth is scratched, an acidic solution is applied as it acts as a etching material.

Thereafter, a bonding material is applied which helps in binding the tooth and the filling material.

Once, the bonding material settles down, resin is applied to the tooth. If required, the dentist may shape the resin material to match your tooth shape.

Quick Note: - Etching material is a gel like material, which is acidic in nature. It helps in increasing the surface area of the tooth for the better adhesion of the bonding material.

Quick Note - Resin material has putty-like consistency, and therefore is easy to mold and shape


c) Hardening of material

Finally, the shaped /contoured resin material is hardened with a U.V light (blue light source). Finishing and polishing of the material will be done at the end.


Advantages of Dental Bonding 

Following are the advantages of dental bonding3S;, O. A. (2011). 'Diastema: Correction of excessive spaces in the esthetic zone' Source:-

  • It is a cheap
  • It’s a reversible process i.e., if required, can be removed after its application on the teeth
  • The process can be completed in a single visit
Disadvantages of Dental Bonding 

Following are the Disadvantages of dental bonding4S;, O. A. (2011). 'Diastema: Correction of excessive spaces in the esthetic zone' Source,5Zhao X;Zanetti F;Majeed S;Pan J;Malmstrom H;Peitsch MC;Hoeng J;Ren Y;. (2017). 'Effects of cigarette smoking on color stability of dental resin composites' Source:-

  • Usually, discoloration develops with time, and therefore periodic replacement of the resin material may be required
  • In case if you are a smoker, be ready for staining the resin material because of the smoke.
  • This technique is successful only for people who maintain good oral hygiene; else, it leads to the resin material’s damage.
Is It For You?
  • This technique can help in fixing small gaps only. Teeth may look huge if attempted to fix a larger gap with dental bonding.
  • If you have crooked, crowded, or misaligned teeth, then, dental bonding may not be the right option as the facial aesthetics may not fall in place.
  • If you tend to bite your nails, then it’s going to chip off the resin material. In such a case, dental bonding is not the right option for you to fix the gap between teeth.
  • If you are a tea/coffee lover or a smoker, dental bonding is not for you because tea/ coffee/ cigarette will stain your teeth. It would look bad. Isn’t it?

Don’t worry if you happen to fall into one of the categories mentioned above. There are plenty of other options, discussed below. Keep on reading to know more.

2- Porcelain Veneer

What are Veneers?

Veneers are a thin layer of porcelain attached to the frontal aspect of the tooth, just like a mask, with the help of a bonding agent/cement-like substance6LJ;, C. C. (2011). 'Treating a maxillary midline diastema in adult patients: A general dentist's perspective'. Source.

How Veneer helps in Fixing the Gap in Teeth?

The dimension of the Veneer is greater than the size of the tooth. It, therefore, fills the gap between the teeth.

How Does a Dentist place Veneer on Teeth?

a) Preparation

The Dentist chooses a color of the porcelain that matches the natural tooth color.

After that, to make space for the porcelain mask’s fitting, your dentist will grind the frontal aspect of teeth and place a temporary veneer. Till the time, permanent veneer is not ready, dentist shall ask you to wear temporary veneer.

b) Tooth impression and lab work

With the help of an impression material, your dentist will then take the tooth’s impression and prepare a tooth model. This tooth model is send to the lab to prepare the permanent veneer.

c) Permanent Veneer Placement

Once designed by the lab,  the veneer is cemented on the tooth's frontal with a cementing or luting material to fix the gap in the teeth.

Advantages7Viswambaran, M., Londhe, S. M., & Kumar, V. (2015, December). 'Conservative and esthetic management of diastema closure using porcelain laminate veneers.' Source,8M Bapat, S., Singh, C., & Bandejiya, P. (2017). 'Closing a Large Maxillary Median Diastema using Bapat Power Arm' Source

- It is a painless, quick, and conservative method with an extensive and long-lasting result

- The veneer perfectly looks like a natural tooth, and therefore, it’s hard for someone to make out

- Though veneer is a thin shell of porcelain, it becomes strong when bonded to the tooth and lasts for a long time.

Disadvantages9LJ;, C. C. (2011). 'Treating a maxillary midline diastema in adult patients: A general dentist's perspective'. Source

- It is a bit costly treatment as compared to dental bonding

- It is a time-consuming process as it involves lab work and therefore the patient might need to make multiple visits to the dental clinic.

Is It For You?

If you have slightly crooked /discolored /chipped off teeth along with a small gap in between the teeth, then veneer is a good option for you.

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3- Crown

What is a Crown?

A crown is a cap-like structure that is placed over the tooth. Before placing the cap, the tooth is shaped to set the cap correctly so that the tooth appears normal in size (and not oversized).

How a crown fills the space

Crowns can successfully help in fixing gap in teeth. When a crown is placed, it encases the tooth and the space that bothers you.

There are various reasons for gap in the teeth which the crown may help in fixing. Out of the various reasons, peg lateral cases are common and shall be considered as an example to understand how crown helps in fixing the gap in teeth. 

Quick Note: - What is a peg lateral

Peg lateral is an abnormal small sized tooth placed next to the central tooth10Schmitz, J. H., Coffano, R., & Bruschi, A. (2002, May 25). 'Restorative and orthodontic treatment of maxillary peg incisors: A clinical report' Source. Due to its small size, it creates a gap in teeth. The following image shows two undersized teeth (A) which are fixed with the help of a crown (B)

How A Crown Fills The Space

Peg lateral cases are straightforward; however, certain cases require treatment with braces before the crown can be placed.

The following picture is a case of an individual where the space in between the teeth is considerable and need braces before a crown can be used to fill the space.

Dental Crown Before Treatment Case

Considerable space between teeth before starting with the treatment

Dental Crown Braces Placement

Placement of braces to reduce the gap

Post Braces Teeth

Ready for placement of Crown

Once the braces are removed, your dentist will start the process of fixing the crown to fill the gap left in between the teeth.

1. Your dentist will first take an X-ray to check the condition of the tooth’s roots that will receive the crown. A root canal treatment shall be required to in cases where the tooth is damaged or infected

2. After that, the dentist shall partially cut the tooth to give it a shape to incorporate the crown in it

3. After the tooth is shaped, a tooth impression is taken and sent to the lab to create the crown for the patient. Your dentist shall also match the crown’s color with your teeth so as to give your smile an aesthetic look

4. Once the crown is ready, it will be cemented on the shaped tooth, with a cement-like binding material

Advantages

Unlike dental bonding or veneers, the use of crown is aesthetically better in filling larger gaps in between the teeth.

Disadvantages

- Cutting of a sound tooth is required to fix the crown in it

- It is costlier than dental bonding and veneers

Is it for You?

Crown to fix the gap in teeth should be preferred in the following cases:-

  • If your tooth is extensively damaged
  • There is an excessive gap between two teeth
  • It’s a case of an undersized tooth (Peg lateral case)
  • You had a fractured or decayed tooth and therefore has undergone a root canal treatment recently

4- Implants

What is an Implant?

An implant is a screw-like structure that is surgically placed in the jawbones. In the case of missing teeth or small-sized teeth, implants can be used to fill the space.

The treatment requires multiple visits.

How Does an Implant Fill the Gap in Teeth?

Tooth implants mimic the structure of a tooth. It is used as a preferred method of fixing the tooth gap when the tooth itself is missing. Therefore when placed,  it fills the large spaces created due to the missing tooth11Castro, M. A., Castro, J. C., Pedrini, D., Panzarini, S. R., & Poi, W. R. (2010). 'Diastemas: Reestablishment of an attractive smile'. Source

How Does an Implant Fill the Gap in Teeth?

1. Your dentist shall start the process by giving anesthesia

2. After that, the dentist drills down till the bone and places a screw (implant) in it. It takes nearly 3 to 6 months for it to heal12Pini, N. I., Marchi, L. M., & Pascotto, R. C. (2015, January 06). 'Congenitally missing maxillary lateral incisors: Update on the functional and esthetic parameters of patients treated with implants or space closure and teeth recontouring' Source

3. Once the screw fits in its place, an abutment is placed inside the screw. It acts as a connecting piece between the crown and the implant

4. Finally, the implant’s impression is taken and sent to the lab for the crown’s fabrication

5. Once the crown is ready, it’s placed on the top of the abutment

Advantage

- Dental implants fill the gaps nicely at the same time looks quite aesthetic

- Dental implants are durable and long-lasting

Disadvantage

Dental implants require multiple visits to your dentist for the treatment

- It is costly as compared to dental implants, veneers, and crowns

Is it for you?

Dental implants are preferred by dentists to fix the gap in teeth where the gap is created due to a missing tooth or teeth. So if the gap in your teeth is due to a missing tooth, dental implant should be a preferred way to fix the gap. 

5- Removable Partial Dentures

Removable partial dentures ( pink acrylic plate with artificial teeth attached to it) can be used to treat space created due to tooth loss. It is much more affordable than the implant and also does not require drilling. It can be easily removed and placed inside the mouth13T;, M. M. (2013). 'Can we close large prosthetic space with orthodontics?'  Source.

How Does a Removable Partial Denture Fill the Gap?

A removable partial denture has artificial teeth attached to it to replace the missing teeth. Once applied, the gap is replaced by the denture, and the gap in teeth is fixed.

An impression of the current denture is taken and sent to the lab for fabrication. Once fabricated, the removable partial denture placement is done, and if required, your dentist shall get it adjusted from the lab. 

Advantages

- It is economical as compared to implants

- It requires less time to fabricate the removable partial denture as compared to implants

Disadvantages

It can get dislodged; thus, it can be embarrassing

- Multiple visits might be required until you get the perfect fit the the removable partial denture

Is It For You?

If the teeth’s alignment is perfect and you want an economical option to fill the large gap in the teeth, then the removable partial denture is a good option for you.

Summary


What does it involve?

No. of visits require for the Treatment

Time Required for the Treatment

PROS

CONS

Gap Size it Will Fix

Dental Bonding

Adding resin material to fill space

1

30-40 mins

-Economical


-Quick dental procedure

-Replacement required


-Staining problem

Small Gap

Veneer

Mask like thin porcelain material bonded to frontal aspect of teeth

2

3 weeks

Painless and strength better than dental bonding

Cutting of sound tooth structure is required

Small Gap

Crown

Tooth cutting is done and a cap is placed

2

2-3 weeks

Can bear more force as compared to veneer and dental bonding

Tooth cutting is required and often done along with braces treatment

Small gap due to undergrown tooth or space left after using braces

Implant

Bone is drilled, and the implant is placed

Multiple visits

5-8 months

-Long life 


-Gives a natural and aesthetic appearance

- Complicated in people with gum problems


- Expensive

Large gaps, caused due to the absence of teeth.

Partial Removable Dentures

Removable prosthesis

Multiple visits

Up to 6 weeks

Economical

Can get dislodged on coughing / sneezing

For large and moderate gaps


This content is medically reviewed by Dr. Navneet Singh and written by Dr. Vijaya Dutta

Last Medical Review Date - 6th November 2020




References

  1. 1
    Alam, Mohammad & Haque, Farzana & Islam, Mushrath & Jamil, Md. Mashfique & Hossain, Mohammad & Islam, Rafiqul & Nishi, Shamima & Sujon, Mamun & Fareen, Nashid & ShailaZaman, & Nowrin, Shifat & Haque, Sanjida. (2017).
    Spaced Dentition Corrected by Fixed Orthodontic Treatment: A Case Series
    Retrieved on 5th November 2020 from https://www.researchgate.net/publication/318701156_Spaced_Dentition_Corrected_by_Fixed_Orthodontic_Treatment_A_Case_Series
  2. 2
    HG;, H. H. (1985).
    Use of composite resin for restorative and orthodontic correction of anterior interdental spacing.
    Retrieved November 5, 2020, from https://pubmed.ncbi.nlm.nih.gov/3891976/
  3. 3
    Six Steps to Consider When Closing Diastemas [PDF].
    (n.d.). American Academy of Cosmetic Dentistry. Retrieved November 5, 2020, from http://aacd.com/proxy/files/Students%20and%20Faculty/AACD_6_steps.pdf
  4. 4
    S;, O. A. (2011).
    Diastema: Correction of excessive spaces in the esthetic zone.
    Retrieved November 5, 2020, from https://pubmed.ncbi.nlm.nih.gov/21473993/
  5. 5
    Zhao X;Zanetti F;Majeed S;Pan J;Malmstrom H;Peitsch MC;Hoeng J;Ren Y;. (2017).
    Effects of cigarette smoking on color stability of dental resin composites.
    Retrieved November 5, 2020, from https://pubmed.ncbi.nlm.nih.gov/29251454/
  6. 6
    LJ;, C. C. (2011).
    Treating a maxillary midline diastema in adult patients: A general dentist's perspective.
    Retrieved November 5, 2020, from https://pubmed.ncbi.nlm.nih.gov/22041411/
  7. 7
    Viswambaran, M., Londhe, S. M., & Kumar, V. (2015, December).
    Conservative and esthetic management of diastema closure using porcelain laminate veneers.
    Retrieved November 5, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705185/
  8. 8
    M Bapat, S., Singh, C., & Bandejiya, P. (2017).
    Closing a Large Maxillary Median Diastema using Bapat Power Arm.
    Retrieved November 5, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571393
  9. 9
    List LJ;, C. C. (2011).
    Treating a maxillary midline diastema in adult patients: A general dentist's perspective.
     Retrieved November 5, 2020, from https://pubmed.ncbi.nlm.nih.gov/22041411/
  10. 10
    Schmitz, J. H., Coffano, R., & Bruschi, A. (2002, May 25).
    Restorative and orthodontic treatment of maxillary peg incisors: A clinical report.
     Retrieved November 5, 2020, from https://www.sciencedirect.com/science/article/abs/pii/S0022391301794851
  11. 11
    Castro, M. A., Castro, J. C., Pedrini, D., Panzarini, S. R., & Poi, W. R. (2010).
    Diastemas: Reestablishment of an attractive smile.
    Retrieved November 5, 2020, from http://revodonto.bvsalud.org/scielo.php?script=sci_arttext&pid=s1981-86372010000200018&lng
  12. 12
    Pini, N. I., Marchi, L. M., & Pascotto, R. C. (2015, January 06).
    Congenitally missing maxillary lateral incisors: Update on the functional and esthetic parameters of patients treated with implants or space closure and teeth recontouring.
    Retrieved November 5, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311382/
  13. 13
    T;, M. M. (2013).
    Can we close large prosthetic space with orthodontics?
    Retrieved November 5, 2020, from https://pubmed.ncbi.nlm.nih.gov/24358658/

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This content is only for educational purpose and should not be considered as a substitute for your Physician's/Doctor's clinical judgement

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